Title X Family Planning
Facts About Title X—The National Family Planning Program
The national family planning program, Title X of the Public Health Service Act, was established in 1970 with broad bipartisan support. The original measure was introduced by then Representatives James Scheuer (D-NY) and George Bush (R-TX) and Senators Joseph Tydings (D-MD) and Charles Percy (R-IL). The program provides federal funds for project grants to public and private nonprofit organizations for the provision of family planning information and services. Title X-funded clinics provide confidential services to low-income Americans that:
- Decrease the incidence of unintended pregnancy
- Improve maternal and infant health
- Reduce the incidence of abortion
- Lower rates of sexually transmitted diseases (STDs)
What services does Title X provide?
- Contraceptive information and services
- Gynecological examinations and basic lab tests
- Screening services for STDs, HIV, high blood pressure, anemia, and breast and cervical cancer
- Pregnancy testing
- Sterilization services
- Natural family planning
- Community education and outreach
Title X prohibits the use of federal funds to pay for abortions.
Where do people receive services?
- Services are provided through a network of approximately 4,600 clinics. The clinics are located in each state, 85 percent of all U.S. counties, and every congressional district in the nation.
- Title X funded clinics include state, county, and local health departments, hospitals, university health centers, Planned Parenthood affiliates, independent clinics, and public and non-profit agencies.
Region VIII includes:
Colorado, Montana, North Dakota, South Dakota, Utah and Wyoming.
Who receives services through Title X?
- The Title X program provides the framework for family planning service delivery throughout the United States. Federal funds flow through approximately 80 regional grantees, who then determine which local providers receive funding.
- Clinics that receive Title X funds are required to follow uniform regulations and guidelines that guarantee women access to contraceptive counseling, a range of contraception options, confidentiality of services, and referral for other health and social services when necessary. The federal regulations and guidelines often serve as the blueprint for state family planning programs.
- Title X funds comprise approximately one quarter of the budget for clinics providing federally subsidized family planning services. These funds are critical in maintaining family planning service delivery in the United States.
Why Does the United States Need a National Family Planning Program?
Family planning works.
- Each year 1.3 million unintended pregnancies are averted among women who receive services at Title X-funded clinics (The Alan Guttmacher Institute, "Contraceptive Services," 2005).
- Title X family planning services reduce the need for abortion. Federal law specifies that "None of the funds appropriated under this Title shall be used in programs where abortion is a method of family planning" (P.L. 91-572, Family Planning Services and Population Research Act).
- As contraceptive use has improved and unintended pregnancies have declined, the number of abortions in our country has dropped. According to data from the Centers for Disease Control, the abortion rate in the U.S. has declined by about 25 percent since 1990 (CDC, "Pregnancy rate down from peak; births and abortions on the decline," 2003).
- Family planning is a basic health service that is a key contributor to healthy families and healthy babies. Women who practice family planning can prevent high-risk births and reduce their chances of having a baby who will die in infancy.
- The services provided by Title X family planning clinics have prevented 20 million pregnancies and 9 million abortions over the past 20 years (Sonfield A. "Preventing Unintended Pregnancy: The Needs and the Means," The Guttmacher Report on Public Policy Vol. 6, No. 5, 2003).
- Title X provides services to women and adolescents before they become pregnant—unlike Medicaid, which generally provides family planning services only after a pregnancy has occurred.
- Americans support federally-funded family planning. In a poll conducted by the Kaiser Family Foundation in June of 2000, 87 percent of the survey participants said they thought it was important for federal officials to fund family planning services such as birth control counseling and services for low-income women.
The Need for Title X is Clear.
Unintended Teen Pregnancy
- Title X is a critical component of a national strategy to lower the incidence of teen pregnancy.
- Recent data show that the United States' teen pregnancy rate dropped 28 percent between 1990 and 2000 (The Alan Guttmacher Institute. "U.S. Teenage Pregnancy Statistics: Overall Trends, Trends by Race and Ethnicity and State by State Info," 2004).
- About 25 percent of the decrease in teen pregnancies since the late 1980s is due to a decrease in sexual activity, and 75 percent is due to more effective contraceptive practice among teenagers. Between 1999 and 2000, the teenage pregnancy rate (including births, abortions, and miscarriages) declined by two percent, the teenage birthrate declined by two percent, and the abortion rate declined by three percent (The Alan Guttmacher Institute. "U.S. Teenage Pregnancy Statistics: Overall Trends, Trends by Race and Ethnicity and State by State Info," 2004).
- Each year, almost one million women aged 15—19 become pregnant; resulting in over a half a million births.
- The teenage pregnancy rate in the United States is higher than in many other developed countries—twice as high as in England/Wales or Canada; and nine times as high as in the Netherlands or Japan (Singh S, Darroch J.E. "Adolescent Pregnancy and Childbearing: Levels and Trends in Developed Countries" Family Planning Perspectives. Vol 32, No. 1, 2000).
- Publicly-funded family planning services have helped prevent 5.5 million teen pregnancies over the last two decades (Gold RB. "Title X: Three decades of accomplishment," The Guttmacher Report on Public Policy. Vol 4 No 1, 2000).
Sexually Transmitted Infections and Diseases (STI/STD)
- Title X family planning clinics can play a critical role in addressing our national STI/STD epidemic and can help to reverse this hidden epidemic by providing confidential screening and treatment for STI/STDs.
- In the United States, approximately 18.9 million people are diagnosed with an STI/STD each year. One quarter of new cases occur in teens 15-19 years old, and nearly half of all new cases occur in people ages 15-24 (Weinstock H., et al. "Sexually Transmitted Diseases Among American Youth: Incidence and Prevalence Estimates 2000." Perspectives on Sexual and Reproductive Health Vol 36, No. 1, 2004). Three STI/STDs—human papilloma virus (HPV), trichomoniasis, and chlamydia—account for 88 percent of all new STD diagnoses in 15-24 year olds (American Social Health Association. "State of the Nation 2005: Challenges facing STD prevention in youth," 2005).
- STI/STD infections are more likely to be asymptomatic in women, resulting in delayed diagnosis and treatment. Women are biologically more susceptible to certain STI/STD infections and bear a disproportionate burden of STI/STD-associated complications than men, such as infertility, ectopic pregnancy, and chronic pelvic pain.
- A conservative estimate of the public and private costs of STI/STD treatment each year in the United States is at least $13 billion (Chesson HW, et al. "The estimated direct medical cost of STI/STDs among American youth 2000" Abstract P075 National STD Prevention Conference, Philadelphia, PA. March 8-11, 2004). STDs also have a high human cost in the form of pain, suffering, and grief.
- At least one in three sexually-active people are estimated to have contracted an STD by the age of 24. The large majority of new STI/STD cases in the United States occur among people 24 years old and younger; a quarter occurs among 15-19 year olds and 42 percent among 20-24 year olds (Dailard C. "Family planning clinics and STI/STD services" The Guttmacher Report on Public Policy, Vol 3 No 3, 2002).
Family Planning is Cost-Effective Yet Under-Funded
Increased funding for Title X is Critical
- Each public dollar spent to provide family planning services saves an average of $3 in Medicaid cost for pregnancy-related and newborn care alone (The Alan Guttmacher Institute, "Contraceptive Services," 2005).