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Hawaii Funds Women's Health Services To Address Trump Rule On Abortion Services

Ted S. Warren

Hawaii officials say they are prepared to maintain women’s health services in the state as the Trump administration orders taxpayer-funded family planning clinics to stop both referring patients for abortion services and discussing the topic with them.

If the clinics refuse to comply with the administration rule, they risk losing federal funding.

Earlier this year, the Hawaii Legislature appropriated $750,000 in state funds to protect family planning services that could lose federal funding. Clinics that need the funding would work with the state Department of Health to get the money released. The extra funding became available July 1.

State Sen. Rosalyn Baker, chair of the commerce, consumer protection and health committee, helped to add the funds to the state budget.

“[The funding] is to ensure that we have providers of reproductive services, including abortion services, to people in our communities that may need them,” Baker said.

She said the family planning and women’s health clinics that are endangered under the federal rule provide more than just abortion services. If they lose funding for violating the ban on abortion discussions, other women’s health services that they provide may be affected as well.

In March, the Trump administration released a final rule that would remove Title X funding programs where abortion is a method, or suggested method, for family planning. Title X is a federal program that allocates funds for affordable family planning and health care.

The Department of Health and Human Services reports Congress has already made it clear that Title X funds cannot be used to support abortion services. A 2014 amendment to the Public Health Service Act states, "None of the funds appropriated under this title shall be used in programs where abortion is a method of family planning."

HHS says Trump's final rule would help family planning clinics to "fully comply with the statutory program integrity requirements, thereby fulfilling the purpose of Title X, so that more women and men can receive services that help them consider and achieve both their short-term and long-term family planning needs."

Title X serves about 4 million women annually with about $260 million a year in grant money. First enacted in 1970, Title X is the only federal program designated for family planning and other preventative health services. Planned Parenthood, a taxpayer-funded family planning and health care service for low-income women, serves about 40% of all clients.

Under the federal rule, professionals at family planning clinics would also not be allowed to make referrals or discuss abortion services with patients, even if the patient brings up the subject.

Doris Segal Matsunaga, maternal child health director at Kokua Kalihi Valley Comprehensive Health Services, said while the $750,000 in state funding helps, it is not enough.

Her clinic received federal Title X funding until July 1, when the state's funding kicked in. However, Matsunaga reports that Title X provided $2.4 million for Hawaii's family planning clinics. 

Kokua Kalihi Valley is one of 13 clinics across six Hawaiian islands that Matsunaga says would be affected by the Trump Administration's rule. She hopes to continue working with the Legislature in the next session to see if family planning services around the island can receive more funds. 

Top officials for Planned Parenthood say the organization won’t comply with the rule. Instead, it’ll stop accepting federal money and ask Congress and the federal courts to reverse Trump’s rule.

Laurie Field, Hawaii state director for Planned Parenthood Votes, said Planned Parenthood aims to protect family planning and health services for nearly 20,000 patients of Title X funded clinics in Hawaii.

“Title X is a critical part of health care access, and it’s important to Hawaii people,” Field said. “Planned Parenthood will never stop fighting for those people who get care through Title X. We will not allow the federal government to censor our doctors and nurses and prevent them from doing their jobs.”

In another effort to challenge the administration’s rule on abortion referrals, Hawaii Attorney General Clare Connors joined 21 other state attorneys general in a lawsuit against Trump’s Title X restrictions. The lawsuit argues the president’s order is unconstitutional. 

“We joined this litigation because the regulations are unconstitutional, were enacted illegally and without any evidentiary basis,” Connors said by a written statement in March. “These new rules would, if implemented, directly harm Hawaii families, particularly women, by limiting their access to quality and comprehensive health care.”

Other states in the lawsuit, led by Oregon and New York, include Colorado, Connecticut, Delaware, District of Columbia, Illinois, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin.

The Department of Health and Human Services Department will also require clinics to maintain separate finances from facilities that provide abortion. HHS also announced it will not allow both abortion clinics and other women’s health care services to be under the same roof. The requirement is set to take effect next year.

The Associated Press contributed reporting to this story.

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