League Sends Letter of Support on Title X to House and Senate

The League joined with 61 other health care and reproductive rights organizations in support of $327 million in funding for the Title X Family Planning program in a letter to House and Senate Appropriations Subcommittee Chairs and Ranking Minority members. In requesting that the Congressional leaders fund the program, the letter notes that more than 4.1 million women and men access life-saving health care such as birth control, cancer screenings, and testing for sexually transmitted infections through Title X health centers. Four out of ten women who receive care at a Title X-funded health center consider it their only source of health care and six in ten women consider it their main source of care.

 March 15, 2016

The Honorable Roy Blunt                                             The Honorable Patty Murray
Chairman                                                                    Ranking Member
Appropriations Subcommittee on                                Appropriations Subcommittee on
Labor, Health and Human Services                              Labor, Health and Human Services
and Education                                                             and Education
260 Russell Senate Office Building                              154 Russell Senate Office Building
Washington, DC 20510                                               Washington, DC 20510

The Honorable Tom Cole                                            The Honorable Rosa DeLauro
Chairman                                                                    Ranking Member
Subcommittee on Labor, Health and Human                Subcommittee on Labor, Health and Human 
Services, Education, and Related Agencies                   Services, Education, and Related Agencies 
House Appropriations Committee                                House Appropriations Committee
2467 Rayburn House Office Building                           2413 Rayburn House Office Building 
Washington, DC 20515                                               Washington, DC 20515

Dear Chairman Blunt, Ranking Member Murray, Chairman Cole and Ranking Member DeLauro:

As you develop Fiscal Year (FY) 2017 appropriations for the Departments of Labor, Health and Human Services, Education, and related agencies, the 61 undersigned members and associated organizations of the Family Planning Coalition respectfully request that you provide $327 million in funding for the Title X family planning program. Title X is the sole source of dedicated federal funding for family planning services for underserved populations. Strong support for the program is incredibly important given that four out of ten women who receive care at a Title X-funded health center consider it their only source of health care and six in ten women consider it their main source of care.ⁱ Moreover, more than 4.1 million women and men access life-saving health care such as birth control, cancer screenings, and testing for sexually transmitted infections through Title X health centers.ⁱⁱ

The organizations listed below collectively represent millions of administrators, providers, patients, researchers, and advocates who share the common mission of supporting and protecting federal funds for critical, cost-saving programs that provide family planning services to millions of women, men and families. By restoring resources for the Title X family planning program you will help protect access to the public health safety net for millions of poor and low-income women and men in need of high-quality health services.

The President’s FY 2017 budget requested $300 million for Title X, signaling the Administration’s support for, and recognition of, the value that Title X provides to communities across the country. Even as more individuals gain health care coverage through the Affordable Care Act (ACA), the Title X health center network will continue to play an essential role in our nation’s service delivery framework. The reality is that the Title X program is fundamental to successful implementation of health care reform. Even in 2014, more than half (54%) of clients seen at Title X-funded centers remain uninsured.ⁱⁱⁱ Title X-funded health centers provide health care access within communities for all patients regardless of payer source, and the program is a critical part of building the service delivery infrastructure needed to support increased demand. Notably, Title X-funded entities have now emerged as entry points to care and to coverage, with many system providing education and enrollment assistance in their communities.^iv

Title X also sets the standard for quality family planning and sexual health service provision— focusing on outcomes and increasing service efficiency. In April 2014, the program issued “Providing Quality Family Planning Services - Recommendations of CDC and the U.S. Office of Population Affairs,” that outlines the most up-to-date clinical recommendations for all providers of family planning care, including Title X-funded providers, to help define patient- centered, quality care in a family planning visit.^v Such efforts reinforce the network’s role as centers of excellence for high-quality health care.

Unfortunately, Title X has suffered devastating budget cuts in recent fiscal years. Between FY2010-FY2014, funding for Title X was cut from $317.5 million to $286.5 million, a net difference of $31 million. Over that same four-year period, the total number of Title X patients receiving care shrunk by 1.1 million,^vi with no indication that patients sought care elsewhere.^vii Since that time, Title X has received no increase in service delivery dollars: it was funded at only $286.5 million in FY 2015 and 2016.

These cuts have also made it difficult for Title X to support the infrastructure necessary for modern service delivery. Traditionally, Title X health centers have been excluded from other funding sources that support the implementation of health information technology (HIT). Resources for electronic health record (EHR) implementation for Title X providers, similar to their other safety net counterparts, are necessary to help achieve the ACA goal of having a nationwide HIT infrastructure and more coordinated models of care. Increased Title X funding is essential to help address the oversight made in the HITECH ACT which made many family planning health providers ineligible for the EHR incentives.^viii

Even as the economic outlook for many Americans continues to improve, low-income women and men are still struggling financially and are in need of affordable health care a number of states have made it more difficult for people to access family planning services. Our organizations, therefore, encourage the Committees to invest in programs that help low-income women and men access the services that help them stay healthy and that save critical taxpayers dollars. For every one dollar invested in publicly funded family planning services, over seven dollars are saved in Medicaid costs.^ix Additionally, services provided in Title X health centers alone yielded $5.3 billion of the $10.5 billion in total savings for publicly funded family planning in 2010.^x We thank you for your consideration and urge you to include at least $327 million in FY2017 for the Title X family planning program.

If you have any questions or would like additional information, please contact Burke Hays at the National Family Planning & Reproductive Health Association by email at [email protected] or by phone at 202-293-3114 ext. 224 or Karen Stone at Planned Parenthood Federation of America by email at [email protected] or by phone at 202-973-4834.

Sincerely,

30 for 30 Campaign
Academic Pediatric Association
Acria, Inc.
Advocates for Youth
AIDS Alabama
AIDS Foundation of Chicago
American Academy of Pediatrics
American College of Nurse-Midwives
American Congress of Obstetricians and Gynecologists
American Pediatric Society
American Psychological Association
American Public Health Association
American Sexual Health Association
American Society for Reproductive Medicine
Association of Maternal & Child Health Programs
Association of Reproductive Health Professionals
Association of Women's Health, Obstetric and Neonatal Nurses
Black Women's Health Imperative
Cascade AIDS Project
Catholics for Choice to this letter
Center for Reproductive Rights
Girls Inc.
Hadassah, The Women’s Zionist Organization of America, Inc.
Healthy Teen Network
HIV Medicine Association
Human Rights Campaign
Institute for Science and Human Values, Inc.
League of Women Voters of the United States
NARAL Pro-Choice America
National Abortion Federation
National Alliance of State and Territorial AIDS Directors
National Association of County and City Health Officials
National Association of Nurse Practitioners in Women’s Health
National Center for Lesbian Rights
National Coalition of STD Directors
National Health Law Program
National Latina Institute for Reproductive Health
National Network of Abortion Funds
National Partnership for Women & Families
National Women’s Law Center
National Women's Health Network
National Women's Health Network
Population Action International
Population Connection Action Fund
Population Institute
Public Health Institute
Rural AIDS Action Network
Sexuality Information and Education Council of the U.S.
Society for Adolescent Health and Medicine
Society for Pediatric Research
The AIDS Institute
The Feminist Majority Foundation
The National Campaign to Prevent Teen and Unplanned Pregnancy
The United Methodist Church, General Board of Church and Society
Unitarian Universalist Association
URGE: Unite for Reproductive & Gender Equity

^{i i Guttmacher Institute. Sonfield, A., Hasstedt, K., Gold, R. Moving Forward: Family Planning in the Era of Health Reform. 2014. http://www.guttmacher.org/pubs/family-planning-and-health-reform.pdf}

^{ii Fowler, C.I., Gable, J., Wang, J., & Lasater, B. (2015, August). Family Planning Annual Report: 2014 National Summary. Research Triangle Park, NC: RTI International.}

^{iii Ibid.}

^{iv Guttmacher Institute. Sonfield, A., Hasstedt, K., Gold, R. Moving Forward: Family Planning in the Era of Health Reform. 2014. http://www.guttmacher.org/pubs/family-planning-and-health-reform.pdf}

^{v The Office of Population Affairs and the Centers for Disease Control and Prevention. Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs. April 2014. http://www.hhs.gov/opa/program-guidelines/family-planning-services/.}

^{vi Fowler, C.I., Gable, J., Wang, J., & Lasater, B. (2015, August). Family Planning Annual Report: 2014 National Summary. Research Triangle Park, NC: RTI International (Compare with Fowler, CI, Lloyd, SW, Gable, J, Wang, J, and Krieger, K. (September 2011). Family Planning Annual Report: 2010 National Summary. Research Triangle Park, NC: RTI International.).}

^{vii Rachel Benson Gold, Adam Sonfield, Cory L. Richards and Jennifer J. Frost, Next Steps for America’s Family Planning Program: Leveraging the Potential of Medicaid and Title X in an Evolving Health Care System, (New York: Guttmacher Institute, 2009), accessed 2015, http://www.guttmacher.org/pubs/NextSteps.pdf.}

^{viii Certification and EHR Incentives: HITECH Act, US Government’s official website for Health Information Technology, accessed 2015, http://www.healthit.gov/policy-researchers-implementers/hitech-act-0.}

^{ix Jennifer J. Frost, Adam Sonfield, Mia R. Zolna, and Lawrence B. Finer, “Return on Investment: A Fuller Assessment of the Benefits and Cost Savings of the US Publicly Funded Family Planning Program,” Milbank Quarterly 92, no. 4 (2014): 667-720.}

^{x Jennifer J. Frost, Mia R. Zolna and Lori Frohwirth, Contraceptive Needs and Services, 2010, (New York: Guttmacher Institute, July 2013), http://www.guttmacher.org/pubs/win/contraceptive-needs-2010.pdf.}