March 5, 2019 | Office of Attorney General Keith Ellison

Press Release

Attorney General Ellison sues federal government to stop illegal gag rule on women’s reproductive healthcare

Multistate lawsuit alleges new Trump administration rule is illegal and unconstitutional; Would have disproportionate impact on women in Greater Minnesota

March 5, 2019 (SAINT PAUL) — Minnesota Attorney General Keith Ellison announced today that he has joined 20 other attorneys general in a multistate lawsuit that challenges a gag rule that the Trump Administration has just imposed on grantees of Title X family-planning funds.

The lawsuit, filed in U.S. District Court in Oregon, claims that the new rule is illegal and unconstitutional, and that the federal Department of Health and Human Services (HHS) violated the federal Administrative Procedure Act in exceeding its statutory authority and in acting in an arbitrary and capricious manner in imposing the rule.

“Title X programs improved the health and lives of more than 55,000 Minnesotans in 2017. Now the Trump administration is illegally trying to gag providers from offering women medically-sound, unbiased, and affordable healthcare, which will impose burdens on everyone in our state, especially in Greater Minnesota. My job is to help Minnesotans afford their lives and live with dignity. This rule makes it harder for people, especially women, to do both. That’s why I’m joining this effort to fight it,” Attorney General Ellison said.

The purpose of the Title X program is to ensure equitable access to high-quality family-planning services for everyone, regardless of income. Title X provided $2.2 million to Minnesota in 2018 and $3.2 million in 2017 for vital family planning and preventive health services to low-income individuals. In 2017, more than 55,000 patients in Minnesota were served by Title X funds, which are granted directly to Planned Parenthood of Minnesota, North Dakota, and South Dakota, and Saint Paul–Ramsey County Public Health Department. Of those patients, 53 percent were at or below the federal poverty level.

Programs funded by Title X are particularly important in Greater Minnesota. Women in Greater Minnesota have a 30 percent higher risk of being diagnosed with invasive diseases like cervical and breast cancer compared to women in the metro area, and are less likely to receive preventive care and timely diagnoses. The ten counties with the highest rates of adolescent pregnancy in Minnesota are also all in Greater Minnesota.

Because of the Trump Administration’s new rule, Planned Parenthood will no longer participate in the Title X program, which jeopardizes healthcare access for tens of thousands of low-income Minnesotans around the state. Ten Planned Parenthood clinics, and all of Planned Parenthood’s subgrantee clinics, are located in Greater Minnesota, large sections of which already suffer from shortages of primary healthcare providers.

Congress enacted Title X nearly 50 years ago, in 1970. It is the only federal grant program focused exclusively on providing comprehensive family planning and related preventive health services for low-income people. Title X has required that all counseling be “non-directive.” Non-directive counseling includes the provision of neutral, factual, accurate, and complete information about prenatal care and delivery, infant care, foster care, adoption, and abortion, as well as any referrals requested by the patient. The non-directive counseling mandate has appeared in every Title X appropriations statute since 1996.  HHS also issued final regulations to this effect in 2000 which formalized long-standing HHS interpretations and positions on non-directive counseling.

Those regulations remained until yesterday, March 4, when the Trump Administration published a final rule that imposes a gag rule on Title X providers by prohibiting most of them from providing non-directing counseling on all legal options relating to pregnancy, which violates laws Congress passed to authorize and fund Title X and the Affordable Care Act. The final rule also requires referring a woman to prenatal counseling, regardless of the professional opinions of the healthcare providers or the needs and desires of the patient, even if information about abortion providers is the only information a patient requests. Finally, the final rule requires strict, unnecessary, and arbitrary financial and physical separation of any Title X-funded provider from all facilities and entities that have anything to do with providing abortion services, which imposes an untenable financial hardship on Title X grantees. 

The lawsuit is led by Oregon Governor Kate Brown, Oregon Attorney General Ellen Rosenblum, and New York Attorney General Letitia James. The attorneys general of Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maryland, Massachusetts, Michigan, Nevada, New Jersey, New Mexico, North Carolina, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin have joined Attorney General Ellison in the lawsuit.