AMA objects to attack on family planning services

Andis Robeznieks , Senior News Writer

The AMA “objects strongly” to a Trump administration proposal to withhold family planning funding from Planned Parenthood and other entities under a program that serves 4 million patients each year.

“We are particularly alarmed about government interference with the patient-physician relationship in the exam room,” said AMA President David O. Barbe, MD, MHA. “High-quality medical care relies on honest, unfiltered conversations between patients and their physicians. Gag orders that restrict the ability of physicians to explain all options to their patients and refer them—whatever their health care needs—compromise this relationship and force physicians and nurses to withhold information that their patients need to make decisions about their care.”

The U.S. Department of Health and Human Services announcement specifically notes that the regulation update “would prohibit referral for abortion as a method of family planning.”

The AMA’s objection to the administration move reflects a broader commitment to protecting free communication between patients and physicians. For example, the AMA was part of a successful effort against a Florida law that restricted the ability of physicians to communicate freely with patients about firearm safety.

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Last year, the AMA raised objections to proposed Affordable Care Act repeal-and-replace bills that would have included restrictions on Title X-funded entities such as Planned Parenthood.

The American Health Care Act, passed by the U.S. House of Representatives last May, would have prohibited federal funds supporting Planned Parenthood activities. A subsequent proposal, known as the Graham-Cassidy Amendment, included a provision that would prohibit individuals from using their Medicaid coverage to receive care at clinics operated by Planned Parenthood or similar organizations.

Those provisions violated AMA policy on patient choice and physician freedom to practice in the setting they choose. The administration’s new proposal would also endanger the access to care that the Title X program has helped facilitate.

“The Title X program ensures that every person—regardless of where they live, how much money they make, their background, or whether or not they have health insurance—has access to basic, preventive reproductive health care, such as birth control, cancer screenings, STI testing and treatment, and exams,” Dr. Barbe said. “This national program serves 4 million people each year—many of whom would otherwise be unable to access this health care.”

Title X programs received $286.5 million in 2016, which helped deliver care during 6.7 million patient visits at about 4,000 service sites. Almost two-thirds of Title X patients had family incomes below the federal poverty level and 3.5 million qualified for subsidized or free services, according to the Title X 2016 annual report.

Title X funds were used for more than 2.3 million screenings for gonorrhea, more than 2 million for chlamydia, and more than 1.16 million for HIV. Title X clinics also provided 2.8 million patients with some type of contraception.

“Title X is popular, successful, and has had bipartisan support for decades,” Dr. Barbe said. “We are at a 30-year low for unintended pregnancy and a historic low for pregnancy among teenagers—largely because of expanded access to birth control. We should not be walking that progress back.”