Letter to Secretary Azar on Trump-Pence Title X gag rule

Monday, April 8, 2019

The Honorable Alex Azar         
U.S Department of Health and Human Services
200 Independence Avenue S.W.
Washington, D.C. 20201

Dear Secretary Azar:

As lieutenant governors representing 60 Million Americans, we join with several governors who are deeply concerned with the Trump-Pence administration’s new policy, the Title X gag rule, that will undermine women’s health and impose sweeping new restrictions on reproductive healthcare providers.

For more than 40 years, the Title X family planning program has been an important partnership between the federal government and states that has been supported by Democrats and Republicans alike. As the only federal program dedicated to the delivery of family planning and related health care services, the Title X program provides access to essential health care services for more than 4 million patients.

Yet, this Administration just released a final rule, known as a domestic gag rule, that undermines the Title X family planning program. The Title X gag rule prohibits health care providers in the program from providing comprehensive, medically accurate information to their patients. Specifically, it makes it illegal for health care providers in the Title X program to refer patients for an abortion.

These politically-motivated restrictions not only threaten access to reproductive healthcare for millions of vulnerable women and men, it upends decades of bipartisan cooperation. It is also notable that the Title X gag rule is opposed by every major provider association, from the American Medical Association, American Nurses Association, National Medical Association, American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, National Association of Community Health Centers.

In addition, 10 newly elected governors joined 14 Democratic governors who have already publicly challenged the Title X gag rule.   

We stand with women and men in our states by rejecting this Administration’s efforts to
interfere in the doctor-patient relationship, gut women’s access to family planning
services, and force medical professionals to knowingly withhold information from their

We strongly urge you not to undermine the important work that our states and administrations of both parties have done for decades to support women and families through Title X. Our voices will be heard, and we are prepared to match our words with action.  We will continue to consult with our states’ Governors, Attorneys General, state legislatures, and state health agencies to stop this rule from harming the millions of women we are sworn to protect.


Lt. Governor Bethany Hall-Long

Lt. Governor Mike Cooney
Executive Committee Member

Lt. Governor Kathy Hochul
New York
Executive Committee Member

Secretary of State Katie Hobbs

Lt. Governor Susan Bysiewicz

Lt. Governor Josh Green

Lt. Governor Garlin Gilchrist II

Lt. Governor Peggy Flanagan

Lt. Governor Kate Marshall

Lt. Governor Dan McKee
Rhode Island

Lt. Governor David Zuckerman

Lt. Governor Mandela Barnes