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Title X Family Planning Program


Women who decide to become pregnant, rather than having it “just happen,” are better prepared emotionally and financially for the demands of parenting. But they can’t make that decision if they lack access to contraception.

Forty-five percent of pregnancies among all women are described by the women themselves as unplanned. Women under age 30 account for the majority of these (nearly 2 million of the 2.8 million unplanned pregnancies in the US). We have seen progress in recent years—as unplanned pregnancies have begun to decline—but more work remains to ensure that everyone has the power to decide.

Unlike many other health issues, unplanned pregnancy is completely preventable. Only 5% of unplanned pregnancies occurred in women using birth control carefully and consistently. The other 95% of unplanned pregnancies occur among women who don’t contraception or who use it inconsistently.

The reasons for this are complex, but it often comes down to a lack of access to the full range of contraceptive options. This is particularly important for people who face the greatest disparities in unplanned pregnancy. For example, the unplanned pregnancy rate remains higher for black and Hispanic women than for white women, and these disparities remain even when controlling for income.

About the Title X Family Planning Program

For nearly 50 years, the Title X family planning program has played a critical role in preventing unplanned pregnancy by offering high-quality contraceptive services, preventive screenings, and health education to low-income women and men. In addition to Medicaid, Title X is an important part of the health care safety net.

Read about private and public insurance for contraception.

What Can You Do to Protect Title X?

If you can advocate, please call or email your Senator and urge them to do the following: "As the Senate works on the FY 2020 LHHS Appropriations bill, please support $400 million for the Title X Family Planning Program and prohibit the use of FY 2020 funds to implement the Administration’s domestic gag rule, as the House-passed bill does."

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FY 2020 (October 1, 2019  - September 30, 2020) - Status: in progress

The Latest

On November 21st, Congress passed and the President signed another continuing resolution (CR) to fund the government through December 20th. This gives Congress more time to work through LHHS and other appropriations bills.

It’s still essential to keep up the drumbeat with your Senators. Call or email and urge them to do the following: ““As the Senate works on funding for FY 2020, please support $400 million in funding for the Title X Family Planning Program, and an amendment that protects the integrity of this critical program." 

We made it easy for you to activate your network. Please share this link with others so they can send emails to their members of Congress with just one click.  

What's happened so far this year on appropriations

On June 19, 2019, the House voted to pass the FY 2020 Labor, Health and Human Services, and Education (LHHS) Appropriations bill, as part of a so-called minibus package that included three other spending bills. The bill, HR 2740, passed largely along party lines (226-203). Like the bill passed by the House Appropriations Committee on May 8th, it includes $400 million in funding (an increase of $113.5 million) for Title X and prohibits the use of fiscal year 2020 funds to implement the Administration's domestic gag rule.

The Senate was scheduled to begin considering their version of the LHHS Appropriations bill during the week of September 9. Senator Murray planned to offer an amendment in the LHHS Appropriations subcommittee to protect Title X, but those efforts were thwarted when Subcommittee Chairman Blunt cancelled the mark-up.

On September 18, Chairman Blunt released a draft LHHS Appropriations bill that ignores the House-passed H.R 2470. Instead the Senate version would provide level-funding for the TPP Program and Title X—without any of the protections included in the House bill—as well as a funding increase for Sexual Risk Avoidance. No mark up has been scheduled for the Senate to consider their version of the LHHS bill. 

Meanwhile, in order to avoid a government shutdown, Congress passed its first FY 2020 CR on September 26 that the President signed the following day. The CR funded the government through November 21. (Power to Decide's statement on the CR is here.)


Final Title X Rule 

On February 22, 2019 the Trump Administration issued the final rule for the Title X Family Planning Program, commonly referred to as the "domestic gag rule." The final rule disallows Title X funding to provide high-quality, affordable contraceptive services in health centers that also offer abortion services, unless those services are offered at a physically separate site. In addition, the rule allows health providers at sites that receive Title X funds to not provide information about abortion alongside other pregnancy options, as well as effectively banning providers from referring for abortion. See Power to Decide's full statement on the final rule. 

The rule is the subject of numerous lawsuits. As such, a nationwide preliminary injunction was issued in April 2019 to temporarily halt the final rule from going into effect while the rule is being disputed. Ultimately, the Trump Administration prevailed in its challenge to have the nationwide preliminary injunction set aside. 

During the week of July 14, HHS announced its plans to begin enforcing the domestic gag rule. As a result, a number of organizations have withdrawn from the Title X program, citing the withholding of information from their patients as medically unethical. This means these organizations have to rely on other funds while the legal challenges continue to make their way through the courts.

In the meantime, people most in need are paying the price of the domestic gag rule.


Title X Resources

Key Points on Title X and Contraceptive Access 

  • 75% of adults favor continuing the Title X Program, including 66% of Republicans and 84% of Democrats.
  • 78% of adults agree that birth control is a basic part of women’s health care.
  • More than 90% of all Americans (across political parties, race, and ethnicity) agree that for those trying not to get pregnant, using birth control is taking personal responsibility.
  • Ensuring women have the power to decide if, when, and under what circumstances to get pregnant and have a child improves educational attainment and family well being, saves taxpayer dollars, and reduces abortion.

State-specific Resources