Kara Hope: Trump’s Title X changes threaten health care in Michigan

abortion
"Stop the Bans" pro-choice rally, May 21, 2019 | Ken Coleman

The war on reproductive freedom has multiple fronts here in Michigan. 

On one front, petition signatures are being gathered to place two extreme anti-abortion measures before voters on the November 2020 ballot. On another front, the federal government threatens access to health care for more than 42,000 Michiganders. The latter threat comes in the form of changes to a federal family-planning program known as Title X. 

Changes to Title X will go into effect soon, though it is not exactly clear when. The federal injunction that had delayed the rules’ implementation was recently lifted, and the guidelines needed to implement the new rules have not been released. Local providers like Planned Parenthood of Michigan and the Ingham County Health Department wait, anticipating negative outcomes for their patients. 

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The changes to Title X were approved by the President Trump administration and the U.S. Department of Health and Human Services. Once in place, they will cut tens of thousands of Michigan patients off from access to cancer screenings, testing and treatment for sexually transmitted infections, and wellness exams as well as family planning counseling and birth control. 

Why eliminate access to health care at a time when Americans of every political persuasion cite health care as one of these top concerns? 

Even though the Hyde amendment has long prevented using federal funds to pay for abortions, these changes to Title X will cut health care providers off from federal funds if they provide abortions or even counsel pregnant patients about their full range of options, including abortion, regardless of the source of funding. 

These changes will force participating providers to choose between withholding information from their patients, thus practicing unethical medicine that violates the rights of their patients, or leaving the program altogether.

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Most likely, Planned Parenthood is the intended target of the Trump administration. Indeed, these changes to Title X make it impossible for Planned Parenthood to participate in the nation’s only federally funded family planning program. 

Here in Michigan, Planned Parenthood provides care for almost 70% of the state’s almost 63,000 Title X patients. If Planned Parenthood of Michigan cannot provide these essential services, there is no one else to pick up those patients. 

Pro-choice demonstration, 2018 | Wikimedia Commons

Like the rest of the country, Michigan is in the middle of an OB-GYN shortage. Twenty-eight of 83 counties in Michigan have no OB-GYNs. Sadly, in some parts of Michigan, it is easier to find a veterinarian than it is an OB-GYN.

Currently, Title X requires that providers offer all medically acceptable and effective types of contraception. With the rule changes, federal funds could go to entities that do not provide any contraception, but instead counsel only on “natural” family planning or abstinence as methods for preventing unwanted pregnancies. 

It should come as no surprise that these changes are not supported by the medical community. Nineteen medical organizations, including the American Medical Association and the American College of Obstetricians and Gynecologists, signed on to a letter opposing the new rules because they disregard evidence-based medicine and the expertise of physicians and other scientists. 

The irony is that Title X prevents 1 million unwanted pregnancies in the U.S. every year and, consequently, thousands of abortions. The logical outcome of restricting access to science-based family planning, including contraception, will be an increase in the number of abortions. 

Planned Parenthood rally | Kelly Schott, Flickr

In a country that values the separation of church and state, it is vital that one group’s religious or philosophical views are not allowed to dictate the health care decisions of individuals who may or may not share those views. 

In 2019, we should be able to take for granted that our leaders will base health care policy on facts and science, not emotion or ideology.

Kara Hope
Kara Hope (D-Holt) is a first-term state representative serving the 67th district. She is an attorney who previously served three terms on the Ingham County Board of Commissioners.

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