Judges in Oregon and Washington issued injunctions on the Title X rule, stating that it impedes patient care access and provider relationships.
A federal judge in the state of Washington has issued an injunction on the Department of Human Services Title X Family Planning rule, which critics state overstep the agency’s authority and interfere with patient-provider relationships and limit patient care access.
Washington US District Judge Stanley Bastian agreed to the injunction, which calls for maintenance of the status quo instead of allowing the rule to go into effect on May 3, 2019, as was originally planned.
The Title X Family Planning rule sought to limit certain provider referrals during the family planning process. Specifically, the rule proposed to prohibit referral to abortion as a form of family planning, thus removing any requirements physicians previously had to disclose those services.
Want to publish your own articles on DistilINFO Publications?
Send us an email, we will get in touch with you.
Instead, HHS says providers may engage in “non-direct” family planning or abortion counseling.
“To preserve open communication between the patient and the healthcare provider, the regulation permits, but no longer requires, nondirective pregnancy counseling, including nondirective counseling on abortion,” the agency wrote in the rule’s fact sheet. “Consistent with the statutory requirement that no funds may be expended where abortion is a method of family planning, this regulation no longer requires, and affirmatively prohibits, referral for abortion as a method of family planning.”
Critics of the rule took HHS to court, stating that the ruling was an overreach of HHS authority and put a limit on patient-provider relationships.
“Plaintiffs also believe the Final Rule appears to be designed to limit patients’ access to modern, effective, medically approved contraception and family planning health care,” Bastian wrote in the injunction. “Plaintiffs argue the Final Rule was designed by the Department to direct Title X funds to providers who emphasize ineffective and inefficient family planning.”
Given the benefits Title X provides to low-income individuals seeking family planning and reproductive healthcare, as well as the provision that no federal funds be allocated to abortion services, Bastian agreed to issue the injunction.
Additionally, Bastian ruled that there is credible evidence that the HHS rule would impose limits to patient care access.
“They have also presented facts and argument that the Final Rule likely violates Section 1554 of the ACA because the Final Rule creates unreasonable barriers for patients to obtain appropriate medical care; impedes timely access to health care services; interferes with communications regarding a full range of treatment options between the patient and the heath care provider, restricts the ability of health care providers to provide full disclosure of all relevant information to patients making health care decisions, and violates the principles of informed consent and the ethical standards of health care professions.”
Other judges are making similar rules in states across the country. Earlier this week, Oregon Judge Michael McShane also issued in injunction against the Title X rule, which he said would be akin to a gag rule for physicians. The rule would impede the patient-provider relationships, which is central to physicians’ jobs.
The proposed rule’s critics championed these decisions, stating that Judges Bastian and McShane accurately described the rule as infringing on patient-provider relationships.
“Judge McShane got it exactly right when he called the new Title X rule a ‘ham-fisted’ approach to health care,” said American Medical Association President Barbara McAneny, MD. “The judge repeatedly asked how the new gag rule would improve health outcomes. The government was unable to answer. The new rule would have placed obstacles to health care for low-income patients. We are pleased the judge shared the AMA’s concern about the physician-patient relationship that the rule would have jeopardized.”
Following the rule’s publication in February, McAneney spoke out against it on behalf of the AMA. Not only does the rule block patient-provider communication, she said, but it could limit patient access to care.
“The AMA also strongly objects to the administration’s plan to withhold federal family planning funding from entities that provide critical medical services to vulnerable populations,” McAneny asserted.
Title X clinics provide women with a plethora of health services, including cancer screenings, birth control, STI testing and treatment, and other reproductive health exams. The rule could get in the way of that by blocking funding if providers decide to offer or refer for abortion services.
“This is the wrong prescription and threatens to compound a health equity deficit in this nation,” McAneny added. “Women should have access to these medical services regardless of where they live, how much money they make, their background, or whether they have health insurance.”
The rule’s proponents point out that it does not actually cut any Title X funding, just reallocates where that funding goes by excluding providers that provide and refer abortion services.
The rule will ideally grant more funding for federally-qualified health centers, which treat men, women, and families. However, the rule would prohibit FQHC providers from referring women to abortion services if the physician and patient decide on that course of treatment.
Date: April 30, 2019
Source: Patient Engagement HIT