Embedded in the authorizing law itself is a strict prohibition on its funds being used for abortion demonstrating the intent of Congress that Title X should be completely apart from the controversial and, at that time, still mostly illegal activity of abortion. In fact, it was argued that Title X was needed in order to reduce the abortion rate.
In spite of this prohibition, the program guidelines governing the early years of the program soon required abortion referrals and allowed abortion providers to perform abortions in the same location, arguably allowing the program to become a direct channel for abortion providers to receive clients as well as federal money for their non-abortion offerings.
To respond to this abuse, President Reagan issued formal regulations in 1987 requiring that Title X service sites be physically and financially separated from abortion centers and not refer or counsel for abortion. These regulations were challenged and successfully defended by the Bush 41 Administration in the U.S. Supreme Court case Rust v. Sullivan of 1991. However, they were rescinded in January of 1993 under President Clinton and replaced by regulations later that year requiring abortion referrals and allowing co-location of Title X clinic sites with abortion sites.
