Title X is Under Attack
Title X is the national family planning and reproductive health program for low income women and men enacted by Congress and signed into law by President Richard Nixon in 1970. The bipartisan program was intended to combat the war on poverty; low income women were having more children than higher income women due to poor access to contraception and its high costs. Title X was created to equalize access to modern contraceptive care, and the program still fulfils that promise today. Clare Coleman, President of the National Family Planning and Reproductive Health Association (NFPRHA), talks to us about NFPRHA, Title X, and what we can do to save Title X from the current administration’s unprecedented attacks.
Access to contraception is not a given in the United States. Many methods of contraception are prohibitively expensive, even with insurance for a lot of people. When contraception gets expensive, patients may turn to skipping methods or stretching methods to make it last. For example, a patient might sacrifice paying $50 for their birth control pill this month and opt only for a condom because that’s all they can afford. That’s where Title X and NFPRHA comes in.
NFPRHA is an organization that was founded by volunteers in 1971. They work to educate the government and policy makers on Capitol Hill about how Title X should work. NFPRHA has 900 members around the country that subsidize care for poor and low income people. These member locations are multiple, including but not limited to feminist health centers, traditional family planning centers, university clinics, primary care centers, and hospital centers. Half of these members are government based, and half are non-profit based.
Title X centers see about 4 million patients annually, but there are an estimated 19 million patients in need of reproductive healthcare.
NFPRHA and Title X centers provide care to anyone who seeks it, but the primary patient is an adult woman between the ages of 20-24 or 24-29. These patients are usually working or going to school and often already have a child. They need affordable counseling, support and services in partnership with their chosen family planning methods.
Title X has been under attack for years. In FY2010, Title X faced both political targeting by a Republican majority that opposed access to reproductive health care, and budget sequestration leading to cuts. The Trump Pence administration has proposed the first comprehensive changes to Title X rules in three decades. These new rules, known as the “domestic gag rule,” are intended to disrupt ethical communication between patient and provider by gagging counseling, information, and for abortion services. In fact, this rule only allows providers to refer for prenatal care or social services, and completely takes abortion off the table. If a patient definitively states to a doctor that they want an abortion, the patient is handed a list with clinics that may or may not include abortion providers.
If you aren’t low income and don’t need to see a Title X provider, why should you care? Well, you don’t need subsidy and you don’t need to be low income to be seen in a Title X-funded setting! Anyone who walks in the door at these settings gets the same high quality care- Title X clinics see people with or without insurance. Inform, educate, and care for. That’s the mission of Title X.