Maryland’s congressional delegation and Baltimore City officials denounced Monday a proposed federal rule that they say could restrict access to women’s health and reverse work made to improve health outcomes, especially for poor women.
A proposed rule change at the U.S. Department of Health and Human Services would prevent health care providers that receive Title X funding for women’s health efforts from referring patients to abortion providers or even discussing abortion with their patients.
The officials worried that the rule could turn back significant gains made in reducing unintended teen pregnancy, infant mortality rates and the disparities between health outcomes for women of color and white women.
“It’s almost like we want to roll back the hands of time,” Mayor Catherine Pugh said. “To even be discussing something like this is a step back in terms of health care.”
Pugh was joined by Dr. Leana Wen, the city health commissioner, Sens. Ben Cardin and Chris Van Hollen and U.S. Reps. Elijah Cummings, Dutch Ruppersberger and John Sarbanes, all Democrats. They spoke at the city health department’s Druid Clinic, in front of more than 30 doctors and medical students who work at clinics throughout the city.
Even if the proposal becomes rule, it appears unlikely the new rule would significantly impact providers in Maryland. A state law that went into effect last year would replace any federal funding lost through actions by Congress or the president.
The nonpartisan Maryland Department of Legislative Services has estimated in the past that funding lost could be around $4 million.
The federal Title X program provides funding for family planning services. It was signed into law in 1970.
Services offered through the Title X program in Maryland prevented 15,000 unintended pregnancies, 1,490 preterm or low birth-weight births, and 1,018 sexually transmitted infections in 2014.
The Baltimore City Health Department distributes about $1.4 million to 23 sites that served more than 17,000 patients in 2016.
The health department estimated that one-in-three women in the city need publicly-funded health care services to access contraception. Between 2000 and 2016, teen birth rates fell 61 percent in Baltimore and about 40 percent nationally. The health department estimated that one in three women in the city need publicly funded health care services to access contraception. Other services provided through Title X funding include cancer screenings, HIV testing and counseling, and substance use and mental health screenings.
Currently, clinics that provide abortions must keep funds from Title X separate from funds used for abortion. Federal law prohibits government funds from being used for abortion.
Supporters of the rule say it will help ensure Title X funds do not indirectly pay for abortion.
“It is of utmost importance that individuals in low-income communities receive comprehensive family planning services, and care that promotes the welfare of adults and youth,” the U.S. Department of Health and Human Services said in a May press release announcing the rule proposal. “It is equally important that, as stewards of taxpayer funds, the department assures that the program operates according to statutory requirements.”
The speakers encouraged people to submit public comments to the federal register, where the comment period will be open through the end of July.
Ruppersberger said it has become important for men to join women in speaking out on women’s health. The congressional delegation is comprised of all men.
“At one time, it was taboo for men to talk about women’s health care, but no more,” he said.
While the politicians spoke out and encouraged others to do the same, the political reality likely prevents them from taking significant action to prevent the rule from going into place. Republicans control both chambers of Congress.
That means Democrats won’t even be able to bring anything to a vote, Van Hollen said.
“In this case you have an executive order, so the best way to block this is, first of all, to have enough comments that they don’t proceed,” he said. “But ultimately, you need that majority in Congress.”