Title X: America’s Family Planning Program

• The Title X program provides comprehensive family planning services. This consists of a broad range of contraceptive methods, including fertility awareness-based methods ("natural family planning"), and related counseling.
  
  
• Title X programs also offer a wide range of other preventive health care services, including
  • breast exams and instruction on breast self-examination
  • Pap tests for early detection of cervical cancer or precancerous conditions
  • testing for high blood pressure, anemia, and diabetes
  • screening and appropriate treatment for sexually transmitted infections (STIs)
  • HIV screening
  • safer-sex counseling
  • basic infertility screening
  • counseling on adoption, foster care, and pregnancy termination
  • referrals to specialized health care
    
    
• Title X funds are not used for abortion. By law, no Title X funds may be spent on abortions.

Who Uses Title X?

• Title X funds are not used for abortion. By law, no Title X funds may be spent on abortions.
  
  
• Each year, more than five million women receive health care services at approximately 4,500 family planning clinics funded by Title X.
  
  
• Title X-supported clinics are open to all women, regardless of age, marital status, income, or health insurance status.
  
  
• Title X patients are predominantly poor and uninsured; approximately 65 percent have incomes at or below the federal poverty level.
  
  
• Sixty-one percent of women using Title X clinics are 20 years or older.
  
  
• It is estimated that these clinics are the only source of family planning for more than 80 percent of the women they serve.
  
  
• Patients are charged based on their ability to pay. If a patient's income is at or below 100 percent of the federal poverty level (FPL), all services are completely subsidized. Patients with incomes 100-250 percent FPL are charged on a sliding fee scale. Patients with incomes above 250 percent FPL are charged full fees.
  
  
• Women obtaining care from Title X-supported clinics typically receive much more than just contraceptive care. Nearly nine out of 10 women visiting a Title X clinic receive some type of preventive gynecologic care.

What Impact Does Title X Really Have?

• Each year, Title-X supported clinics enable one million women to avoid unintended pregnancy.
  
  
• Women served at Title X-supported clinics have avoided almost 20 million pregnancies since 1980. Nearly half of these pregnancies would have ended in abortion.
  
  
• Without Title X, the number of teenage pregnancies over the last two decades would have been 20 percent higher.
  
  
• For every dollar that the federal and state governments spend on family planning services, three dollars are saved in Medicaid costs for pregnancy-related and newborn care.
  
  
• Title X-supported clinics have helped numerous women detect and obtain early treatment for a range of dangerous, and even life-threatening, medical conditions.
  
  
• Between 1995 and 1998, Title X clinics performed 19 million tests for STIs, including 1.4 million for HIV.
  
  
• Over the past 20 years, an estimated 54.4 million breast examinations have been conducted at Title X-supported clinics.
  
  
• Providers funded by the program have taken an estimated 57.3 million Pap tests, which resulted in the early detection of as many as 55,000 cases of invasive cervical cancer.

Title X Is Under-Funded

The Title X program has achieved remarkable results in its three decades of existence. Amazingly, it has managed to achieve these successes in spite of the fact that, for the most part, the program has been grossly under-funded. Given more adequate funding, the Title X program could do even more to lower unintended pregnancy and abortion rates, increase detection and treatment of STIs, and increase early detection of breast and cervical cancer, thus preventing serious illness and death. With more adequate funding, the Title X program could do so much more to provide much-needed reproductive health care, both basic and preventive, for women who often have nowhere else to go.

• Title X is funded at $283 million for FY2006, the same level of funding it received in FY2005.
  
  
• During the 1980s, the program suffered deep funding cuts and, despite fairly steady increases in appropriations since then, it has never fully recovered.
  
  
• Taking inflation into account, the program's funding level in 1999 was 59 percent lower than it had been 20 years ago.
  
  
• If the program's funding had simply kept pace with medical inflation since 1980, the program would be funded at almost $693 million.
  
  
• This lack of funding means fewer people getting services, fewer services offered, and those that are being served have less chance of receiving the latest, most effective contraceptives and screening tests.
  
  
• Title X is in real danger of becoming a second class health care program for low income women.