Compliance, Contraception, and Care: The Objectives and Effects of the Title X Rule Change
Open AccessIn 2019, the Trump administration promulgated a rule that made changes to the Title X family planning program and had serious impacts on the accessibility of reproductive healthcare for low-income populations across the country. The purpose of this study was to explore the objectives and effects of these changes, including the stated and unstated goals and how these changes affected the provision of reproductive healthcare and the providers and administrators themselves. This single-case study had two phases: a review of three sets of documents related to the rule change, to determine the objectives of the Trump administration; and eight interviews of providers and administrators who left the Title X network, to determine the effect of the rule. I used qualitative grounded theory methods to collect and analyze data, coming from a distinctly feminist viewpoint. The official stated goal of the rule change was to ensure compliance with statutory prohibitions on the provision of abortion known as Section 1008. I identified three unstated goals of the rule change: securing a symbolic victory for President Trump’s base, defunding Planned Parenthood, and reducing abortions in the United States. Many providers and administrators left the network due to concerns about their ability to provide complete information. Many expressed that the fallout from the rule change affected them more than their patients. Some felt insulated from the worst effects of the rule change by state politics. Most expressed a sense of risk in reincorporating program funds into their budget in the future and were unsure that applying for funding would be ‘worth it.’ These findings have several implications, including: the politicized nature of the program; the difficulty of applying; the shrinking value of grants; and the potential reshaping of the network as standalone clinics find the funds no longer worth the burden of applying. Given these implications, I recommend that policymakers simplify the grant application process, increase funding for the program, and amend or eliminate Section 1008. I recommend that advocates, providers, and administrators develop two strategies: one to prevent something like this from happening again and one to prepare for if it does.
- All rights reserved
Notice to Authors
If you are the author of this work and you have any questions about the information on this page, please use the Contact form to get in touch with us.