FARGO — Since 1972, Fargo Cass Public Health Family Planning Clinic has offered an array of reproductive health care options, including abortion referrals.
But now the clinic has dropped that option rather than risk losing $172,000 in federal Title X funding.
Clinics that receive Title X funding must now comply with a new Trump administration rule that bans such clinics from referring patients for abortions. The administration has delayed the ban, giving clinics 60 days to comply.
The nation’s largest reproductive health care provider, Planned Parenthood, however, walked away from the bipartisan program this week after nearly 50 years “due to an unethical and dangerous gag rule,” said CEO Alexis McGill Johnson.
“We will not be bullied into withholding abortion information from our patients. Our patients deserve to make their own health care decisions, not to be forced to have Donald Trump or Mike Pence make those decisions for them,” Johnson said. “For nearly half a century, Title X has ensured that those struggling to make ends meet or who don’t have health insurance can access services like birth control, cancer screenings, and STD testing and treatment in their communities.”
Those services, including abortion referrals, are still available at Planned Parenthood locations, including in Moorhead, 803 Belsly Boulevard. But Fargo's Family Planning Clinic, 1240 25th St. S., which is part of Fargo Cass Public Health, no longer offers such services, in compliance with the new rule.
The Family Planning Clinic's brochures and materials have been scrubbed of any mention of abortion or the Red River Women’s Clinic in Fargo, North Dakota's only abortion provider. And staff have been trained to not mention the option to patients.
“Because of the new rules, abortions are not one of the options,” said Larry Anenson, director of health protection and promotion at Fargo Cass Public Health.
Anenson said Title X accounts for about 16% of the clinic's budget, or $172,000.
“We still need to accept the Title X funding because there is so much good we do with that,” he said. “If we lost that funding, we would have to make some drastic changes on the way we operate. A lot of that funding goes toward people who need reproductive health services, need birth control, need to be tested, but don't have any money.”
Anenson added that one-third of clients are uninsured and all services are provided at no cost or on a sliding fee scale based on household size and income. In 2018, the clinic served nearly 2,700 clients, 20% of whom were male.
Services span from depression screening, breast and testicular exams to contraceptive counseling and health education. Nearly 900 HIV tests were done last year and nearly 4,000 tests for gonorrhea, chlamydia, syphilis and herpes.
With news of the Title X changes, Anenson said the clinic is receiving calls from people “concerned about how they are going to be able to meet their reproductive health needs.”
“We really want to make sure people realize we are here. We don't want you to go without your birth control,” he said, noting that the clinic is taking on new patients.
Jennifer Aulwes, a spokesperson for Planned Parenthood in Minnesota and the Dakotas, said the Moorhead clinic has the highest number of patients (3,000) relying on Title X in Minnesota, but about two-thirds (2,064) of those patients are from North Dakota.
"Our doors are still open, and we will work very hard to cut the cost of everyone’s care as much as possible," Aulwes said in a message to The Forum.
Aulwes said there is a misconception that Title X is funding abortions, but the funds "are never used for abortions."
"This funding is used for preventive care like birth control and STD testing," she said. "This gag rule would mean our doctors would have to withhold information from any patient about abortion — even if they ask. That goes against the medical oath doctor’s take to give their patients information about all of their options. We would never withhold information from a patient in exchange for grant funding."
Tammi Kromenaker, director of the Red River Women’s Clinic, said her clinic does not accept Title X dollars, therefore is unaffected by the change.
She said many people are unaware that Fargo and North Dakota have a “very excellent Title X program,” so instead sought services at the Moorhead Planned Parenthood in Minnesota. Kromenaker and Anenson said this is due to a lack of brand power compared to Planned Parenthood, which has no locations in North Dakota.