Position

Healthy Teen Network supports continuation of the federal Title X family planning program, which provides federally funded health services to women and families, including preconception and prenatal healthcare, contraceptive care, and other health and screening services. We support sustained and increased funding of the Title X program. Healthy Teen Network opposes the exclusion of qualified family planning organizations from the Title X program.

Issue

Title X of the Public Health Service Act authorizes federal financial support for family planning health centers throughout the U.S. It is estimated that 4000 centers serve about 4 million beneficiaries annually.¹ The beneficiaries of Title X are among the most vulnerable women and men in the nation, including those who lack health insurance, adolescents who are uninsured or wish to have confidential services, and women who prefer confidential services who may be on a spouse’s insurance plan or who are experiencing or threatened with intimate partner violence.

The beneficiaries of Title X are among the most vulnerable women and men in the nation, including those who lack health insurance, adolescents who are uninsured or wish to have confidential services, and women who prefer confidential services who may be on a spouse’s insurance plan or who are experiencing or threatened with intimate partner violence.

This care must be provided without discrimination or threats to access to ensure equity of care and universal rights to family planning services.

Title X is the funding source for essential health services for many Americans. For example, for 40 percent of women, visits to Title X family planning health centers represent their sole access to health surveillance and primary care.² Title X is essential to the ability of women and their families to prevent and plan pregnancies. And it is documented that in 2010, Title X prevented 87,000 low birth weight or pre-term infants, 63,000 sexually transmitted infections (STIs), and 2,000 cases of cervical cancer.³ Limiting beneficiary access to Title X family planning health centers by eliminating the program, reducing funding for centers, or excluding qualified providers, would threaten many Americans’ access to general and sexual and reproductive health care.

Even though federal law restricts the use of Title X and other federal funds from being used for abortion services, opponents of Title X still wish to eliminate or de-fund the program as a means to prevent abortions. In actuality, the elimination of Title X could have the opposite effect and actually increase the rates of unintended pregnancies, births, and abortions. It is estimated that, in 2014, contraceptive care delivered by Title X providers helped women avoid 904,000 unintended pregnancies, including 439,000 unplanned births and 326,000 abortions.⁴ In other words, the unintended pregnancy and abortion rates would have been 33 percent higher and the teen pregnancy rate 30 percent higher if not for Title X.⁵

In 2017, the U.S. Congress overturned a federal regulation that would have prohibited state grantees of Title X from excluding qualified family planning providers or giving preferential treatment to specific types of providers. The Congressional Action is understood to give states authority to exclude Planned Parenthood Federation of America affiliates and other organizations that provide abortion services with non-federal funds from participating in their states’ Title X networks.

Supporting Information

Title X of the Public Health Service Act authorizes funding for health organizations to provide family planning services. This funding is predicated on the provision of comprehensive, full options counseling for pregnant women to make informed choices about the pregnancy. Options may include maintaining the pregnancy and accessing prenatal care and keeping the baby or placing the baby through adoption services.

Title X requirements ensure information about and access to abortion services, with counseling provided at appropriate times to ensure that abortion is an option. Title X funding ensures that family planning providers offer state-of-the art, highly effective, and long-acting reversible contraceptive methods (LARCs), including on-site and same day insertion. Seventy percent of Title X sites fill prescriptions for oral contraceptives on site, precluding transportation and other barriers to effective use of birth control pills.⁶

In addition to contraception, family planning, and birth spacing, Title X funding for family planning health centers allows for such services as preconception healthcare and counseling; STI testing and treatment; HIV testing, counseling, and referral; vaccines to prevent Human Papillomavirus (HPV); and PAP smears for early detection of cervical cancer. Pregnancy testing and full options counseling are also key components of family planning services. Family planning health centers also screen patients for many other potential health issues, including hypertension, diabetes, and depression.

To participate in the Title X program, grantees and family planning health centers must ensure that their services are accessible, affordable, evidence-based, voluntary, comprehensive, confidential, and respectful of beneficiaries.⁷