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Title X Family Planning Program

WHY IS CONTRACEPTIVE ACCESS IMPORTANT?

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.

APPROPRIATIONS

FY 2021 (October 1, 2020 - September 30, 2021) - Status: Complete  

On December 27, the President signed an omnibus appropriations bill, the “Consolidated Appropriations Act, 2021,” which funds the federal government through the end of FY 2021 on September 30, 2021. The bill also includes provisions that extend expiring health programs and provides some relief funding to help address the impact of the COVID-19 pandemic.

Importantly, the omnibus bill includes level funding ($286.5 million) for the Title X Family Planning Program. 

Unfortunately, the bill does not eliminate the domestic gag rule or the Hyde Amendment. The gag rule has severely damaged the Title X Program and the Hyde amendment disproportionately harms people of color and people of low income, putting access to abortion care financially out of reach. We look forward to working to undo these harmful policies.

Please see Power to Decide’s full statement on the omnibus appropriations bill.

If haven’t already seen it, we encourage you to take a look at Power to Decide’s recommendations on how the next Administration can advance reproductive well-being.

EXECUTIVE BRANCH THREATS TO TITLE X

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.

ADDITIONAL RESOURCES

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