AMA files suit to block administration’s Title X restrictions

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The American Medical Association (AMA) has filed a lawsuit to block the Trump Administration’s rule that would decimate the Title X program and limit the medical advice physicians can give their Title X patients about contraception and other family planning issues. Oregon Medical Association and Planned Parenthood Federation of America joined the lawsuit.

Filed in the United States District Court, District of Oregon, the lawsuit asks the court to block the new rule. The AMA contends the rule would violate patients’ rights under the Code of Medical Ethics, would force doctors to violate their obligation to give honest and informed advice, would withhold federal family planning funding from entities that provide critical medical services to vulnerable populations, and would harm millions of patients who rely on Title X for their reproductive health.

“Because of the administration’s overreach and interference in health care decision making, physicians will be prohibited from having open, frank conversations with their patients about all their healthcare options. This blatant violation of patients’ rights under the Code of Medical Ethics is untenable,” said AMA President Barbara L. McAneny, M.D. “The new rule imposes a government gag rule on what information physicians can provide to their patients. The administration wants to allow Title X clinics not to provide full information to patients about all of their health care options and block physicians from providing appropriate referrals for care.”

Dr. McAneny has written a commentary on Title X and the implications the proposed changes would have on patients.

Family planning rights

Congress created the Title X program to ensure that all people – especially low-income women – have access to health care for family planning. Yet, the rule would eliminate current requirements that Title X sites offer a broad range of medically approved family planning options. Through the new rule, the government endorses clinics that refuse to provide all pertinent information to patients – even if the patient requests it – and endorses clinics providing misleading information.

The Trump-Pence administration’s gag rule is unethical, illegal, and dangerous, which is why Planned Parenthood is suing to protect patients’ rights and access to health care,” said Dr. Leana Wen, President of Planned Parenthood Federation of America. “Four million people receive care through Title X, our nation’s program for affordable birth control and reproductive health care, and for many of our patients, we are their only source of care for cancer screenings, birth control, and crucial preventive care.

“Title X serves women and families with low-incomes, the majority of whom are people of color, Hispanic, or Latino, and the gag rule will worsen existing racial, socioeconomic, and geographical health disparities. Families that are struggling to make ends meet and people who live in rural areas must have the same access to full, unbiased information from their doctor as everyone else. Planned Parenthood will never force our doctors and nurses to withhold medical information from our patients, and we will fight the Trump administration in the courts to protect everyone’s fundamental right to health care,” Wen said.

“The Oregon medical community is deeply troubled by government rules that intrude on the practice of medicine and the physician-patient relationship,” said Dr. Fred Williams, President of the 8,000-member Oregon Medical Association (OMA). “Title X has allowed the provision of quality contraceptive and pregnancy care to millions of women who are financially struggling. An irreplaceable part of this care consists of providing competent and complete medical information about all of the options available, and this rule imposes a gag order on physicians fulfilling their roles as trusted consultants in reproductive health.”

“Biased and incomplete counseling”

The lawsuit argues the U.S. Department of Health and Human Services’ proposed rule “blesses biased and incomplete pregnancy counseling where the interests of the patient are no longer paramount.” The rule directs physicians and other providers to give pregnant patients full information about only some of their reproductive health care options while withholding information about others.

The gag rule “threatens the core of family-planning health care” by interfering with communication about patients’ health care options, and sets a dangerous precedent of government interference with the patient-physician relationship. The lawsuit notes that if the rule is not blocked, it would undercut the very purpose of Title X and irreparably harm Title X providers, their patients and the health of the nation.

Title X providers serve more than 4 million patients a year. In 2017, Title X provided more than 2.8 million patients with contraceptive services and helped women avoid more than 800,000 unintended pregnancies. Without Title X, the rates of unintended pregnancy and abortion would have been 31 percent higher, according to estimates. Most of these patients served by Title X are economically disadvantaged and live in areas where there are few health care options.

If the rule becomes law, vast swaths of providers would have no choice but to withdraw from Title X entirely. These consequences would be disproportionately felt by the very patients that Title X was meant to help, the AMA said.