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Title X, 02.5.2018

Senator Kate Bolz (left) and Sen. Anna Wishart look at a document provided to them by Marion Miner, associate director for pro-life and family with the Nebraska Catholic Conference during a hearing Feb. 5.

Lincoln Sen. Kate Bolz made another attempt Wednesday to make changes to a Title X family planning funding provision in the mainline budget bill proposed by Gov. Pete Ricketts.

Two motions failed to get more than three senators, out of nine members on the Appropriations Committee, to support the changes that would make the provision comply with existing federal Title X regulation.

Sen. Dan Watermeier, who opposed any change, said the provision had a hearing and passed legal arguments. 

Bolz brought the Title X funding topic up to the committee after receiving a legal analysis from the Health Center Association of Nebraska that says compliance by federally qualified health centers with both the Title X regulation and LB944 as written is impossible.

Title X authorizes a family planning program and provides grants to assist in establishing and operating voluntary family planning projects. The federal regulation prohibits Title X funds from being used in programs where abortion is a method of family planning.

The analysis by a Washington, D.C., law firm, Feldesman Tucker Leifer Fidell, said the federal regulation requires projects to engage in abortion-related activities under certain circumstances, such as when the patient requests a referral or when a referral is medically indicated. 

Amy Behnke, chief executive officer of the Health Center Association of Nebraska, said the association's concern is if the referral language in the budget bill provision is not removed or clarified, it would be inconsistent with federal law.

"That places a lot of uncertainty on our health centers and all Title X providers, which could have serious implications on access to care, particularly in the rural parts of the state," Behnke said in an email.

The provision in the budget bill was added by Ricketts to "revise the distribution of federal Title X health care funding to prevent the use of taxpayer dollars for abortions and abortion-related services," according to spokesman Taylor Gage. 

"If you provide abortion services or refer or provide directive counsel for abortions, you can’t receive Title X funding," he said. 

Gage said all clinics will continue to be eligible for funding as long as they do not provide abortion services or refer for or provide directive counseling for abortions. If an organization has been providing abortions or related services, it will have to take steps to ensure that the entity providing Title X services is "objectively independent."

"Clinics can continue to explain to patients what their options are, but they cannot use taxpayer dollars to connect them to abortion services," he said. 

Ricketts' provision will go to the full Legislature as proposed when the bill is voted out of committee this week. Bolz said it was important that senators have the analysis from the health centers so they can make an informed decision on what the provision means to access to women's health care. 

The bottom line is, the provision that prevents referrals to abortion providers is inconsistent with Title X regulations, she said. 

"My takeaway would be that they would not access Title X dollars because they could not both comply with state law and federal regulation," she said. 

The next step of the implication is that Nebraska residents lose access to cancer screenings, wellness checks and prenatal care, she said. 

"I would argue that protecting access to women's health care and prenatal care is pro-life in its essence," Bolz said. 

Reach the writer at 402-473-7228 or

On Twitter @LJSLegislature.


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