At a time when dangerous and unconstitutional abortion restrictions are being enacted at an alarming and devastating clip across the country, the Biden administration’s recent action to restore the integrity of the Title X program represents a pivotal step toward ensuring access to essential health care for millions of people.
Title X was created more than 50 years ago with strong bipartisan support to equalize access to modern methods of birth control for everyone, especially those with low incomes. The program has played an integral role in our nation’s public health infrastructure and family planning has been touted as one of the most successful public health achievements of the 20th century.
In 2019, the Trump administration imposed extreme policy changes that unraveled our family planning safety net and dictated a lower standard of care for patients. The Trump-era rule reduced access to a wide range of birth control methods, denied pregnant people basic health information, restricted abortion referrals and opened the door for organizations that don’t deliver health care to participate in Title X. These harmful and regressive restrictions were opposed by every major medical organization in the country.
As a result, about one-third of Title X providers made the decision to withdraw from the program. This mass exodus, in conjunction with COVID, left 2.4 million people without access to Title X-funded care — with a disproportionate impact on rural communities and people of color living with lower incomes. In California, the number of people served by the program dramatically dropped by 80 percent due to both the Trump rule and the pandemic. To save Title X and protect family planning and sexual health care for millions, we spent nearly two years in court challenging this disastrous rule.
Fortunately, earlier this month, the Biden administration stepped in to put a stop to the restrictions that have beleaguered the program for too long. The new rule allows withdrawn providers to return to Title X and begins to fill deepening gaps in access to care in communities nationwide. Not only will the U.S. Department of Health and Human Services be able to distribute critical funding across a provider network that is desperate for resources, but additional funding has been dedicated to expand access to contraceptive care and enhance providers’ telehealth capabilities.
The Biden administration is also making key updates to ensure that the program is more equitable and inclusive and once again governed by principles that reflect the gold standards of care that have long been a hallmark of this public health program.
The Trump-era Title X restrictions, unconstitutional abortion laws and the COVID-19 pandemic have laid bare the pervasive inequities across the nation’s health system. These sobering challenges have underscored the urgent need to make birth control options more available and ensure access to complete and unbiased information about pregnancy options. The Biden’s administration’s Title X rule brings us closer to achieving those goals.
But our work doesn’t end there. We need Congress to approve a historic funding increase for Title X in the next fiscal year. The House recently passed a funding measure that includes $400 million for the program. We are calling on the Senate to follow suit so that we can rebuild a stronger family planning safety net equipped to increase the availability of affordable, client-centered, and high-quality sexual and reproductive health services — particularly in communities that are underserved and historically marginalized.
The last two years have been marked by unimaginable challenges, but they have also prompted an awareness and conversation about health disparities, systemic racism and structures that widen gaps in health access and worsen cycles of poverty in this country. It is critical that our federal government continue to center the needs and values of the millions of patients who rely on Title X for care.
The time is now to create a more just and equitable health system that offers all people the opportunity to achieve their health goals and thrive.
Clare Coleman is president & CEO of the National Family Planning & Reproductive Health Association (NFPRHA). Nomsa Khalfani is Chief Strategy + Equity officer of Essential Access Health and a NFPRHA Board member. Essential Access Health is the Title X grantee for the state of California.