Charlene Maxwell, Multnomah Countys deputy nurse practitioner director
Charlene Maxwell, Multnomah County's deputy nurse practitioner director Multnomah county

A Trump administration effort to further limit abortion access has translated to less federal funding for Portland area medical clinics, leaving Oregon’s state budget to fill in the gaps.

Last year, the Department of Health and Human Services (DHS) announced it was adding a new rule for all medical providers who benefit from Title X, a federal program that reimburses clinics for reproductive health services they provide for low-income and uninsured patients. Title X covers contraceptives, ultrasounds, wellness exams and more, but does not cover abortions—and under the Trump administration’s new rule, it also would prohibit fund recipients from even discussing the option of abortion with their patients, or referring them to abortion providers.

“The problem with Title X and the rule change is, if you get Title X funding, you aren’t even allowed to talk about abortion anymore,” said Kate Willson, a spokesperson for the Multnomah County Health Department, which operates many medical clinics. “If a woman wants an abortion, our providers under Title X wouldn’t even be allowed to give her a list of providers or identify which providers can perform abortions.”

A group of 22 state attorney generals, led by Oregon Attorney General Ellen Rosenblum, are suing to stop the new rule. In April, a Portland-based federal judge sided with them and granted an injunction against the rule. But the federal government is appealing that injunction, and a federal appeals court ruled in June that for the time being, the new requirement can stay in effect.

Rather than following the new rule, called a “gag rule” by its opponents, many states—and Planned Parenthood—are choosing to stop using Title X funds.

That includes Oregon, which recently chose to stop using Title X funds after DHS told grantees they needed to comply with the new rule soon, or lose the money. OHA is still operating a reimbursement program that's more or less identical to pre-gag rule Title X, but without using federal dollars. That will apply to Multnomah County clinics, as well as all Oregon clinics and doctors' office' that use Title X funds to provide patients with necessary reproductive health services.

In Oregon, all Title X funds are distributed through the Oregon Health Authority (OHA). Multnomah County usually receives about $80,000 a year from OHA for Title X reimbursement, but that money will now be covered by Oregon’s general fund budget instead. The county announced its new funding source in a press release sent last week.

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It isn't clear what impact the change will have on Oregon's budget as a whole.

The news that the state budget would cover funds lost from Title X was a relief for medical professionals who work at Multnomah County clinics, many of whom feared the rule change would hamper their ability to provide the best care for their patients.

“As a primary care provider, I have a duty to provide unbiased information that allows the client to make an informed decision about their health,” said Charlene Maxwell, the county’s deputy nurse practitioner director, in the press release. “No one other than the client is able to make these decisions, and no one other than the client will experience the full outcome of these decisions.”

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