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Trump Administration Actions to Protect Life and Conscience

Title X Reforms

Final

Issued by: Office for Civil Rights (OCR)

Issue Date: January 24, 2020

Trump Administration Actions to Protect Life and Conscience

Title X Reforms

Title X Final Regulation: In February 2019, HHS finalized a new Title X regulation that ensures compliance with statutory program integrity provisions, including the statutory prohibition on funding programs where abortion is a method of family planning, and no longer permits Title X-funded family planning services at the same location where abortion is provided. HHS is vigorously defending the final rule against litigation.

Redirecting Relinquished Title X Funds: Rather than comply with the Title X final rule, certain former grantees relinquished their grants. The HHS Office of Population Affairs awarded the relinquished funds (more than $33.6 million) to 50 of the remaining grantees. These funds will be used to expand services in unserved or underserved areas.

Broadening Participation in Title X: In its August 2018 Title X grant awards, HHS reprioritized Title X funding to applicants who connect patients to a broader continuum of primary care, protect victims of sexual abuse, and encourage family involvement in family planning decisions, consistent with the statute and regulations. These awards funded 12 organizations that were not current Title X grantees, including state health departments, a faith-based organization, and several community health centers.

Protecting Conscience

Notice of Violation for California's Universal Abortion Mandate: In January 2020, OCR issued a Notice of Violation to the state of California, formally notifying California that it cannot impose universal abortion coverage mandates on health insurance plans and issuers in violation of federal conscience laws. California has deprived over 28,000 people of plans that did not cover elective abortion, but now must cover abortion due to California's mandate.

Protecting Healthcare Workers' Conscience Rights: In August 2019, OCR issued a notice of violation to the University of Vermont Medical Center, which violated the Church Amendments by forcing a nurse to assist in an elective abortion procedure over her conscience-based objections.

Finalized Conscience Regulation: In May 2019, HHS finalized a rule to protect individuals and health care entities from discrimination on the basis of their exercise of conscience in HHS-funded programs and strengthened enforcement procedures for 25 health-related federal conscience and religious freedom laws, so that such laws can be enforced as robustly as other civil rights laws enforced by OCR. HHS is defending the final rule against challenges to it. While the final rule is being litigated in court, OCR will continue to vigorously enforce the law under pre-existing authorities.

Enforcing Weldon & Coats-Snowe Amendments: In January 2019, the HHS Office for Civil Rights (OCR) notified the State of California that its law requiring pro-life pregnancy resource centers to refer clients for abortions, by posting notices about free or low-cost family planning services and abortion, violated the Weldon and Coats-Snowe Amendments. This is the first time that any state has been found in violation of these laws, reflecting HHS's heightened commitment to enforcing conscience protection statutes.

Protecting Conscience in Health Insurance: In November 2018, HHS and the Departments of Labor and of the Treasury issued two final rules to provide regulatory relief to American employers, including organizations like the Little Sisters of the Poor, that have religious or moral objections to providing coverage for contraceptives, including those they view as abortifacient, in their health insurance plans. The Departments are vigorously defending the final rules, and the Supreme Court has granted the government’s petition for writ of certiorari to review a decision by the Third Circuit striking down the final rules.

New Division to Protect Conscience and Religious Freedom: In January 2018, OCR launched a new Conscience and Religious Freedom Division, the first time a federal office for civil rights has established a separate division dedicated to ensuring compliance with and enforcement of laws that protect conscience and free exercise of religion in healthcare and human services.

The Affordable Care Act and Abortion

Separate Billing for Abortion Coverage: In December 2019, HHS issued a final rule to require issuers of Qualified Health Plans—individual insurance plans under the Affordable Care Act (ACA)—to bill and send separate invoices for insurance coverage of non-Hyde abortions.

Ensuring Access to Policies without Abortion Coverage: In January 2019, HHS issued a proposed rule to require that insurance companies that offer ACA plans covering abortions of pregnancies that do not threaten the life of the mother or result from rape or incest must also offer at least one identical plan in the same geographic area that does not cover these abortions. (The rule would not apply in states with abortion coverage mandates.)

Transparency on Abortion Coverage on HealthCare.gov: Starting with the 2019 open enrollment period, HHS ensured for the first time that consumers could identify whether a plan covers non-Hyde abortion by clearly displaying such information on HealthCare.gov.

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.