[nytimes.com] ...............................................................................................

"Planned Parenthood Refuses Federal Funds Over Abortion Restrictions.
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Facing a Trump administration rule that forbids referrals for abortion, the organization decided to reject federal funds for family planning for low-income women.

Planned Parenthood said Monday that it will withdraw from the federal family planning program that provides birth control and other health services to poor women, rather than comply with a new Trump administration rule that forbids referring women to doctors who can perform abortions.

Planned Parenthood receives about $60 million of the $286 million given annually through the federal program known as Title X, funds that have enabled the group to provide more than 1.5 million low-income women each year with services like birth control and pregnancy tests, as well as screenings for sexually transmitted diseases and breast and cervical cancer. In some rural communities, Planned Parenthood is the only provider of such services.

In states like Utah, where Planned Parenthood is the only organization receiving Title X funds, and Minnesota, where Planned Parenthood serves 90 percent of the Title X patients, those seeking care may face long waits for appointments, the group said, while other patients may delay care or go without.

The group’s decision to stop accepting the money was a win for anti-abortion groups that have long sought to deprive Planned Parenthood of federal support. “It is a long-awaited victory that will energize the pro-life grass roots,” said Jeanne Mancini, president of the March for Life.

Planned Parenthood said this is the first time it has been out of Title X since the program was enacted in 1970 during the Nixon administration.

Alexis McGill Johnson, acting president of Planned Parenthood, on Monday accused the administration of forcing Planned Parenthood out of the Title X program. “When you have an unethical rule that will limit what providers can tell our patients, it becomes really important that we not agree to be in the program,” she said.

The Department of Health and Human Services said in a statement Monday that groups that refused to comply with the rule “are now blaming the government for their own actions.” The agency added: “They are abandoning their obligations to serve their patients under the program.”

The Trump administration’s rule says that while clinics accepting Title X funds may continue to talk to patients about abortion, they may not refer women to an abortion provider or suggest where to obtain an abortion.

Planned Parenthood and many other organizations, including the American Medical Association, say the restriction would force physicians and clinics to withhold medical information from patients, would interfere with the doctor-patient relationship and could deny pregnant women the range of options available to them.

Since it came into office, the administration has steadily shifted federal health programs toward conservative preferences like promoting abstinence in teen pregnancy prevention programs and allowing exemptions to insurance coverage of birth control for employers with religious objections.

Withdrawing from Title X will not deprive Planned Parenthood of all government funding, a longtime goal of many conservatives. Figures from Planned Parenthood’s 2017-18 annual report showed that the organization received about $500 million from Medicaid, the joint federal and state health care program for low income people. Federal funds cover most of that spending.

The immediate effect of a Planned Parenthood withdrawal is unclear and likely to vary by state. Hawaii, Illinois, New York, Oregon and Washington have said their states would not participate in Title X under the new rule. Legislatures in Massachusetts and Maryland have passed laws that essentially have the same effect. Planned Parenthood expects some of the states to make up some of the money.

The Trump administration rule, announced in February, is being challenged in court by Planned Parenthood, other organizations and more than 20 states, but a federal appeals court in July said the policy change could take effect while the legal cases were pending.

Planned Parenthood and some other organizations that receive Title X funds had decided to stop using the money until the legal challenges were resolved, although they had not officially withdrawn from the program.

The Department of Health and Human Services said that such an intermediate status would not be acceptable. It said that organizations had until Aug. 19 to submit an “assurance and action plan” showing they intend to make “good faith efforts” to comply with the new rule.

Last week, Planned Parenthood sent a letter to the United States Court of Appeals for the Ninth Circuit, asking a panel of judges to stay the deadline until the legal cases could be decided. On Friday, the court declined to do so."
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How undemocratic is the federal govt. to restrict health care organizations like planned parenthood from offering a complete range of healthcare options?