{"database": "press", "table": "releases", "rows": [["http://hultgren.house.gov/newsroom/press-releases/hultgren-joins-effort-protecting-states-rights-by-opposing-hhs-title-x", "Hultgren Joins Effort Protecting States Rights by Opposing HHS Title X Family Planning Rule", "2016-09-27", "2016", "2016-09", "Republican", "House", "IL", "Randy Hultgren", "H001059", "hultgren.house.gov", null, null, "legacy", "Washington, DC \u2014 U.S. Representative Randy Hultgren (IL-14) joined a bipartisan, bicameral letter, led by U.S. Senator Joni Ernst (R-IA) and Congressman Diane Black (R-TN), to U.S. Department of Health and Human Services (HHS) Secretary Sylvia Burwell expressing their opposition to the Department\u2019s new proposed rule to amend regulations implementing the Title X Family Planning Program. The letter questions HHS\u2019 assertion that providers with a reproductive health focus are more \u201ceffective\u201d than other health care providers which offer more comprehensive care for women and men. This dubious claim, if pushed through, would all but establish a nationwide mandate that these more narrow providers receive priority for the receipt of Title X subawards\u2014at the expense of other entities like comprehensive primary care providers and community health centers.\nIn the letter to Secretary Burwell, the lawmakers stated, \u201cIf HHS cannot clearly define an \u2018effective\u2019 or \u2018high quality\u2019 provider, it is unclear to us how state and local project grantees are supposed to do so in order to comply with this proposed rule. It is also therefore unclear how HHS will be able to determine in every case whether state or local project recipients \u2013 who are generally closer to and more familiar with subrecipients and the patient base in their geographical region \u2013 have considered inappropriate criteria in evaluating subrecipients. Rarely do the American people benefit when the federal government attempts to substitute its judgment for that of state or local governments \u2013 particularly when the criteria used to inform that judgment are unclear, and that judgment is not supported by coherent and impartial facts.\u201d\nThe letter was also sent by Senators Roy Blunt (R-MO), John Boozman (R-AR), Bill Cassidy (R-LA), Mike Crapo (R-ID), Ted Cruz (R-TX), Steve Daines (R-MT), Mike Enzi (R-WY), Deb Fischer (R-NE), James Inhofe (R-OK), James Lankford (R-OK), Mike Lee (R-UT), Jerry Moran (R-KS), Jim Risch (R-ID), Pat Roberts (R-KS), Marco Rubio (R-FL), Ben Sasse (R-NE), Tim Scott (R-SC), David Vitter (R-LA). In addition, Congressman Robert Aderholt (R-AL), Rick Allen (R-GA), Brian Babin (R-TX), Lou Barletta (R-PA), Andy Barr (R-KY), Gus Bilirakis (R-FL), Marsha Blackburn (R-TN), Charles Boustany, Jr. (R-LA), Kevin Brady (R-TX), Michael Burgess (R-TX), Earl \u201cBuddy\u201d Carter (R-GA), Tom Cole (R-OK), Chris Collins (R-NY), Doug Collins (R-GA), Mike Conaway (R-TX), Ron DeSantis (R-FL), Scott DesJarlais (R-TN), Jeff Duncan (R-SC), John Duncan, Jr. (R-TN), Stephen Fincher (R-TN), Chuck Fleischmann (R-TN), John Fleming, (R-LA), Bill Flores (R-TX), Jeff Fortenberry (R-NE), Virginia Foxx (R-NC), Trent Franks (R-AZ), Bob Gibbs (R-OH), Louie Gohmert (R-TX), Paul Gosar (R-AZ), Trey Gowdy (R-SC), Tom Graves (R-GA), Glenn Grothman (R-WI), Andy Harris (R-MD), Vicky Hartzler (R-MO), Jeb Hensarling (R-TX), Jody Hice (R-GA), Tim Huelskamp (R-KS), Bill Huizenga (R-MI), Lynn Jenkins (R-KS), Bill Johnson (R-OH), Sam Johnson (R-TX), Walter Jones (R-NC), Mike Kelly (R-PA), Trent Kelly (R-MS), Steve King (R-IA), Doug LaMalfa (R-CA), Doug Lamborn (R-CO), Robert E. Latta (R-OH), Daniel Lipinski (D-IL), Barry Loudermilk (R-GA), Mia Love (R-UT), Blaine Luetkemeyer (R-MO), Kenny Marchant (R-TX), Cathy McMorris Rodgers (R-WA), Rep. Mark Meadows (R-NC), John Moolenaar (R-MI), Markwayne Mullin (R-OK), Randy Neugebauer (R-TX), Pete Olson (R-TX), Steven Palazzo (R-MS), Gary Palmer (AL), Steve Pearce (R-NM), Collin Peterson (D-MN), Robert Pittenger (R-NC), Joe Pitts (R-PA), Ted Poe (R-TX), Bill Posey (R-FL), Tom Price (R-GA), John Ratcliffe (R-TX), Martha Roby (R-AL), Phil Roe (R-TN), Dana Rohrabacher (R-CA), Peter Roskam (R-IL), Keith Rothfus (R-PA), David Rouzer (R-NC), Steve Scalise (R-LA), Austin Scott (R-GA), James Sensenbrenner, Jr. (R-WI), Pete Sessions (R-TX), John Shimkus (R-IL), Adrian Smith (R-NE), Chris Smith (R-NJ), Ann Wagner (R-MO), Tim Walberg (R-MI), Randy Weber (R-TX), Brad Wenstrup (R-OH), Joe Wilson (R-SC), Kevin Yoder (R-KS), and Ted Yoho (R-FL) signed the letter.\nRead the full letter below or by clicking here.\n\u00a0\nThe Honorable Sylvia Mathews Burwell  \n\tSecretary  \n\tU.S. Department of Health and Human Services  \n\t200 Independence Avenue, S.W.  \n\tWashington, D.C. 20201\nDear Secretary Burwell,\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 We write to express our strong opposition to the Department of Health and Human Services (HHS) September 7, 2016, notice of proposed rulemaking titled \u201cCompliance with Title X Requirements by Project Recipients in Selecting Subrecipients.\u201d Although we appreciate the Department\u2019s intent to follow proper regulatory procedure pursuant to the Administrative Procedure Act, HHS\u2019s purpose for engaging in the rulemaking appears on its face to be an attempt to subvert the will of elected representatives.\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Moreover, apart from the Department\u2019s impetus for the notice of proposed rulemaking, we also question whether the Department\u2019s stated rationale adequately supports its conclusion that providers with a reproductive health focus are more \u201ceffective\u201d than other health providers that offer comprehensive care for women and men. Nowhere in the proposed notice of rulemaking does HHS clearly define what it means to provide Title X services in an \u201ceffective\u201d manner. It does appear to assert that a number of factors \u2013 such as the range of contraceptive methods on-site, the number of clients in need of publicly funded family planning services served, and the availability of preconception care \u2013 distinguish providers with a reproductive health focus as more \u201ceffective\u201d and \u201chigh quality\u201d than other types of providers. However, that list of factors falls far short of all of the attributes and recommendations included in the Centers for Disease Control and Office of Population Affairs report entitled \u201cProviding Quality Family Planning Services: Recommendations of CDC and the US Office of Population Affairs.\u201d\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 To further complicate the argument about quality and effectiveness, the data cited in the notice of proposed rulemaking is not adequate for determining patient outcomes. The Department relies heavily on utilization and demographic statistics, but appears to lack hard data regarding actual patient outcomes and need, as the Department does not require grantees to track patients or verify their income. As you know, the issue of inadequate data has previously been raised by the Institute of Medicine (IOM), after the HHS Office of Family Planning in 2007 asked IOM to provide a critical review of the Title X Family Planning Program. In addition to finding \u201cno clear, evidence-based process for establishing or revising program priorities and guidelines,\u201d IOM stated the following in its May 2009 Report Brief:\n\u201cThe committee concludes that the program does not collect all the data needed to monitor and evaluate its impact. Therefore, the committee proposes a comprehensive framework to evaluate the program and assess how well clinics meet the family planning needs of the program\u2019s clients. The committee concludes that additional data will be needed in the areas of client needs, structure, process, and outcomes in order to assess the program\u2019s overall progress.\u201d\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 We welcome evidence that this recommendation has been fully adopted, but are unaware of any clear evidence confirming that to be the case. If HHS cannot clearly define an \u201ceffective\u201d or \u201chigh quality\u201d provider, it is unclear to us how state and local project grantees are supposed to do so in order to comply with this proposed rule. It is also therefore unclear how HHS will be able to accurately determine in every case whether state or local project recipients \u2013 who are generally closer to and more familiar with subrecipients and the patient base in their geographical region \u2013 have considered inappropriate criteria in evaluating subrecipients. Rarely do the American people benefit when the federal government attempts to substitute its judgment for that of state or local governments \u2013 particularly when the criteria used to inform that judgment are unclear, and that judgment is not supported by coherent and impartial facts.\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Finally, if HHS is going to assert the authority to adapt its rules in order to address changing circumstances, we implore HHS to consider the recent general shift in health care policy toward comprehensive care. As HHS states on its website, in addition to assisting individuals and couples in planning and spacing births, part of the mission of Title X is to contribute to \u201cimproved health for women and infants.\u201d HHS\u2019s suggestion that subrecipients like federally qualified health centers \u2013 which provide greater preventive and primary health care services than providers with a reproductive health focus \u2013 are per se less \u201ceffective\u201d than providers with a reproductive health focus does not comport with that stated mission.\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 We urge HHS to reconsider this overreaching and ill-supported rule. We will continue to closely monitor this proposed rulemaking, and intend to submit this letter as a formal comment. We look forward to a detailed response from your Department.\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Sincerely,\n###", 1, "2026-03-30T12:14:52Z", "2026-03-30T12:14:52Z"]], "columns": ["url", "title", "date", "year", "month", "party", "chamber", "state", "member_name", "bioguide_id", "domain", "scraper", "source", "date_source", "text", "has_text", "collected_at", "updated_at"], "primary_keys": ["url"], "primary_key_values": ["http://hultgren.house.gov/newsroom/press-releases/hultgren-joins-effort-protecting-states-rights-by-opposing-hhs-title-x"], "units": {}, "query_ms": 0.754673033952713, "source": "dwillis/congress-press", "source_url": "https://github.com/dwillis/congress-press", "license": "MIT", "license_url": "https://github.com/dwillis/congress-press/blob/main/LICENSE"}