How Title X change could affect family planning in US

Title X funds help low-income Americans pay for health services.

ByABC News
April 13, 2017, 4:32 PM

— -- President Donald Trump signed a bill into law today that could have far reaching effects on family planning services for many people in the U.S.

The rollback of the rule impacts how states dole out Title X funds, which provide low-income people and others access to family planning and related preventive health services.

States are supposed to award funding to providers based on their ability to provide services. However, some had changed the way Title X funds were given out and reduced the amount of funds available for centers that provided abortions.

The rule signed by President Obama last December made it difficult for states to continue to receive federal funds if they did not allocate Title X grants based on the quality and quantity of service providers, as originally intended.

Here's some background on Title X and what overturning this rule could mean.

What is Title X?

Title X of the Public Health Service Act was passed in 1970 by President Richard Nixon and provides funds to ensure access for family planning and related preventive health services for low-income or uninsured individuals, among others.

"Title X is the only federal grant program dedicated solely to providing individuals with comprehensive family planning and related preventive health services," according to the Health and Human Services website.

No Title X funds -- nor any federal funds -- can be used for abortion services specifically.

In 2015 more than 4 million individuals received services through nearly 4,000 health centers that are partially funded by Title X grants, according to the U.S. Department of Health and Human Services.

The Guttmacher Institute, which focuses on reproductive health policy, estimates that the unintended pregnancy rate would be 33 percent higher and the teen pregnancy rate would be 30 percent higher without contraceptive care provided by Title X centers. Moreover, the institute predicted the services provided by Title X centers have prevented "87,000 preterm or low-birth-weight births, 63,000 STIs and 2,000 cases of cervical cancer."

According to Planned Parenthood, Title X health centers provided 800,000 pap smears, 1 million breast exams and 6 million tests for sexually transmitted infections in 2015.

What was the rule passed by the Obama administration?

The Obama administration's rule was designed to reinforce the existing law and guarantee that states would not deny Title X funds to clinics for reasons other than subpar services, poor performance or noncompliance.

According to the 2016 rule, a number of states have taken actions to restrict Title X funding access to some providers "for reasons other than the provider's ability to provide Title X services."

How will changing this rule affect people?

Overturning the rule means that states will more likely be able to change funding or withhold Title X funds from clinics if they provide abortion. While it's not quite clear what the immediate effects will be, in the past, the number of people serviced by Title X providers diminished as states withheld coverage.

Kinsey Hasstedt, senior policy manager at the Guttmacher Institute, said states may think they have free reign to restrict funding now that the rule has been rolled back.

"States may be emboldened," Hasstedt said. They may think they are "entitled to deny Title X funding to Planned Parenthood and other safety net planning providers."

Hasstedt said Planned Parenthood and other providers have brought lawsuits against states for improperly withholding Title X funding.

"In reality it's not carte blanche for states to do this," she said. "Those funds should be going to whatever providers are best able to fit the need for contraceptive care."

According to the 2016 rule, services provided to patients in Texas had been drastically reduced after funding was cut.

"The combination of these actions decreased the Title X provider network from 48 to 36 providers, and the number of Title X clients served was reduced dramatically," according to the legislation. "Title X clients served decreased from 259,606 in 2011 to 166,538 in 2015."

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