A senior Trump health official who has promoted abstinence will be the final arbiter of which groups receive federal family planning funds — a change from prior years, when a group of officials made the decision, POLITICO has learned.
Conservatives have long criticized the $286 million Title X program, which funds family planning services, mostly for low-income women, because it gives money to Planned Parenthood and other groups that provide abortions, even though there is a prohibition on using those dollars for abortions.
Now, for the first time, the final decision of who gets the funding will be in the hands of one person — Valerie Huber, the acting deputy assistant secretary for population affairs at HHS, a longtime advocate of abstinence.
Prior to joining the Trump administration, Huber was president and CEO of Ascend, a national organization that promoted “sexual risk avoidance” — a term she used instead of abstinence — among young people. Huber also managed the Ohio Department of Health’s sexual risk avoidance program from 2004 to 2007.
Women’s health advocates on the other side of the debate fear that the Trump administration will funnel money away from groups that provide contraception and toward crisis pregnancy centers that oppose abortion or groups that promote abstinence-only education.
"This is unprecedented, and has dangerous implications,” said Kashif Syed, a senior analyst at the Planned Parenthood Federation of America. “We’re talking about a program that 4 million people rely on for basic reproductive health care — or in many cases, their only form of health care. Now is not the time to play politics with people’s lives — but that’s exactly what the Trump-Pence administration is doing.”
Planned Parenthood treats about 41 percent of Title X patients but did not say how much total funding it gets through the program.
An HHS official this week confirmed the change in decision-making authority in response to questions from POLITICO.
HHS has been working since 2013 to “streamline administrative function” for Title X to bring it in line with other grants from the Office of the Assistant Secretary for Health, according to an HHS spokesperson. “The selection process in the funding opportunity announcement has been updated to reflect that the office head, in this case, the [deputy assistant secretary for population affairs], will make the final selections,” the spokesperson said.
The policy change was little noticed when the Trump administration announced the new Title X application process last month, but a close review of this year’s application, compared with prior years, shows a change in decision-making. Until now, final decisions were made by a regional health official along with the HHS deputy assistant secretary for population affairs and the assistant secretary for health, according to language in applications distributed in prior years.
The shift comes on top of other Title X policy changes: Administration officials have stressed the importance of abstinence education and downplayed the role of all FDA-approved forms of contraception.
They mark the latest administration moves against Obama-era policies in support of contraception. The administration recently eliminated funding for the Teen Pregnancy Prevention Program and reversed the Obamacare requirement that most employers provide contraception in their employee health plans.
Huber believes public health officials should normalize the idea of delaying sex, according to a statement her organization wrote in 2016.
“As public health experts and policy makers, we must normalize sexual delay more than we normalize teen sex, even with contraception,” Huber said in the statement while at Ascend. “We believe young deserve the best opportunity for a health future.”
Huber has criticized American culture in general and Planned Parenthood specifically for “normalizing” sex among teens and for glossing over the risks of sex before marriage.
“We think it’s very important for teens to know that even if they use a condom or contraception, that doesn’t make sex safe. It doesn’t mean they won’t get pregnant. It doesn’t mean they won’t have an STD. It doesn’t mean they won’t have any negative consequences,” she said in a 2012 speech to the Bringing America Back to Life symposium. “We think that young people need to know information that is going to help them make the best decision — and that best decision is to wait.”
Syed criticized Huber for backing abstinence pledges and imposing her opposition to birth control on other people.
“The Trump-Pence administration is handing the future of the country’s program for affordable birth control over to a woman who wants to mandate abstinence pledges,” Syed said. “Valerie Huber has called abstinence an anti-poverty program, and has made it clear she will impose her beliefs on people no matter how many get hurt in the process.”
Title X applications are due in May, and grants will be rolled out in September. As in prior years, Title X applications will be reviewed by an independent review panel, which is typically made up of public health experts.
The applications will then go to Huber, according to the language in the funding announcement.
Huber said a conference call with reporters last month that Planned Parenthood is welcome to apply for funding. But she stressed that she wants to expand the reach of Title X.
"This is a program that’s important to the administration, and we think it’s really important to make some meaningful changes to extend the coverage of the program," Huber said.