Sens. Tom Carper and Chris Coons joined more than 200 of their colleagues in sending a letter to Secretary of Health and Human Services Alex Azar expressing opposition to the implementation of a domestic gag rule on Title X, the federal grant program dedicated to the family planning and related preventative services.

The Congress members on this letter outnumber the House and Senate Republicans who urged the Donald Trump administration to implement the rule in April.

Each year, roughly 4 million people rely on Title X-funded health centers for basic preventive health care, including cancer screenings, birth control, sexually transmitted infection screenings, pregnancy testing and well-woman exams. In Delaware, 28 Title X providers have helped provide care to more than 18,000 Delawareans. In keeping with longstanding legal, ethical and medical standards of health care, Title X providers can offer patients medically accurate counseling on and referrals for all pregnancy options-including parenting, adoption and abortion.

“The domestic gag rule would bar patients from receiving information to support their ability to make informed decisions about their own reproductive health,” wrote the members of Congress. “We strongly oppose efforts to undermine the integrity of the Title X program and harm the millions of people who rely on it for care. Federal health policy should be evidence-based and produced with the best interests of patients in mind.”

Reinstatement of the gag rule, which has never been fully implemented, would be President Trump's latest attempt to fulfill his pledge to "defund Planned Parenthood," whose health centers serve 40 percent of the patients who go to Title X for contraceptive care. If Planned Parenthood were eliminated as a Title X-funded provider, other Title X-funded health centers would have to expand their contraceptive caseloads by an average of 70 percent. The move would disproportionately impact communities of color, the uninsured and low-income individuals, and could reverse progress made in critical areas. Title X has helped Delaware women avoid 3,600 unintended pregnancies, which would have resulted in 1,700 unplanned births and 1,300 abortions. Title X also yields critical cost savings to the American health care system — every dollar invested in Title X saves more than seven dollars in Medicaid-related costs.

Nearly two-thirds of Title X patients have incomes at or below the federal poverty level, and 43 percent of patients are uninsured. In 2016, nearly 4,000 Title X-funded health centers provided 720,000 Pap tests, nearly 1 million women with breast exams and 1.2 million HIV tests. Title X providers offer confidential, medically accurate and evidence-based care. Implementing a domestic gag rule would do harm to the patients across the country who count on the standard of medical care provided by these health centers.