Pro-life and pro-choice demonstrators argue outside of the Supreme Court in Washington, D.C., March 4, 2020. (Tom Brenner/Reuters)

The Fourth Circuit Court of Appeals has blocked a Trump-administration rule that removes Title X family-planning funds from abortion providers. The administration announced the policy, also known as the “Protect Life” rule, in May 2018, and since then it has been embroiled in legal battles with abortion providers and other abortion advocates including the ACLU, which have argued that the rule infringes on abortion rights as defined in U.S. jurisprudence.


But in late February, judges on the Ninth Circuit upheld the policy, lifting injunctions that district courts had placed on the rule and allowing it to take effect across most of the country. This latest decision from the Fourth Circuit makes Maryland the one state where the Protect Life rule cannot take effect while the legal challenge is pending, and the circuit-court split suggests that the Supreme Court may take up the case to resolve the dispute.

Planned Parenthood has been, unsurprisingly, one of the most prominent opponents of the Protect Life rule, and it has joined attorneys general from Democratic states in suing the federal government. As the largest abortion provider in the country — performing more than 348,000 abortions each year, which is somewhere between one-third and half of all the annual abortions in the U.S. — Planned Parenthood had the most to lose when this policy took effect.

Though the Protect Life rule does not specifically target Planned Parenthood, it requires any organization that performs abortions to financially separate its abortion business from any health care that it offers in order to continue receiving family-planning funds under Title X. Planned Parenthood refused to comply, and as a result its affiliates lost about $40 million that it had typically received each year from Title X. (It is worth noting that this barely makes a dent in the half a billion dollars that Planned Parenthood receives annually from the federal government, most of which comes not from Title X but in the form of Medicaid reimbursements.)


In his decision blocking the policy, prior to this latest ruling from the Fourth Circuit, district judge Richard D. Bennett wrote, “Literally every major medical organization in the United States has opposed implementation of this rule. There is almost no professional support for its implementation.” Bennett appears to have forgotten that a judge’s role is not to assess whether various public institutions support or oppose a policy but rather to determine whether that policy is imposed lawfully and in line with previous precedent.

It was this absurd decision that the Fourth Circuit upheld late last week, ignoring the fact that, as the Ninth Circuit opinion acknowledged, the Title X rule is less restrictive than a 1988 version of the same policy that the Supreme Court upheld. The Ninth Circuit’s deviation from its typical support for unlimited abortion rights was a welcome surprise; the Fourth Circuit’s choice to play to type is disappointing.