Key Elements of the Biden Notice of Proposed Rule Making 1. There was a decrease of close to 400,000 women who received contraception through the Title X program from 2018 to 2019, about 300,000 fewer cancer screenings, and over one million fewer sexual transmitted infection (STI) tests. There has also been a substantial decrease in the number of sexual and reproductive health services provided from 2018 to 2019. Compared to 2018, there was a decrease in over 800,000 low-income clients (incomes < 250% of the Federal Poverty Level (FPL)) and over 300,000 uninsured clients. The Trump Administration regulations have had a substantial impact on low-income and uninsured clients that have relied on these services. There are an additional eight states that lost over half of their Title X network (AK, CT, IL, MA, MD, MN, NY, NH). There are currently six states without any Title X-funded services (HI, ME, OR, UT, VT, WA) and Office of Population Affairs (OPA) has been unable to find new grantees to fill most of the gaps that the Trump Administration rule created. This dramatic drop is likely due to a combination of the impact of the pandemic with fewer people seeking care and the significant reduction in Title X sites serving clients due to the Trump Administration regulations.įigure 1: Impact of the Trump Regulations on the Title X Programįrom 2018 to 2020, HHS reports a loss of 26 grantees (26%) who receive Title X funding and then distribute funds to the Title X clinic sites within their networks, as well as a loss of 1,272 clinic sites. The number of clients served by the program dropped from 3,939,749 clients in 2018 to 3,095,666 clients in 2019 (a 21% decrease), and then further decreased to 1,536,744 clients in 2020 which is a 60% decrease in clients served from 2018 ( Figure 1). In the proposed rules, HHS outlines the substantial impact the Trump Administration regulations have had on the network over the time that the regulations have been in effect. Impact of the Trump Administration Title X Regulations This brief provides an overview of the key elements of the Biden Administrations proposed regulations for the federal Title X family planning program. The Biden HHS is proposing to revise the Trump Administration rules by essentially re-instating prior regulations that are very similar to those that were in effect from 1993-2019 with several revisions that focus on “ensuring access to equitable, affordable, client-centered, quality family planning services” for all clients, especially for low-income clients. The Trump regulations made many programmatic changes to the Title X family planning program, notably adding restrictions to federal funding for abortion counseling and referral, as well as bans on federally-funded Title X sites from being co-located with abortion services. On April 15, 2021, the Department of Health and Human Services (HHS) published a notice of proposed rulemaking (NPRM) in the Federal Register entitled “ Ensuring Access to Equitable, Affordable, Client-Centered, Quality Family Planning Services”, which proposed to replace the Trump Administration rules published on March 4, 2019.
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