WASHINGTON — Mindful of the clock ticking down to a Trump presidency, the Obama administration issued a final rule on Wednesday to bar states from withholding federal family-planning funds from Planned Parenthood affiliates and other health clinics that provide abortions. The measure takes effect two days before the Jan. 20 inauguration of Donald Trump.
The rule was proposed three months ago, when many Democrats assumed the next president would be Hillary Clinton; she presumably would have promoted the rule’s completion if it were still pending. It requires that state and local governments distribute federal funds for services related to contraception, sexually transmitted infections, fertility, pregnancy care, and breast and cervical cancer screening to qualified health providers, regardless of whether they also perform abortions.
Trump has sent mixed messages on Planned Parenthood’s work, supporting its health-related services other than abortion. Yet with backing from Republican leaders in Congress, he has indicated he will undo many Obama administration regulations, especially last-minute additions. In this case, however, unraveling the new rule would first require a time-consuming process, according to the Department of Health and Human Services.
The department initiated the rule-making effort in September after more than a dozen Republican-dominated states in recent years had moved to “defund” Planned Parenthood by blocking clinics from receiving public money. Those funds included so-called Title X money — named for the federal family-planning program — as well as Medicaid reimbursements for treating low-income patients.
Federal law already prohibits government funding for abortion, except in cases of rape or incest, or to save a woman’s life. But anti-abortion groups and politicians in a number of states have sought to ban any public payments to abortion providers even for unrelated health services.
State courts have ruled against such restrictions specifically for Medicaid reimbursements, citing the legal right of low-income beneficiaries to seek care where they choose. And the Obama administration warned in April that all states withholding Medicaid payments from Planned Parenthood affiliates would be “out of compliance with federal law.”
But Title X family-planning money is a separate matter. Grants go directly to states and nongovernmental organizations, which then distribute money to health care providers seeking funds for such services. The new rule says that states cannot withhold money from potential recipients for any reason except those that go to their ability to provide the family-planning services.
“This rule will strengthen access to essential services like cancer screenings and contraception for some of the most vulnerable patients in this country,” Dr. Karen A. Scott, chief medical officer at the Department of Health and Human Services, said in a statement.
Scott added that “public comments showed overwhelming support for finalizing the rule” — 91 percent of the roughly 145,000 responses received since September, according to department officials.
The 30-page rule was to be posted Wednesday morning on the website of the Federal Register, the government’s official journal. It will not take effect, however, until Jan. 18.
According to the department, repealing the rule would require a new rule-making process, or a joint resolution of disapproval by the House and Senate, with concurrence by the new president.
Republicans in Congress and state legislatures have singled out Planned Parenthood for years because its network is the single largest provider of abortions, though about half of affiliated clinics do not perform them. The effort to starve Planned Parenthood of funding picked up in mid-2015, after anti-abortion activists began posting videos online that surreptitiously recorded local Planned Parenthood officials and were heavily edited to suggest their affiliates were illegally profiting from selling fetal parts to scientific researchers.
Anti-abortion lawmakers have argued that community health centers can provide the care that is now provided to many low-income people by Planned Parenthood. But groups representing those centers have disputed that. They say the centers are already overtaxed, and, because they treat health issues of all kinds, are often unable to provide the full range of family-planning services that Planned Parenthood offers.
About 10 percent of health centers that receive Title X family-planning money are Planned Parenthood affiliates. But they treat about one-third of all patients receiving such services, according to records.