For nearly half a century, the Title X Family Planning Program has been a crucial source of federal dollars for family planning and related health care services for low-income Americans. Enacted with bipartisan support in 1970, the program’s mandate to provide “a broad range of acceptable and effective family planning methods and services” has helped millions of lower-income women each year obtain contraceptives.
In 2015, a government report found that more than 4 million patients (mostly women) got health care through Title X funds, including screening for breast and cervical cancers and sexually transmitted diseases. Researchers at the Guttmacher Institute, which supports reproductive rights, estimate that Title X care helped women avoid more than 800,000 unintended pregnancies that year.
The program has survived numerous changes of administrations, carrying out its mission relatively unscathed by politics. But the biggest provider of Title X services is also the GOP’s favorite health care punching bag: Planned Parenthood, which operates 13 percent of the clinics funded under the program and cares for about 40 percent of the patients. Now the Trump administration is steering the program itself in the wrong direction.
New guidelines for providers applying for funds signaled such a disturbing shift away from the program’s previous guidelines and statutory mandate that it triggered two lawsuits. The complaints argue that the Department of Health and Human Services is unlawfully directing applicants to emphasize natural family planning or abstinence as birth control. They’ve asked for an injunction that would stop the guidelines from being implemented, and the courts should grant it.
The statute has required providers to offer natural family planning (or “rhythm” method) and abstinence as possible means of birth control. But the previous guidelines (from 2016) also emphasized that providers should offer the full range of FDA-approved contraceptives, or justify why any of the methods were not offered. The new guidelines don’t even mention the word “contraceptive.” Instead, they instruct providers to put a “meaningful emphasis” on counseling that extols the benefits of avoiding the risks of sex outside marriage, both for adolescents and adults. For adolescents, providers should communicate the benefits of delaying sex, the guidelines say.
No one disputes that abstinence is guaranteed to prevent pregnancy. What’s not guaranteed is that people will actually abstain.
FROM AN EDITORIAL IN THE LOS ANGELES TIMES