Khazan: How is the money spent?

Geoffray: We leave it up to providers to figure out how they best want to use these funds. For many of them, it’s to pay for staffing, like their doctors, their nurses, or many of them set it up essentially as a bucket of funds to pay for uninsured individuals. But either way, direct services are delivered as a result of these Title X grants.

Khazan: Has Title X ever paid for abortions? Before this rule change, what did Title X have to do with abortions?

Geoffray: Title X has longstanding rules that abortion is not a method of family planning. So no, the answer is no. Government funding is not being used to pay for abortion services.

Khazan: So what did this rule actually change? If you already weren’t paying for abortions, what is different now?

Geoffray: This really is much more than a gag rule. There’s a lot of changes in this proposed rulemaking.

The way things work now, when a woman comes into one of our clinics and takes a pregnancy test, if she receives a positive pregnancy test, staff are able to provide counseling to her around her pregnancy options. There are three options—parenting, adoption, or termination—and we do treat these fairly equally, because we want to present information in an unbiased way.

Our philosophy is that all counseling should be led by the client. So if a client is very clear that they want to terminate a pregnancy, that is the information that they will get. If a client is very clear that they want to continue the pregnancy and parent, they will get referred into prenatal care and that is the way it will go.

So we have resource lists available that are specific to each of those options, and we provide information [depending on what the] client is really saying that they desire. What this rule seeks to do is essentially take the abortion conversation off the table. The resources that providers are able to give must include information about parenting and adoption, even when someone is very clear that they want to terminate their pregnancy.

Khazan: Does this rule mean that you cannot give clients the abortion referrals, or that you have to give them, in addition to the abortion referral, parenting and adoption resources?

Geoffray: What you cannot do is give someone only abortion referrals. You can provide them with a list of providers, and some of those providers may offer abortion. But you can’t give a list knowing that everyone on that list is an abortion provider or everyone on that list would refer to an abortion provider. The examples that are included in the rule text make it very clear that you must offer prenatal care at a minimum. You can have a list of providers, and maybe they’ll be some abortion providers on there, but if a woman asks you, “I want an abortion. How do I get that taken care of? How do I get my pregnancy terminated?” The provider has to say, "Well, abortion is not a method of family planning in the Title X project. We do not refer for abortion. I can give you a list of resources to healthcare providers. Some of these people may provide abortion.”