Guest editorial: VMS opposes ‘onerous’ changes imposed on Title X funds

Physicians and physician assistants from the Vermont Medical Society (VMS) and the American Academy of Pediatrics Vermont Chapter (AAPVT) strongly oppose onerous federal restrictions placed on Title X monies that went into effect last Thursday. These changes have resulted in the inability of 12 health centers across the state of Vermont, including Planned Parenthood clinics, to accept federal Title X funding. 
While VMS and AAPVT applaud the announcement by Planned Parenthood centers in Vermont that this will not disrupt health care services at this current time, losing this funding may limit access to necessary care in the future for both women and men particularly in rural, hard to serve areas of Vermont. 
Title X funding covers birth control, STD screenings, and other reproductive health services for low-income patients who may lack adequate health insurance coverage. These clinics often serve as a patient’s only access to health care in Vermont and this funding is used for basic health care services like wellness exams and cancer screenings. 
Last week’s decision by the 9th U.S. Circuit Court of Appeals to lift the injunction placed on the Title X rule changes means that Title X funding is no longer available to organizations that also provide or refer for abortion and that health professionals at locations that accept such funding are prohibited from providing complete information about abortion as an option. 
These requirements threaten the sanctity of the physician-patient relationship and are in violation of medical ethics. The physician-patient relationship is dependent on trust, therefore it is critical for health care professionals to have the ability to give patients their full range of reproductive options in an honest, candid way. 
The VMS specifically opposes: 
• Reduced funding or access for birth control or preventive care from reproductive health care professionals like Planned Parenthood; 
• Forcing doctors, nurses, and health centers to choose between funding and the ability to refer their patients for safe, legal abortion; 
• Denying patients the right to get full and accurate information about their reproductive health care options from medical professionals. 
When the rule was proposed in May of 2018, the VMS joined the American Medical Association (AMA), the American Nurses Association (ANA), the American College of Physicians (ACP), the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP), the American College of Nurse Midwives (ACNM), the American College of Physicians (ACP), the Association for Physician Assistants in Obstetrics and Gynecology (APAOG), the National Association of Nurse Practitioners in Women’s Health (NPWH), Nurses for Sexual and Reproductive Health (NSRH), and the Society for Adolescent Health and Medicine (SAHM) in their condemnation of the rule. 
In March 2019, Vermont joined 20 other states in filing a legal challenge to the federal restrictions placed on the Title X program, arguing “it’s unreasonable to ask healthcare providers to withhold crucial information from their patients.” 
We call on the federal Health and Human Services Department to withdraw this rule in the interest of public health and for the benefit of all Vermont patients and applaud Vermont’s ongoing legal challenge to the rule changes. 
Note: Jill Sudhoff-Guerin is the policy and communications manager of the Vermont Medical Society based in Montpelier. Periodicals Postage Paid at Middlebury, Vt. 05753 A D D I S O N C O U N T Y 

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