Attorney General Becerra Continues Fight in Court to Protect Title X Family Planning Access

SACRAMENTO – California Attorney General Xavier Becerra today continued his fight to protect Californians from the Trump-Pence Administration’s Rule that attacks Title X, the nation’s family planning program. The Rule restricts access to preventive healthcare including access to birth control, restricts healthcare providers' ability to provide comprehensive information to patients, and prohibits referrals for abortion. Injunctions in three districts were entered preventing this Rule from going into effect. However, on June 26th, a three-judge panel entered a motion that would allow the Rule to go into effect. All plaintiffs, including California, filed motions seeking a full panel review of the motion. In filing an answering brief in the United States Court of Appeals for the Ninth Circuit, Attorney General Becerra petitioned the court to affirm the district court’s order entering a preliminary injunction, halting implementation of the Trump-Pence Administration’s Title X Rule.

“The President and Vice President have no business interfering in women’s reproductive medical decisions. Period,” said Attorney General Becerra. “Access to critical family planning should never be used as a political football. Title X clinics and providers are on the front lines of our healthcare system providing basic care to California's most vulnerable communities. This unlawful Rule would cause irreparable harm to them and communities nationwide. We refuse to sit back as this Administration continues its persistent attacks on women’s access to reproductive care.”

In the brief, Attorney General Becerra explains why the district court’s issuance of a preliminary injunction to block enforcement of the Rule in California should stay in place. Specifically, Attorney General Becerra argues that the court did not abuse its discretion in issuing the preliminary injunction and upholding the status quo while this case is litigated to final judgment. In the answering brief, Attorney General Becerra further argues that:

• The Rule is contrary to law: Applying well-established principles of statutory construction, the district court correctly determined that the Rule likely violates two statutes: the nondirective-counseling provision of the annual Title X appropriations legislation and the Affordable Care Act, which prohibits HHS from enacting regulations that impede patient access to care or interfere with doctor–patient communications.
• The Rule is arbitrary and capricious: The Rule seeks to require costly physical separation of facilities serving Title X patients from facilities providing abortions, ostensibly because of concern about misuse of Title X funds. However, HHS cannot cite a single instance from the past three decades—during which shared facilities have been permitted, under certain conditions—in which a Title X provider has misused funds to support abortion. 
• California would suffer irreparable harm to its public health and public finances if the Rule were to go into effect: Providers would withdraw from the program, reducing access to care across the state. Rates of unintended pregnancy and complications at birth would increase; early diagnoses of serious but treatable illnesses would decrease. Patients seeking information about where to exercise their constitutional right to obtain an abortion would be kept in the dark. 

BACKGROUND:

On May 22, 2018, the U.S. Department of Health and Human Services released a proposed Rule that would place several harmful restrictions on the Title X family planning program. California is home to the largest Title X program in the nation. Attorney General Becerra announced his legal concerns shortly after the proposed Rule became public. On July 18, 2018, Attorney General Becerra requested that the Office of Management and Budget reopen its review of the Rule given the insufficient and controversial reasoning offered by the Administration for its proposed changes. On July 30, 2018, he led a coalition of 13 attorneys general in filing a comment letter opposing the Trump-Pence Administration’s proposal. Further, Attorney General Becerra also filed a Freedom of Information Act (FOIA) request on August 28, 2018, seeking documentation about the formulation of the proposal. 

Despite these efforts, the Rule was finalized on March 4, 2019. On March 8, 2019, Attorney General Becerra filed a lawsuit challenging the final Rule in the Northern District Court of California, claiming the proposed restrictions to Title X disregard the Rule of law and would harm California. On April 26, 2019, the district court concluded that implementing the Rule while those challenges are litigated would be highly disruptive and would result in irreparable harm to public health and public fisc, causing an exodus of high-quality Title X providers who cannot accept restrictions requiring them to compromise the quality of care they provide and violate standards of medical ethics. Three other district courts entered similar orders. On May 6, 2019, the federal government filed a motion to stay the injunction in the district court and allow the Rule to go into effect. On May 8, 2019, the district court denied this request. On May 10, 2019, the federal government appealed this decision to the Ninth Circuit. On June 20, 2019, a panel of three Ninth Circuit judges stayed all three injunctions against the Rule, pending appeal. On June 26, 2019, Attorney General Becerra filed a motion seeking an en banc reconsideration of that ruling. 

A copy of the brief can be found here.