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.
FY 2023 (October 1, 2022 - September 30, 2023) - Status: In process
On March 28, President Biden released his fiscal year (FY) 2023 budget request, which proposes increasing funding for the Title X Family Planning Program from its current level of $286.5 million to $400 million.
Please see Power to Decide’s full statement on the President’s proposed FY 2023 budget.
As a reminder, the President’s budget is just the first step in the appropriations process; Congress ultimately decides what gets funded.
As that process begins to unfold, we’ll share what you can do to help ensure that the TPP Program and Title X get the funding they need to continue their critical work around the country. Check back in April for updates.
FY 2022 (October 1, 2021 - September 30, 2022) - Status: Complete
The latest: On March 15, President Biden signed H.R 2471, an omnibus appropriations bill to fund the federal government through fiscal year (FY 2022), which ends on September 30, 2022. Among other things, the bill provides level funding of $286.5 million for the Title X Family Planning Program.
We are disappointed that this appropriations bill does not include a funding increase for Title X. For more information about the bill, please see Power to Decide’s full statement.
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. The Department of Health and Human Services estimates that between 2018 and 2020 there was a total decrease of people served by Title X clinics of 2.4 million. Of that amount, 63% or (1.5 million) was the direct result of the gag rule.
Action by the Biden-Harris Administration and the 117th Congress
In October 2021, the Department of Health and Human Services issued a final rule for the Title X Family Planning Program that eliminates the Trump Administration’s harmful “domestic gag rule.” The new rule eliminates restrictions and paves the way for health centers forced out of the program to rejoin the network of Title X clinics. The rule will take effect November 8, 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. 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.)
- FY 2020 to FY 2023 Budget Chart
- Power to Decide's FY 2023 Appropriations Request Letter
- Federal Funding Streams at a Glance
- Power to Decide's 2021-22 Federal Policy Agenda
- Power to Decide’s recommendations on how the Administration can advance reproductive well-being
- State Resources on Reproductive Well-Being - Visit our one-stop shop that includes state specific data sheets, state profiles, and more
Title X Resources
- Power to Decide's statement on the elimination of the Title X Domestic Gag Rule
- Impacts of the Domestic Gag Rule: People Most in Need Are Paying the Price
- State Responses to the Title X Domestic Gag Rule
- Power to Decide's statement on the final gag rule.
- Fact Sheet: Key points on Title X
- Polling data: Shows widespread support for Title X
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.