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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 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.

But regulations put in place by the Trump Administration (the Title X “domestic gag rule), and years of underfunding have made it harder for health centers supported by Title X to meet the demand for services. Take action now to help Title X.

Read about private and public insurance for contraception.

APPROPRIATIONS

FY 2022 (October 1, 2021 - September 30, 2022) - Status: In Progress

The latest: On July 29, 2021, the U.S. House of Representatives passed HR 4502, a funding package for Fiscal Year (FY) 2022. Among other things, the bill provides $400 million for the Title X Family Planning Program, which is an increase of $113.5 million over the current funding level. The bill also eliminates the Hyde Amendment, as well as bans on coverage of abortion care for federal employee health insurance plans and for Medicaid beneficiaries in the District of Columbia. You can read Power to Decide’s full statement on the House’s passage of this historic bill.

Please reach out to thank your member in the House if they voted for this bill that provides critical investments in the TPP Program.

What's Next: It is unknown when the Senate will consider its version of an appropriations bill that funds the TPP Program and Title X, but it’s important that your Senators hear from you. Contact your Senators now, especially if they are on the Senate Appropriations Committee and urge them to provide robust funding for Title X as the House-passed bill HR 4502 does. If you can only educate, there is still value in contacting your Senators to share the important work that this funding is supporting in your community.

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.

TITLE X DOMESTIC GAG RULE

2019 Final Title X Domestic Gag Rule 

In August 2019, the Trump Administration damaged the Title X program severely by enforcing the “domestic gag rule.” Put simply, the domestic gag rule has forced health centers that receive Title X funds to make an impossible choice—reject the Title X funds they need to support their patients who might not otherwise be able to afford family planning care or withhold some information from patients about abortion services, including where to access abortion care. Nationwide, more than 900 clinics have left the Title X program since the gag rule went into effect. Between 2018 and 2019 (when the gag rule went into effect) the Title X program served 844,000 fewer patients, a 21 percent decline in a single year.

Action by the Biden-Harris Administration and the 117th Congress

While legal challenges to the Title X gag rule continue (and the Supreme Court recently agreed to hear the case), the work to undo the rule must proceed. Fortunately, on January 28, 2021, President Biden instructed HHS to review the Title X gag rule and consider rescinding it. HHS has announced they will begin this process by April 15, 2021, and they aim to have the Title X gag rule replaced by Fall 2021.

Separate from the Appropriations process, in March 2020, the American Rescue Plan (P.L 117-2) included a one-time investment of $50 million in funding for Title X. This will help bring clinics back into the program once the domestic gag rule is replaced. These funds are not tied to the fiscal year and will be available until expended. (See Power to Decide's statement on the American Rescue Plan.)

For more information on the domestic gag rule, see:

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