Title X, the Federal Family Planning Program, Is in Danger


Title X provides family planning and reproductive health services to low-income women. (Photo: Laura Johansen/Getty Images)

While the headlines of late have all been about gay marriage, lethal injection, and the Affordable Care Act, a major strike against women’s health care has been quietly mounting in Washington.

In preparing its budget proposal for the upcoming year, the GOP-led Congress has made moves to fully eliminate Title X, the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related reproductive health services, including contraception.

Ninety percent of the people Title X serves have incomes below 200 percent of the federal poverty level, and 63 percent are uninsured. Six in 10 women who access health care services from a Title X-funded health center consider this their main source of health care.

Funded at $286 million for fiscal year 2015, Title X has already sustained cuts totaling $31 million since fiscal year 2010, significantly reducing the number of patients served by its programs. There were 600,000 fewer individuals served by Title X programs in 2013 versus 2010 as a result of past cuts.

However, there’s evidence that Title X saves taxpayers money: For every public dollar invested in family planning, the American taxpayer saves approximately $7 in Medicaid-related costs. Nearly half of all births in the U.S. are paid for by Medicaid, the health care program for low-income families and individuals; the average national cost for one Medicaid-covered birth is $12,770. This is a stark contrast to the $239 per-client cost of publicly funded contraceptive care through Title X family planning. It is estimated, then, that Title X saves taxpayers nearly $7 billion a year.

Related: 4 Things You Should Know About the Link Between Birth Control and Financial Security

There’s also evidence that Title X prevents unintended pregnancies — 1.1 million in 2012, to be exact, according to the Guttmacher Institute. These pregnancies would have resulted in 527,000 unplanned births and 363,000 abortions. Without the services provided by Title X — which include Pap smears, breast exams, cancer screenings, sexually transmitted infection screenings, and HIV tests — it is estimated that the number of unplanned births and abortions would be 66 percent higher.

So if Title X reduces costs and reduces the abortion rate, why the opposition?

It might have to do with the fact that while more than half of Title X-funded clinics are public health departments and another 14 percent are federally qualified health centers, 13 percent are Planned Parenthood clinics, according to the National Campaign to Prevent Teen and Unplanned Pregnancy.

Planned Parenthood health centers provide preventive care to approximately 1.5 million women served by the nation’s family planning program — which is roughly one-third of Title X’s total client base. And while Planned Parenthood does offer abortions, Title X funding cannot in any way be used for those services.

Related: ‘I Set Her Free’: What One Woman Wants Lawmakers to Know About Her Late-Term Abortion

Yahoo Health has reached out for comment to conservative think tanks the Family Research Council, the Susan B. Anthony List, and Concerned Women for America, as well as the offices of Sen. Jeff Sessions, R-Ala., the ranking member of the Senate Budget Committee; Rep. Hal Rogers, R-Ky., the chair of the House Committee on Appropriations; and Sen. Roy Blunt, R-Mo., a member of the Senate Committee on Appropriations. This piece will be updated upon their response.

On a recent call with reporters, Sarah Brown, the outgoing CEO of the National Campaign to Prevent Teen and Unplanned Pregnancy, pointed out that since reaching an all-time high in the 1990s, teen pregnancy is currently down 61 percent, declining 29 percent between 2010 and 2014. Last month, the federal government announced that the nation’s teen birth rate declined a full 9 percent in 2014 alone. “As some of you have probably already figured out,” Brown said, “it just so happens that this steep and recent decline matches up exactly with the start of the focused federal investment in evidence-based programs to prevent teen pregnancy” — funding that comes from Title X.

The federally funded Teen Pregnancy Prevention program — another program proposed to be cut from the federal budget — is currently funded at $101 million, a tiny drop in the huge bucket of the annual federal budget. Brown noted that the Teen Pregnancy Prevention program has been held up as a “gold standard in evidence-based policymaking and a model for what we should be doing more of, not something to eliminate.”

Federal programs to prevent unintended pregnancy are not only effective but also popular: A survey of more than 1,000 U.S. adults from the National Campaign to Prevent Teen and Unplanned Pregnancy shows that 81 percent of people support government efforts to help women obtain access to birth control when they cannot otherwise afford it.

“The only way that women who are uninsured, who live in places where there is no other health care provider, or who’ve fallen through the cracks have access to these services” is through Title X-funded health centers, Cecile Richards, president of the Planned Parenthood Action Fund and the Planned Parenthood Federation of America, told reporters in a recent media call. “Leave it to this Congress, and this congressional leadership, to find the only program that actually works” in preventing teen pregnancy “and axe it at the first opportunity.”

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