Senator's View Column: Title X ruling hampers access to reproductive health care

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U.S. Sen. Tina Smith
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In late August, Kaitlyn Vaske-Wright, a nurse practitioner at a Planned Parenthood clinic in Minneapolis, noticed her patients were canceling appointments, forgoing medical tests, and failing to fill prescriptions. She found out her patients could no longer afford the cost of their health care services at the clinic, and many of them had to wait for another paycheck before they scheduled another appointment.

For decades, thousands of Minnesotans have depended on Planned Parenthood clinics for affordable and high-quality health care services. So what changed that put these health benefits out of reach for Katilyn’s patients? The Trump-Pence administration issued a rule meant to dismantle the only federally funded family-planning program in the country, Title X.

This program has helped millions of Americans receive quality health care since President Richard Nixon signed it into law in 1970. The current administration’s rule forced Planned Parenthood and other clinics providing low-cost primary care in Minnesota to forgo this critical funding. While Planned Parenthood’s clinic doors remain open for now, it is now charging for care that previously was provided at no-cost, forcing too many patients to make the difficult choice between accessing critical health care and paying for rent, food, or other necessities.

Since taking office, President Donald Trump has fixated on destroying Americans’ access to the primary and reproductive health care afforded by Title X. The administration’s new rule makes it illegal for health care providers to discuss abortion referrals with their patients and creates new program requirements that would inhibit access to affordable birth control, STI testing, and cancer screening. Rather than provide compromised care, Planned Parenthood and other clinics have decided to withdraw from the Title X program and are doing their best to stay afloat. This rule is an affront to the 56,000 Minnesotans who depend on Title X for essential health services.

That includes Minnesotans like Carla from St. Paul. When she moved to Minnesota for school, she had catastrophic health insurance, the kind that covers accidents and emergencies but not regular checkups or primary care. Carla was apprehensive about visiting a clinic at first, and she was concerned about what her health insurance would cover. Thanks to Title X, Carla was able to receive the checkups and preventive care she needed, as well as the peace of mind to know that her biggest worries would be related to school and her career and not paying for her health care.


The care that Minnesotans have received from Title X clinics has done more than help ease minds. It has saved lives. Jodi from St. Cloud relied on a Title X clinic in Minnesota for her annual exams. A few years ago, a nurse practitioner conducted Jodi’s annual physical and noticed a lump in Jodi’s neck. After a thyroid test and a referral to a specialist, Jodi found out she had follicular thyroid cancer. Due to the cancer screening she received at her local Title X clinic, Jodi caught the cancer early and is on her way to a clean bill of health.

Title X has proven to be a lifeline for Minnesotans, providing primary care to prevent, detect, and treat illnesses as well as the family-planning services that are key to economic opportunity.

Since 1971, Title X has been ingrained in the fabric of Minnesota’s health care system. In 2017, Title X grantees provided more than $3.18 million to support reproductive health care services at 35 sites across the state. And last year, Planned Parenthood’s network of clinics served more than 90% of Title X patients in Minnesota. According to 2013 estimates, without Title X, the rate of unintended pregnancy and abortion in Minnesota would be 32% higher. With new requirements that have already forced Minnesota’s Planned Parenthood clinics out of Title X, the health and well-being of 53,000 Minnesotans is at risk.

We should trust women and their families to make their own decisions about their reproductive health care. But in order to make those decisions, people must have accurate and complete information about their health care options. The Trump-Pence administration’s move to change Title X family-planning programs will limit honest conversations between patients and their providers.

Think about this: A woman goes in to talk with her health care provider about what her options are, and it is as if President Trump and Vice President Mike Pence are hovering over the doctor’s shoulder, telling them what they can and can’t tell their patient about her health care options. That’s not just creepy, it’s flat-out wrong.

Protecting Title X is about trusting that Americans can make their own decisions about what is best for them, their health, and their families. While the GOP continues to use all the tools at its disposal to limit our freedom, options, and access to health care, I stand with Minnesotans and will do everything in my power to protect our rights.

Sen. Tina Smith represents Minnesota in the U.S. Senate. She wrote this exclusively for the News Tribune.

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