There has been a lot of buzz in the media recently about Planned Parenthood and the federal government’s ability to pass laws that may interfere with reproductive health services. Unfortunately, this is not a new topic of discussion for lawmakers. In fact, it has been pervasive in politics since Planned Parenthood first started distributing birth control pills in the ’60s. Now, in 2019, we seem to be back where we started. Except, instead of birth control pills, lawmakers are targeting federal funds that make it possible for many low-income families to afford contraception and wellness check-ups.
I know for me, it always takes a shocking development in the news like this to remember the privilege I hold as someone with healthcare benefits, easy access to a doctor, and a breast cancer screening or Pap test if I need one. But there was also a time when I needed Planned Parenthood before I could pay for its services. A time when I walked up to a counter and asked for a pregnancy test when I was in high school. A time when I breathed a sigh of relief when that test came back negative and the woman helping me shoved a wad of condoms in my hand as I dashed out the door. A time when I was completely naive that I was directly benefiting from funds and government grants that I didn’t even know existed. I am — was — lucky.
It’s hard to know exactly what the fate of Planned Parenthood and other small publicly-funded family planning clinics will be as the changes to Title X slowly take effect this year and next. But what is certain is the type of positive impact these kind of resources can have on disenfranchised communities, and also on ill-equipped teenagers, like I was. If you’re still curious about the history of Title X and what the recent restrictions will mean for Planned Parenthood and the families they serve, read everything that we know so far about the recent changes and what you can do to help:
What is Title X?
Title X is a program within the Public Health Service Act that provides low-income families (in particular) with access to family planning tools like contraception and wellness screenings with the use of government-appropriated funding. Every fiscal year, Congress determines the amount of funds to set aside for Title X through a discretionary appropriations process. This process can cause the federal Title X budget to vary substantially every year, or remain the same, based on the federal budget objectives of the White House Office of Management and Budget, and by extension, the president.
In 1971, for example, the year after Title X began, federal funds totaled $6,000,000. From 2009 to 2010, funding saw an $10 million increase, reaching $317,491,000 in 2010 under the Obama administration. From there, funds ultimately decreased in 2011 and leveled out at $286,479,000 in 2015, where they have remained for the past five years.
Why is Title X Important?
Title X is currently the only program in the United States that puts federal funding towards family planning services, according to the National Family Planning & Reproductive Health Association. These programs help many low-income families gain access to and afford resources that provide healthcare services like Pap tests, wellness exams, and breast cancer screenings, as well as access to affordable birth control, contraception, and STI testing and treatment.
In 2019, healthcare clinics with Title X funding administered 2,142,561 chlamydia tests, 1,237,968 HIV tests, performed 625,808 Pap tests, as well as 816,202 breast exams, 6 percent of which resulted in a referral to conduct further tests when abnormalities were found. In addition to STD testing and cancer screenings, Title X-funded clinics also helped 2.7 million women begin or continue their preferred use of contraception from IUDs and hormonal birth control pills, to male condoms and vaginal rings.
What Effect Does Title X Funding Have on the United States?
While the positive influences of Title X are undeniable at an individual level, it is estimated that Title X services prevent approximately 1 million unintended pregnancies every year in the United States, according to estimates from the Guttmacher Institute. In addition to preventing pregnancy and saving many families from the economic strain often associated with additional children, Title X-funded services, combined with the services provided by other publicly funded family planning programs, ultimately helped federal and state governments save a whopping $13.6 billion in expenses related to healthcare in 2010, according to the Planned Parenthood Action Fund. This staggering number not only signifies the importance of publicly funded health programs and services, but also the impact that federally funded programs can have on the nation’s economy.
How Does Planned Parenthood Use Funds from Title X?
As one of the largest providers of family planning services in our country with over 600 centers nationwide, Planned Parenthood is the most convenient healthcare resource for many low-income families. When individuals are uninsured or do not meet the eligibility standards of Medicaid or other state-funded healthcare programs, they can still gain access to the type of reproductive care they require via an organization like Planned Parenthood with the help of federal grants like Title X. This means women living below the poverty line have access to a wide-range of contraception and birth control methods, sex education, and breast cancer screenings and Pap tests, without fear of cost or paying directly out of pocket.
While clinics and healthcare centers that provide abortions are permitted to use Title X funding for some of their offerings, it is a common misconception that this money also goes directly to abortion services. This has never been the case and, in fact, the presence of such federal funds and grant programs have actually been found to result in a decrease in abortion rates and unwanted pregnancies. What’s more, Title X makes it possible for low-income women to receive unbiased counseling and Planned Parenthood the ability to follow the mission at the heart of the organization’s creed: Care. No matter what.
How Has Title X Changed and How Does it Affect Planned Parenthood?
In March of 2019, the Trump administration proposed changes to Title X that would ban clinics and centers that receive Title X funding from referring patients to abortion providers or performing abortions, as NPR reported. These changes also stipulate that pregnant patients are required to be referred to prenatal centers regardless of the patient’s choice. And while many prenatal centers can be a great resource for expecting mothers, some of these centers, also known as crisis pregnancy centers, have an anti-choice agenda that would not provide adequate counseling for a woman seeking to end a pregnancy.
Perhaps the most challenging component of the Title X changes, however, center around the attempt to narrow the network of providers that are eligible to receive Title X funding. According to the new rules, clinics that provide abortion services are not to receive Title X funds unless they abide by a series of stringent physical and financial requirements to separate Title X activities from the activities that involve abortion procedures, per The Atlantic.
These new regulations would make it very difficult for clinics that offer abortion services, like Planned Parenthood, to also continue taking Title X funds out of fear that they would be subject to expensive renovations to meet the new standards or forced to close. Many proponents of the changes argue that resisting the new guidelines simply signal an unwillingness to comply. But as we have seen in the past, TRAP laws and their facility improvement guidelines have had a devastating success rate at closing family planning centers across the country. In states like Texas, for example, the amount of women who live more than 100 miles away from the closest abortion clinic nearly tripled between 2013 and 2014 due to the implementation of TRAP laws.
How Have Lawmakers Fought Back Against Title X Changes?
According to reporting from NPR, Planned Parenthood decided to forego their Title X-funded status to remain unaffected and continue providing high-quality and unbiased care. In some states, however, local governments are working to ensure that there is still access to care.
Governor of Illinois J.B. Pritzker, for example, recently signed into law the Reproductive Health Act as a means to thwart any attempts to restrict contraception access. The Illinois Department of Public Health also plans to set aside $2.4 million in funding to grantees who previously benefited from Title X in an effort to soften any blows caused by lack of federal funding. And in Hawaii, state lawmakers likewise set aside funds to help avoid any potential lapses in care. Providers are also relying on awareness from the public to spread the word and support reproductive health clinics like Planned Parenthood and the patients that benefit from their services.
What Can You Do to Help?
Many states have already taken the initiative to set aside funds for any financial repercussions that will be felt as a result of Title X funding losses, but you can also make a donation directly to Planned Parenthood to show your support. Additionally, you can call Congress using this number, 202-601-3441, and talk directly to your representatives. Or participate in a walk or an event hosted by NARAL, a nonprofit organization at the center of the pro-choice movement.
For a more long-term solution, you can make a concerted effort to buy products from corporations that are not affiliated with re-election efforts of politicians who support decreased funding to the government services you support. You can also register to vote either online or in-person and begin participating in House and Senate races with each election cycle.
It may feel like there isn’t enough energy in the world to push against the forces that are actively fighting against you. But the truth is, we all have the power to decide what level of energy we are willing to invest in long-term change and the more people decide to take action — even if it’s small — the more those actions will accumulate to greater influence. In the case of Title X, there has already been a lot of positive momentum in the direction of resistance, and if you’re not ready to make a donation or scrawl a catchy saying on a protest sign, simply staying informed is a great place to start.