Title X Family Planning Grants for Low-Income Americans Save Taxpayers Money

The House Appropriations Committee deems family planning for low-income Americans a “low-priority” according to its draft FY 2018 Labor, Health and Human Services, and Education (Labor-HHS) funding bill, released yesterday and being marked up today in subcommittee.

Ughhhhhhh.

Specifically, the offensive bill calls for “An elimination of all funding for the controversial Family Planning (Title X) Program, saving taxpayers nearly $300 million.”

The program that since 1971 has ensured that low-income Americans who don’t qualify for other safety net programs can still get family planning and reproductive healthcare services is anything but controversial. Hell, on the HHS website, the program is touted as “critical.” I suspect the 4,018,015 clients who were served in 2015 would agree.

And cutting off any type of preventive healthcare does nothing to save taxpayers money—especially preventive healthcare that prevents unintended pregnancies. When people who can’t even afford the full cost of birth control become pregnant, far greater costs arise, and they persist for much longer. Who do the authors of this bill think pays for the perinatal care of woman living in poverty, and then the healthcare of their mistimed or unwanted children?

And to make the whole exercise of justifying the legitimacy of Title X even more absurd, we’re not even talking about a lot of money, in budgetary terms—$286,479,000 in 2016 (the same level as 2015). That’s down from a peak of $317,491,000 in 2010 (actual dollars), when the number of patients served was also at its high point (5,224,862).

In 2015 (the most recent data available), this $286 million was distributed via grants to 91 agencies across the country, which operate nearly 4,000 clinics.

The 4,018,015 clients served by Title X-recipient clinics in 2015 received:

  • 9 million family planning encounters
  • 769,807 Pap tests—14% of which had abnormal results
  • 1,044,055 breast exams—4% of which required further evaluation
  • 2,037,716 chlamydia tests
  • 2,183,955 gonorrhea tests
  • 576,706 syphilis tests
  • 1,113,635 confidential HIV tests—2,423 of which were positive

Anyone who’s ever made use of a sliding fee scale at a family planning clinic has benefited from Title X—it’s the subsidy that makes up the difference when a patient’s income is deemed low enough to pay less than the full cost of services. The HHS poverty guideline is $24,250 for a family of four, and anyone falling below that mark is entitled to free services at Title X clinics. Those who earn up to 250% of that level ($60,625, again, for a family of four) fall somewhere on the sliding scale.

A government doesn’t save taxpayers money by denying its poorest citizens preventive healthcare, even in the near term. And in the longer term, it doesn’t make any sort of economic sense to keep generation after generation of low-income individuals in poverty through ill-timed or unwanted childbearing. Without Title X, that’s what the House Appropriations Committee is telling Americans we are going do. It’s our job to tell them: No!

Statistics on service provision for 2015 and the chart above are from Fowler, C. I., Gable, J., Wang, J., & Lasater, B. (201 6, August). Family Planning Annual Report: 2015 national summary. Research Triangle Park, NC: RTI International.

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