Title X: America’s Family Planning Program

What is Title X?

• The Title X program provides comprehensive family planning services.  This consists of a broad range of contraceptive methods, including natural family planning, and related counseling.
  
• Title X programs also offer a wide range of other preventive health care services, including
  o breast exams and instruction on breast self-examination
  o Pap tests for early detection of cervical cancer or precancerous conditions
  o testing for high blood pressure
  o screening and appropriate treatment for sexually transmitted infections
  o HIV screening
  o counseling on adoption, foster care, and pregnancy termination
  o 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?

• 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 serve all women, regardless of age, marital status, income, or health insurance status.
  
• Title X patients are predominantly poor and uninsured; two-thirds have incomes at or below the federal poverty level.
  
• Seventy-four percent of women using Title X clinics are 19 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 between 100 percent FPL are charged on a sliding-fee scale. Patients with incomes above 250 percent FPL are charged full fees.
  
• In addition to receiving contraceptive care, nearly nine out of 10 patients at Title X-supported clinics receive some type of preventive gynecologic care.

What impact does Title X really have?

• Title X-supported clinics help one million women avoid unintended pregnancy each year.
  
• Women served at Title X-supported clinics avoided almost 20 million unintended pregnancies between 1980 and 1999.  Nearly half of these pregnancies would have ended in abortion.
  
• Without Title X, the number of teenage pregnancies between 1980 and 1999 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 enable many women to detect and obtain early treatment for a range of dangerous, sometimes life-threatening, medical conditions.
  
• Title X-supported clinics provided 19 million tests for sexually transmitted infections, including 1.4 million tests for HIV, between 1995 and 1998.
  
• Title X-supported clinics provided an estimated 54.4 million breast examinations between 1980 and 1999.
  
• Title X-supported clinics conducted an estimated 57.3 million Pap tests, resulting in early detection of approximately 55,000 cases of invasive cervical cancer.

Title X is under-funded.

The Title X program has achieved remarkable results in its more than 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 sexually transmitted infections, and increase early detection of breast and cervical cancer, thus preventing serious illness and death, and could do so much more to provide much-needed reproductive health care, both basic and preventive, for women who have often have nowhere else to go.

• Title X is funded at $283 million for FY2007, the same level of funding it received in FY2006.
  
• 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 today is 61 percent lower than it had been in 1980.
  
• If the program’s funding had simply kept pace with inflation since 1980, the program would be funded at more than $725 million.
  
• This lack of funding means fewer people getting services and fewer services offered, and those who 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

Title X is dramatically under-funded.  There are 17 million women who need publicly funded family planning, and there is not enough funding to meet the need.  At present, Title X serves more than five million patients per year — but millions more women in need go without critical reproductive health care services.  In FY2008, at a minimum Title X should be funded at $311 million, which will begin to address this unmet need by serving approximately 139,000 new clients per year.

For more information, please contact Planned Parenthood’s Government Relations Department at (202) 973-4848.