In July of 1969, President Richard Nixon proposed the creation of a Commission on Population Growth and the American Future. Congress passed an act establishing the Commission on March 16, 1970. President Nixon also reorganized family planning service activities by establishing the National Center for Family Planning Services within the Department of Health, Education, and Welfare, HEW (latter the Department of Health and Human Services). The first federal subsidies helping lower-income families obtain access to birth control started in 1965 as part of President Lyndon Johnson’s “War on Poverty.” However, President Nixon thought the subsidies were not adequate, so sought a clearer source of federal financial support. He also sought to expand research in contraceptive development and behavioral sciences. The result was the Family Planning Services and Population Research Act, Title X of the Public Health Service Act, which President Nixon signed on December 26, 1970. The purpose of Title X was, and still is, to provide expanded family planning services, research, and training.
Since its inception, Title X has provided family planning and preventative health services for low income women and men which include:
- A broad range of FDA-approved contraceptive methods and counseling services;
- Breast and cervical cancer screening;
- Pregnancy testing and counseling; and
- Screening and treatment for sexually transmitted infections (STIs), HIV testing, and other patient education and referrals.
In addition to clinical services, Title X also funds training for family planning clinic personnel, family planning research, and community-based education and outreach.
The Department of Health and Human Services’ (HHS) Office of Population Affairs (OPA) currently administers Title X, while the program’s funding ($286,400,000 in FY14) is provided through HHS’s Health Resources and Services Administration (HRSA). Approximately fivemillion clients are served annually through a network of 4,400 family planning centers that include state, county, and local health departments, community health centers, hospitals, schools, faith-based centers, and other private nonprofits.
These services yield significant savings to taxpayers by offering contraceptive services, which reduce Medicaid costs related to pregnancy care and delivery, as well as the cost of care of infants in their first year of life. Additional benefits include prevention and treatment of STIs, avoiding and detecting reproductive cancers, and the broader health, social, and economic benefit of allowing women to time or prepare for pregnancy.
Although Title X is the only federal domestic program primarily focused on family planning, other programs also finance family planning, including: Medicaid, the Health Centers program under Section 330 of the Public Health Service Act, Maternal and Child Health Block Grants, and Social Services Block Grants. In FY2010, Medicaid accounted for 75% of U.S. public family planning expenditures (including federal, state, and local government spending). In comparison, Title X accounted for 10%.
Office of Population Affairs, Title X: The National Family Planning Program, www.hhs.gov/opa
History of Title X, http://www.hhs.gov/opa/title-x-family-planning
The American Presidency Project, Richard Nixon 477- Statement on Signing the Family Planning Services and Population Research Act of 1970, http://www.presidency.ucsb.edu/ws/index.php?pid=2865&st=&st1=
Title X (Public Health Service Act) Family Planning Program, Congressional Research Service, Angela Napili, September 3, 2014, http://fas.org/sgp/crs/misc/RL33644.pdf