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Cutting Title X Family Planning in the Sequester Hurts Women’s Reproductive Health

Community health care

SOURCE: AP/Seth Wenig

Tiffany Ashe prepares her son Aaron Ashe for his check-up at the William F. Ryan Community Health Center in New York, Wednesday, June 27, 2012.

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If the automatic across-the-board budget cuts known as the sequester are allowed to take effect tomorrow, Title X—our nation’s family-planning program—could be cut by $15 million in fiscal year 2013.* The cut would be a significant blow to Title X, which has already been cut by more than $23 million over the past two fiscal years—limiting access to family-planning services and causing clinics to cut back on staff and hours.

For more than 40 years, Title X has served primarily low-income women, who rely heavily on community health centers for their reproductive health care. Cutting this vital women’s health program is just one of many examples of the ways in which sequester cuts would harm the most vulnerable Americans—all for the sake of protecting the wealthy few from higher taxes. The sequester cuts millions of dollars from a number of other key programs serving women.

Here is what you need to know about the critical role that Title X plays in access to reproductive health services around the country.

  1. Title X clinics provide a range of services, including breast and cervical cancer screenings; Pap smear tests; prevention and treatment of sexually transmitted infections, or STIs; HIV testing, prevention, and counseling; infertility services; and health care referrals. In 2010 alone Title X provided 1.8 million Pap smear tests, 2.2 million breast exams, 6.1 million STI tests, and 1.1 million confidential HIV tests. Six out of 10 women who visit Title X clinics consider them a primary source of health care.
  2. One-quarter of all poor women who obtain contraceptive services in the United States do so at a Title X-supported center. Title X is a crucial funding stream for public and community health centers around the country—expanding access to family-planning and reproductive-health services for poor women by allowing services to be offered in their communities. Ninety-one percent of all Title X clients earn less than $28,000 a year.
  3. Title X has helped millions of women prevent unintended pregnancies. Unplanned pregnancies are associated with a range of negative health, social, and economic outcomes for women and their children. Nearly half of all pregnancies in the United States are unintended, and the rates are even higher for young women. Sixty-nine percent of pregnancies of women between the ages of 20 and 29 are unplanned, and nearly half of unplanned pregnancies for the same age group are experienced by women living below 100 percent of the federal poverty line. It is estimated that overall levels of unintended pregnancy would be one-third higher without the services provided through Title X-supported centers.
  4. Title X saves money. Every $1 invested in family-planning care averts nearly $4 in Medicaid expenditures. The total public cost of unintended pregnancies is estimated at $11 billion a year, and that cost would be even higher without the critical family-planning services provided to women though Title X funding. Title X is estimated to prevent more than 900,000 unintended pregnancies each year.
  5. Title X has raised national standards for providing high-quality care that meets the unique health needs of women. Title X is the first and only federal program focused exclusively on the provision of contraceptive services and reproductive health care. The program sets national policies and standards ensuring that clients receive high-quality reproductive health care. Title X clinics have worked to clear obstacles to women’s access to contraception by specializing care to overcome language barriers and meet special health needs, including the health needs of young women.
  6. Title X is important for all women regardless of their income or insurance status because it funds specialized providers that offer women the care that they need. Whether a woman is covered by Medicaid, private insurance, or is uninsured, she needs access to a provider that offers a range of reproductive health services. Because Title X funding is flexible and can be offered to a diverse range of grantees, the program has effectively partnered with other public and private entities to create a vast network of reproductive health providers in every state, which benefits all women regardless of income by providing facilities where they can go to receive high-quality and specialized reproductive health care. As of 2011 there were more than 4,000 providers receiving Title X funds in the United States.

Title X has already been cut substantially in the deficit-reduction efforts of late, but cutting this cost-effective and crucial health service for women is more likely to hurt the country’s financial prospects than improve them. It’s a perfect example of why the blunt across-the-board spending cuts set to take effect tomorrow should be avoided in favor of a thoughtful and balanced approach to deficit reduction that protects crucial investments in programs such as family-planning services.

Lindsay Rosenthal is a Research Assistant for the Women’s Health and Rights team and Health Policy team at the Center for American Progress.

* Author’s calculations based on ‪Angela Napili, “Title X (Public Health Service Act) Family Planning Program” (Washington: Congressional Research Service, 2013), available at https://www.fas.org/sgp/crs/misc/RL33644.pdf.

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