Planned Parenthood of Wisconsin will play a key role in a federal lawsuit seeking to block the Trump administration from making major changes to the federal Title X family planning program that would stress abstinence and practices like the "rhythm method" over comprehensive contraception methods.
The Wisconsin organization is leading three state Planned Parenthood affiliates in the challenge, filed Wednesday in federal court. A second suit was filed by the National Family Planning & Reproductive Health Association.
Both lawsuits come in response to guidelines issued in February by the U.S. Department of Health and Human Services for the next round of Title X grant applications. The guidelines do not mention contraception, but repeatedly mention "natural family planning methods" — known as fertility awareness or the rhythm method. Rather than using contraception like a condom, this method tracks a woman's menstrual periods to determine when she is most likely to conceive.
The plaintiffs in the cases argue these guidelines violate the federal Title X statute approved by Congress with bipartisan support in 1970. The cases also argue the HHS policy guidance did not go through the proper channels for changing federal regulations.
"It's really clear that Title X was formed and created in order to make modern contraceptive methods and services available to people of all incomes, but particularly for those who couldn’t afford it unless the government helped provide access," said Clare Coleman, National Family Planning & Reproductive Health Association president and CEO, on a Wednesday call with reporters.
The Title X program funds clinics that provide reproductive health and family planning services to low-income and insured patients throughout the country. Services include birth control, STD testing and pap smears. The grant program may not be used to fund abortion services, but clinics that provide abortions — such as Planned Parenthood — may receive these funds.
In a letter sent earlier this week, national anti-abortion groups urged HHS Secretary Alex Azar to "disentangle abortion centers from the Title X network."
"By shifting funding to clinic sites that do not perform or refer for abortion, you will send a strong message that abortion is not family planning consistent with the law creating the program," the letter read.
But Planned Parenthood of Wisconsin president and CEO Tanya Atkinson argued that by directing the federal funds away from groups like Planned Parenthood, low-income and uninsured women would lose access to crucial services.
According to the organization, Planned Parenthood clinics serve 41 percent of people nationally who receive services through the Title X program. In Wisconsin, Atkinson said, the percentage is more than 80 percent.
"In over 70 percent of the counties we serve there is already a shortage of health care providers," Atkinson said. "In seven counties, Planned Parenthood is the only Title X provider."
Christy Miceli, a 39-year-old small business owner from Hartford, told reporters Planned Parenthood and the Title X program saved her life when she was uninsured in her 20s. She visited the West Bend Planned Parenthood clinic and paid for her visits on a sliding, income-based scale.
At age 24, after her pap smear showed abnormal results, she was diagnosed with cervical cancer.
"I can’t have children, but because of Planned Parenthood and Title X, I am alive," Miceli said.
Since his first budget, which blocked Planned Parenthood from receiving federal Title V family planning dollars, Wisconsin Gov. Scott Walker has signed into law a series of measures that have chipped away at the organization’s funding.
Early in his first term, Walker ended a contract with Planned Parenthood to administer services for the state’s Well Woman Program in four counties.
In 2016, he signed into law a pair of bills that placed limits on how much Planned Parenthood can be reimbursed for prescription drugs acquired through a Medicaid program and required the state Department of Health Services to apply for the Title X family planning grant funds that had traditionally gone to Planned Parenthood. If DHS were to receive the grant funds, it could not distribute them to an organization that provides abortion services. Planned Parenthood has continued to receive the federal grant funds since the law was enacted, based on the existing set of guidelines the Trump administration has proposed changing.