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Vermont's Response To New Federal Limits On Family Planning Funding

Rule changes to the federal Title X program have prompted the state of Vermont to step in to continue funding some of the care provided by Planned Parenthood.
Delmaine Donson
Rule changes to the federal Title X program have prompted the state of Vermont to step in to continue funding some of the care provided by Planned Parenthood.

The federal Title X family planning program provides reproductive health care to low-income and uninsured families. We'll hear about the state's recent decision to fill the $800,000 gap that now exists for Planned Parenthood funding after a recent policy change by the U.S. Department of Health and Human Services.

We'll discuss the new rules issued earlier this year that prohibit Title X grantees from providing or referring patients for abortion, except in cases of rape, incest or medical emergency.

Our guests are:

Title X

In previous years, Planned Parenthood has been the state’s only provider to receive Title X money for family planning and preventative health services. Of the 19,000 people who walked through the doors each year, just over 11,000 of Vermont Planned Parenthood patients were served using those federal funds.

But no longer. Planned Parenthood of Northern New England vice president of public affairs Lucy Leriche told Vermont Edition that the organization decided at the national level to stop taking Title X funds following the U.S. Department of Health and Human Service’s rule change, which prohibits providers from giving information or referrals for abortions (except in cases of rape, incest or medical emergency).

“The provider-patient relationship is based on trust,” Leriche said. “The provider’s job really is to educate the patient to the fullest extent that they can, so the patient can make the best health care decisions for themselves.”

She added, “This ‘gag rule,’ that would essentially censor healthcare providers, is a clear violation of medical ethics and standards of care. And it is also now a violation of Vermont state law.”

(Gov. Scott signed H. 57, which codifies abortion rights in the state, in June).

While the Title X funds never did pay for abortions in Vermont, they previously went toward reproductive health care, during which the subject of abortion could be brought up for discussion.

Contingency Funds

When Planned Parenthood decided to reject Title X money, it knew there were contingency funds available in Vermont. The state had set aside a surplus $800,000 in a reserve account within this year’s budget.

“Our total state budget is a little over $6 billion, of which a little over $2 billion is federal money,” said state Department of Finance and Management Commissioner Adam Greshin. “So it would be foolish not to set aside some contingency funding in case the winds coming from Washington changed direction.”

Greshin pointed out that Gov. Phil Scott was in office for less than three weeks when he called for reserve accounts in his 2017 budget speech.

“This is not an $800,000, one-time item,” Greshin said. “We have other reserve funds set aside … in case federal policy changes or in case federal funds decline.”

Following the Trump administration’s rule change for Title X funds and Planned Parenthood’s decision to no longer accept them, Martha Maksym — the acting secretary of the state’s Agency of Human Services — said it was important to maintain Vermonters’ access to the organization’s health care services.

“It was important to us to make sure that those services to those individuals continued,” Maksym said. “The governor’s been really clear throughout his entire tenure that his three priorties are to make Vermont more affordable, grow the economy and protect the most vulnerable. We do continue to try to understand the impacts of changes that are happening at the federal level.”

In The Exam Room

Tanya Waters, director of clinical care at Planned Parenthood of Northern New England (which serves Maine, New Hampshire and Vermont), has thought about what would have happened if the organization continued accepting Title X funds.

Breaking the law — and offering information on abortion — did not seem like an option. But neither did asking her peers to violate their code of medical ethics by withholding the third option patients have aside from becoming a parent and adoption: termination.

Waters said complying with the federal rule would also have created a two-tiered system in which Title X patients didn’t have access to abortion information but higher-income patients did.

“If we had complied, it would definitely have meant that there were worsening disparities across the state because of it,” she said.

Broadcast on Wednesday, Aug. 28, 2019 at noon; rebroadcast at 7 p.m.

Ric was a producer for Vermont Edition and host of the VPR Cafe.
Jane Lindholm is the host, executive producer and creator of But Why: A Podcast For Curious Kids. In addition to her work on our international kids show, she produces special projects for Vermont Public. Until March 2021, she was host and editor of the award-winning Vermont Public program Vermont Edition.
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