Key Facts About Title X
How is the Program Administered?
- Similar to other federal safety-net health care programs, the Title X grant program funds are appropriated to the Health Resources Services Administration (HRSA) through the annual, discretionary appropriations process by Congress. However, the program is unique in that while it is funded through HRSA, it has been administered by the Office of Population Affairs (OPA) within the Office of the Assistant Secretary for Health in the Department of Health and Human Services (HHS) since 1983.
- OPA provides Title X funding to 91 public and private nonprofit grantees in 3,951 service delivery sites across the country.
- State, county, and local health departments make up the majority (51%) of Title X service providers. Hospitals, family planning councils, Planned Parenthoods, federally qualified health centers and other private non-profit organizations make up the rest (49%) of the Title X network.
What Does the Provider Network Look Like?
- In 2015, 3,569 health care professionals provided Title X services including nurse practitioners, physicians, physician assistants, certified nurse-midwives, registered nurses, counselors, and health educators.
- By law, Title X funds are not the sole source of income for providers. Rather, Title X funding is leveraged throughout the health centers in its network. In 2015, Title X grantees reported their major sources of revenue to include 40% Medicaid, 19% Title X, 10% state funding, 8% local funding, 4% patient fees, private third-party reimbursement and 19% other funding streams.
What Clinical Services Health Centers Provide?
- Title X health centers provide access to contraceptive services, supplies, and information to all who want and need them. By law, however, priority is given to persons from low-income families.
- Since its inception, Title X has statutorily required that its providers preserve patients’ confidentiality for the array of services delivered, despite Title X funds not covering the full costs of services provided.
- Title X clinical services include pregnancy testing; contraceptive counseling and services; pelvic exams; screening for cervical and breast cancer; screening for high blood pressure, anemia, and diabetes; screening for sexually transmitted diseases (STDs) and HIV/AIDS; infertility services; health education; and referrals for other health and social services.
- In 2015, Title X-funded centers provided over 769,807 Pap tests, over 1 million breast exams, nearly 5 million STD tests, and 1.1 million confidential HIV tests.
Who Does Title X Serve?
- Six in ten women who obtain health care from a family planning center consider it to be their usual source of health care.
- In 2015, Title X-funded providers served over 4 million low-income women and men.
- Sixty-six percent of Title X patients have incomes at or below the federal poverty level—meaning they earn less than $11,770 per year. These patients receive services at no cost to them.
- Since 1999, the percentage of total users with family incomes at or below the poverty level has increased gradually from 65% during 1999 through 2002 to 66% in 2015.
- Forty-eight percent of Title X patients are uninsured, 35% have Medicaid or other public health insurance, and 15% have private insurance.
- Title X patients are disproportionately black and Hispanic or Latino, with 20% of Title X patients self-identifying as black and 32% as Hispanic or Latino, as compared to 18% and 13% of the nation, respectively. Ninety percent of Title X patients are female, 10% are male.
What are the Benefits of Publicly Funded Family Planning Health Centers?
- Title X funding has been proven effective while simultaneously saving millions in taxpayer funds.
- Publicly funded health centers services helped prevent 1.5 million unintended pregnancies, which would have resulted in 741,000 million unplanned births and 510,000 abortions in 2012.
- Services provided by Title X centers helped women avert half (1.1 million) of these unintended pregnancies, which would have resulted in 527,000 unplanned births and 363,000 abortions in 2012.
- Title X provides significant cost savings to the federal and state governments. The Guttmacher Institute estimates that for every dollar invested in family planning, the taxpayer saves $7.09. Services provided in Title X-supported centers alone yielded $5.3 billion of the $10.5 billion in total savings for publicly funded family planning in 2010.
Key Budget Facts
- In total, between FY 2010-FY 2016, funding for Title X was cut by $30.5 million - a 10% reduction.
- The Title X program took a $14.9 million cut in FY 2013 due to sequestration alone, and only $8.2 million of that cut was restored to the program in FY 2014.
- In early February of 2016, President Obama released his budget blueprint for FY 2017, requesting $300 million for the Title X program. In June of 2016, the Senate Labor-H Appropriations Subcommittee proposed $286.5 million for the program. The House of Representatives' Labor-H Subcommittee proposed completely eliminating the Title X program.
For a PDF version of the information above and sources, see the Introduction to Title X factsheet and the Title X Budget & Appropriations page.