Bonnie Arbittier / Rivard Report
Women’s health organizations nationwide are working to complete a months-long process to secure federal funding after the U.S. Department of Health and Human Services' Office of Population Affairs released a long-awaited announcement that $260 million in funding would be made available to eligible providers.
Prior to the announcement on Feb. 23, President Donald Trump signed a measure that allows states to exclude from receiving Title X money women’s health organizations that provide abortions. This change could impact low-income women in San Antonio, where the only provider of the federally funded services are local Planned Parenthood clinics.
For nearly 50 years, Title X grants have helped providers offer family planning and preventive health services such as breast and cervical cancer screening to millions of low-income or uninsured people. These providers serve 17,670 women in the South Texas region and 85,332 statewide, according to Planned Parenthood.
Mara Posada, director of public affairs with Planned Parenthood, told the Rivard Report that while the organization is technically eligible for funding, the wording of the funding announcement indicates preference will be given to “organizations that provide only natural family planning.”
Because of laws prohibiting use of state or federal funds for abortions, only four local Planned Parenthood clinics are eligible to receive a portion of the $14 million in Title X funding secured by the Women’s Health and Family Planning Association of Texas’ (WHFPT), the organization responsible for funding the 28 Title X providers and their 100 clinics statewide.
It's not yet known how Title X services provided by San Antonio's Planned Parenthood clinics will be impacted by the new funding announcement. Grant applications aren’t due until May, so it's unclear which groups will actually receive the funding. Kami Geoffray, CEO of WHFPT, declined to comment for this story.
In 2015, 66 percent of people seen at clinics that received Title X funds had a family income at or below the poverty level, 35 percent were covered by Medicaid or another public program, and nearly half (48 percent) were uninsured, according to the Title X Family Planning Annual Report.
The National Family Planning and Reproductive Health Association, the WHFPT’s national counterpart, issued a statement following the funding opportunity announcement criticizing the Trump administration on its decision to “omit 'contraceptive services' and de-emphasize healthcare.”
Title X funding is particularly important in Bexar County, where teen pregnancy rates have been on the decline, but still remain above the national average. The rate of births among 15- to 19-year-old Bexar County teens was 30.2 per 1,000 teen births, nearly 50 percent higher than the national rate of 20.3 per 1,000 in 2016.
Posada said that the funding announcement does not include mention of many approved methods of contraception, but "references natural family planning six times."
"The [announcement seems] designed to roll back access to the most effective forms of birth control," Posada said, including oral contraceptive pills, birth control shots, vaginal contraceptive rings, and female and male condoms.
Clare Coleman, president and CEO of the National Family Planning and Reproductive Health Association, said in a prepared statement on Feb. 26 that the Title X program "has been a bedrock, cost-effective health care program serving millions of poor and low-income individuals each year,” and that “the latest funding announcement seeks to compromise that excellence by omitting any reference to nationally recognized clinical guidelines.
“It is contrary to public health to silo contraception from health care in Title X, and deliberately shift toward a move more focused on behavior change."
According to the Guttmacher Institute, an advocacy organization for sexual and reproductive health care, 20.2 million U.S. women were in need of publicly funded contraceptive services and supplies in 2014.
Between 2010 and 2014, the overall number of women in need of publicly funded contraceptive services rose 5 percent, and particularly large increases were seen among Hispanic women and low-income women.
Title X-funded clinics alone helped women avert 904,000 unintended pregnancies, 439,000 unplanned births and 326,000 abortions in 2014. Without the services provided by these clinics, the U.S. rates of unintended pregnancy, unplanned birth and abortion each would have been 33 percent higher, and the teen pregnancy rate would have been 30 percent higher, the Guttmacher Institute reported.
Organizations receiving funding through Title X may see a gap in services, as their three-year block grant funding is set to run out on March 31. Texas is set to run out of funding at the end of the month.
In the meantime, the Department of Health and Human Services says grantees can apply for funding to keep the clinics running. While some clinics may be able to continue to run on cash reserves, others cannot exist without Title X funding, according to the Guttmacher Institute.