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Oregon dumps federal health care funds in Trump rule change skirmish

State weighs legal and political options as federal appeals court takes up proposed barriers to some reproductive care for low-income women.

PHOTO BY: JAIME VALDEZ - Although abortion in among the services that Planned Parenthood provides, it represents a small fraction of the reasons that patients seek care there., Clackamas Review - News  Planned Parenthood reopens in Clackamas CountyOregon is foregoing hundreds of thousands, if not millions, in federal dollars in the latest move of its ongoing battle with the Trump administration over abortion access.

U.S. Health and Human Services gave all states until midnight to decide how to respond to its new regulations around Title X funding as several court battles fighting a proposed rule change by the federal agency play out.

Proposed regulations throw up significant barriers to health care providers, forcing them to completely sequester abortion services from other services, and bar doctors from discussing all options with patients.

"The new federal regulations impose some conditions that Oregon cannot comply with because doing so would violate its own laws that prohibit it from interfering with or restricting benefits, services or information regarding a woman's right to choose to terminate a pregnancy," said Oregon Health Authority spokeswoman Delia Hernandez in a statement.

PMG/EO MEDIA/SROregon will stay in the program, but decline funds for at least the next month while it awaits a ruling from the Ninth Circuit Court of Appeals. OHA sent a letter to U.S. Health and Human Services on Monday to inform them of the decision.

In some states, the new regulations could mean limited access to abortions as well as family planning services, sexually transmitted infection testing and cancer screenings. But in Oregon, access to reproductive health care is not expected to change.

Anne Udall, chief executive officer of Planned Parenthood Columbia Willamette, which runs the Salem Health Center, said she's been in close contact with Gov. Kate Brown's office as the state evaluates its options for filling the funding gap. Brown's office did not return a request for comment.

In the 2017-18 fiscal year, Oregon received about $3 million in Title X funds. "In terms of impact on patients for us, we plan to continue to serve everyone we are serving," Udall said.

Unlike some other states, Oregon itself is the designee of the Title X finding, rather than the clinics. As of 2015, there were 81 clinics in Oregon receiving Title X funds, providing contraception care to 50,000 women. Planned Parenthood provided care to 41% of those patients, according to a Planned Parenthood fact sheet.

In Salem, the Marion County Public Health Salem Clinic also receives Title X funds. Marion County's Public Health Director, Katrina Rothenberger, said the clinic plans to still provide the same services, and has been assured by the Oregon Health Authority that it will still be reimbursed by the state for reproductive health services.

Anti-abortion group Oregon Right to Life released a statement Monday condemning Planned Parenthood for turning down the federal dollars, saying it was choosing abortions over other health care services. But Udall said Planned Parenthood will not cut any services in giving up the federal money.

"We will continue to have our doors open and have full service," she said.

Legal fights

It's the latest move in an ongoing battle between progressive states and the Trump administration, which is working to limit the amount of federal dollars clinics like Planned Parenthood get. Oregon is leading a multi-state legal challenge of the proposed rule change.

The Title X program was signed by President Richard Nixon in 1970 to limit unintended pregnancies. It provides funding for contraception, wellness exams, cervical cancer screenings, treatment for sexually transmitted diseases and more. It does not provide funding for abortions, and there is no evidence of the funding being misused in the program's 50-year history, according to court documents.

Anne UdallThe rule change was announced by the Trump administration in February. It bans reproductive health care providers receiving Title X funds from discussing abortions with their patients. If a patient were to ask their doctor about an abortion, the doctor would have to refer them to a neonatal clinic.

It also forces clinics receiving Title X funds to physically separate abortion services from other services with actual walls, as well as separate electronic records.

"It is a calculated attack on Planned Parenthood, and it is a calculated attack on anyone who provides sexual and reproductive health care," Udall said.

She added that it's an attack on women, as the money overwhelmingly goes to women's reproductive health services. "We really believe that the Trump/Pence administration is completely out of step with what the vast majority of Americans want," Udall said.

Oregon took the lead on a legal challenge, and was joined by 19 states, the District of Columbia, Planned Parenthood and the American Medical Association. Washington filed its own lawsuit and two more were filed in California.

In April, Oregon got a win when Judge Michael McShane ruled in federal court in Portland that the rule should not go into effect while it's being challenged. McShane gave blistering criticism of the rule from the bench, calling it a "a ham-fisted approach to health policy that recklessly disregards the health outcomes of women, families and communities."

But McShane's decision was reversed in July when three judges of the Ninth Circuit Court of Appeals ruled that the rule could go into effect. Health and Human Services set a Tuesday deadline for clinics to decide what to do. A last-ditch request from Planned Parenthood to stay the rule was declined Friday.

Udall said the fight is not over, and Planned Parenthood will lobby Congress as well as continue the fight in the courts.

In July, Oregon and joining states filed a motion arguing the three-judge panel was not sufficient for such a crucial issue, and that all 11 judges should weigh in. In a rare move, the court accepted the argument.

In September, Oregon Department of Justice's Solicitor General, Ben Gutman, will argue on behalf of all parties to the 11-judge panel of the Ninth Circuit Court of Appeals in San Francisco. He will ask that the rule not be imposed during the legal fight.

"We feel like we have a really, really strong case," Udall said. "You just continue to fight it in the courts and see what happens."

Reporter Aubrey Wieber: aubrey@salemreporter.com or 503-375-1251. He is with the Oregon Capital Bureau, a collaboration of the Pamplin Media Group, EO Media Group, and Salem Reporter.