Don’t reverse decades of progress in ensuring access to women’s care
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Republican leaders in Congress are hoping to have a vote on a budget reconciliation bill to repeal the Affordable Care Act in the coming weeks. There is significant concern that the repeal bill will cause millions to lose their health care coverage and make affordable health insurance out of reach for many. In this time of uncertainty, the importance of preserving programs that have provided access to essential health services and have been an effective part of our public health system for decades, is perhaps greater than ever before. 

Title X – established in the Public Health Services Act in the 1970’s with strong bipartisan support - was signed into law by President Richard Nixon. Since then, it has been a proven success and a critical component of the health care safety net. Today, Title X supports the delivery of family planning and related services, including the full range of birth control methods and breast and cervical cancer screenings, to over four million patients nationwide. Recent polling shows that while support for family planning has largely fallen along party lines in Congress, there is widespread bipartisan support among the American public for federal funding for contraception.


The rate of unplanned pregnancy is declining and abortion rates are at the lowest levels since Roe v. Wade. These declines have been largely attributed to greater use of effective contraception and consequently less unplanned pregnancy. Without Title X funding, the number of unintended pregnancies, unplanned births and abortions each year in the United States would be 68 percent higher.

The need for publicly funded contraception is already far greater than the supply. Recent research shows that nearly 20 million American women currently live in contraceptive deserts—defined by their lack of reasonable access to public health care sites offering the full range of contraceptive methods. An article published in the American Journal of Public Health noted that Title X would need at least $737 million allocated annually to provide care to all women in need of publicly funded family planning care. This estimate was developed with coverage options that are available in our current health care environment and would surely be much higher if those coverage options were eliminated.

For those that are more focused on fiscal impact than public health outcomes, Title X is a good investment and cost-saver. Every $1 invested in the program saves taxpayers more than $7, that’s a net government savings of $15 billion.

California’s Title X program – the largest and most diverse Title X system in the country program is a model of the program’s success. Over one million women, men and teens are served each year – that’s 25 percent of the nation’s Title X patient population through a comprehensive network of providers. California’s Title X network includes federally qualified health centers, city and county health departments, universities, hospitals, school-based clinics, Planned Parenthoods and stand-alone family planning and women’s health specialists. 

Title X providers in California collectively helped women avoid one million unintended pregnancies in 2013. A key part of this success is ensuring that patients have access to their provider of choice that they trust to provide quality, confidential services in their local communities and that providers have access to training and technical assistance to help them provide care based on current clinical guidelines and best practices. 

In our polarized Congressional environment, let’s call on our representatives on both sides of the aisle to come together in support of Title X and what should be widely shared domestic goals of reducing unintended pregnancy, saving taxpayer dollars, enhancing women’s economic security, and strengthening families and communities.

Julie Rabinovitz, MPH, is the President and CEO of Essential Access Health.  Julie serves on the Board of the National Family Planning & Reproductive Health Association (NFPRHA) and was Board Chair from 2009-2011. She is the current Chair of the Family Planning Councils of America Board of Directors.

The views expressed by this author are their own and are not the views of The Hill.