March 21, 2014 — Reproductive health advocates at a Capitol Hill briefing on Thursday urged lawmakers to maintain funding for the federal Title X family planning program, even as the Affordable Care Act (PL 111-148) extends insurance coverage to more U.S. residents, CQ HealthBeat reports.
Title X was established under the Public Health Service Act to provide comprehensive family planning services at no cost to individuals with incomes at or below the federal poverty level and on a sliding scale for people with incomes above the FPL. Although the program does not pay for abortion care, many social conservatives oppose it because some providers who offer family planning services and other preventive care also offer abortions.
According to CQ HealthBeat, the enactment of the ACA has "rekindled" debates over the program's funding. Supporters of the program want the fiscal year 2015 Labor-HHS appropriations bill to at least maintain the FY 2014 funding level of $286 million, which was a decrease from the FY 2012 Title X budget of $294 million.
Meanwhile, Republicans and groups that oppose abortion-rights are advocating legislation (HR 217, S 135) that would prevent Title X funding from being distributed to providers, such as Planned Parenthood, that also offer abortions.
The National Family Planning and Reproductive Health Association hosted the briefing on Thursday with Sen. Elizabeth Warren (D-Mass.). At the briefing, reproductive health advocates argued that despite the ACA's "historic investment in family planning," the law's potential to reduce the number of unintended pregnancies cannot be realized without continuous funding of the Title X program, CQ HealthBeat reports.
Advocates explained that a lack of funding for Title X clinics could potentially obstruct access to contraceptives and other reproductive health services for newly insured individuals who cannot readily access other clinics. Many clients -- such as adolescents and domestic abuse victims -- especially appreciate the centers' guaranteed confidentiality and on-site access to contraceptives.
Andrea Flynn, a fellow at the Roosevelt Institute, added that access to contraception is especially important in a fragile economy, particularly for low-income women. "Access to affordable contraception enables women to pursue educational and professional opportunities that strengthen their families and their entire communities," she said.
Amanda Dennis of Ibis Reproductive Health noted that demand for Title X services did not slow in Massachusetts after the state in 2006 implemented a health insurance law that is similar to the ACA. "People continued to go to family planning providers for care," including people who were newly insured, those who preferred a family planning specialist over other providers and those who had questions about their newly acquired benefits, she said.
Flynn added that many women used Title X clinics as their main point of care when it became more difficult to get an appointment elsewhere because the new law increased demand for care at other providers. In addition, she cited a Guttmacher Institute report that found women often use family planning providers as their "'entry point into the health care system.'"
NFPRHA President Clare Coleman cited statistics from the Congressional Budget Office that estimate about 30 million people will remain uninsured under the ACA, at least partly because of some states' decision to not expand Medicaid. Coleman said Title X is valuable because it helps clinics pay "for a little bit of a lot of things," by not only supporting care and supplies, but by underwriting the "cost of rent and utilities," administrative costs and "community education."
Advocates also noted that many states, such as Texas, have cut family planning funding or implemented strict regulations that force providers to close (Reichard, CQ HealthBeat, 3/20).