Five Questions for HHS Secretary Azar

Last year, Azar testified to Congress that the Title X gag rule would increase access to care. Now that the gag rule has been in effect for more than 6 months, the reality is that Title X is serving half as many patients as it typically does.

For more than four decades, the goal of the Title X program has been to ensure access to affordable birth control. Yet one of the new grantees approved under the Trump-Pence administration has declared that it doesn't offer birth control pills or longer-acting methods. This goes against the very mission of the Title X program.

President Trump has declared the opioid crisis a “public health emergency.” The Surgeon General has called it an “all-hands-on-deck emergency,” saying that we must “harness the powerful resources of everyone who has a stake in health.” But Title X-funded health centers — as an entry point, and sometimes the only source of health care in many communities — are on the front lines providing care to those most in need, and play an instrumental role in fighting the opioid crisis.

During the 2019 State of the Union address, Trump declared that HIV/AIDS was a top priority — and pronounced that he would end the HIV epidemic. The Title X program funded nearly 1.2 million confidential HIV tests in 2017 alone, but the Trump-Pence administration’s domestic gag rule has reduced the Title X network's capacity by 47% nationwide.

The New England Journal of Medicine looked at the case of a 2015 HIV outbreak in Scott County, Indiana, and found that the outbreak was exacerbated by the closure of a Planned Parenthood health center that had been the county’s only regular source of HIV testing. The inability to quickly identify the outbreak resulted in many that could have been prevented. As patients lose access to Planned Parenthood health centers and other providers because of the gag rule, this scenario could play out in communities across the countries.

Attempts to “defund” Planned Parenthood are clearly ideological attacks — opposed by public health experts because they lead to worse health outcomes. When Texas first barred Planned Parenthood from serving patients in the program, nearly 40% fewer people got the health care they needed. Data from the Center for Public Policy Priorities estimates that nearly 45,000 fewer people received birth control, cancer screening, and other services through the program — a nearly 40% drop — than when Planned Parenthood participated in the program.