Sending Office: Honorable Joseph Crowley
Support the Title X Family Planning Program
**Deadline to Sign On: Monday, March 12**
FY19 Signers: Sheila Jackson Lee, Kathy Castor, Joaquin Castro, Anthony G. Brown, Seth Moulton, Jerry McNerney, Chellie Pingree, Rick Larsen, Danny K. Davis, Lois Frankel, Anthony G. Brown, Earl Blumenauer, David N. Cicilline, Bonnie Watson
Coleman, Eleanor Holmes Norton, Eliot L. Engel, Kathleen M. Rice, Salud O. Carbajal, Bill Foster, Tim Walz, Gwen S. Moore, Susan A. Davis, Suzanne Bonamici, Alcee L. Hastings, John Yarmuth, Charlie Crist, Michael E. Capuano, Donald S. Beyer Jr. , Grace F.
Napolitano, Peter A. DeFazio, James P. McGovern, Peter Welch, Mark Takano, Jerrold Nadler, Bradley S. Schneider, Donald M. Payne, Jr., Joseph P. Kennedy III, Frederica S. Wilson, Debbie Wasserman Schultz, Steve Cohen, Adam B. Schiff, Juan Vargas, Raja Krishnamoorthi,
Albio Sires, Alma S. Adams, Kurt Schrader, André Carson, Ben Ray Luján, Jamie Raskin , Doris Matsui, David Scot, Sean Patrick Maloney, Julia Brownley, Darren Soto, Louise McIntosh Slaughter, Donald A. McEachin, Robert A. Brady, Mark DeSaulnier, Adam Smith,
Paul Tonko, Ron Kind, Niki Tsnogas, Michelle Lujan Grisham, John Sarbanes, Dina Titus, James R. Langevin, Michael F. Doyle, James A. Himes, Brendan F. Boyle, Bobby L. Rush, Lloyd Doggett, David E. Price, Adriano Espaillat, Alan Lowenthal, Stephanie Murphy,
Stephen F. Lynch, Scott H. Peters, Elizabeth H. Esty, Jared Polis, Emanuel Cleaver, II, Norma J. Torres, Carol Shea- Porter, Marc A. Veasey, Gerald E. Connolly, Cedric L. Richmond, Jared Huffman, Eric Swalwell, Maxine Waters, John B. Larson, Val Butler Demings,
Jacky Rosen, Henry C. “Hank” Johnson, Jr., Marcia L. Fudge, Luis V. Gutiérrez, Filemon Vela, Zoe Lofgren, John K. Delaney, Gregory W. Meeks, Daniel T. Kildee, Al Green, Sander M. Levin
Please join me in supporting one of our most important health programs for lower-income Americans, the Title X program. Title X offers quality primary and preventive health care to the underserved in our communities. It is proudly the only federal program
dedicated to assisting low-income patients with not just family planning services, but also services like breast and cervical cancer screenings, HIV testing, and STD treatments. Title X has quickly become a critical lifeline for more than 4 million mostly
low-income individuals each year.
The proven success of Title X has contributed to bipartisan acknowledgment of the program as a critical public health resource since it was signed into law by President Richard Nixon 47 years ago. For decades, Title X has not only served as a health care
safety net, but also supports nearly 4,000 health providers, who are both independent clinics and public health departments, and strengthens our nation financially, as every $1 invested in Title X saves $7 in Medicaid costs.
Recent years have brought severe cuts to Title X’s funding and administrative threats to the integrity of the program, jeopardizing quality care for its 4 million patients. Further defunding would constrict the program from providing appropriate and culturally
competent care. Previous cuts over the past six years have dropped 1.2 million patients, limited services, and closed health center doors. Reversing these cuts and putting the program back on the track of adequate funding will help meet the very real need
that is felt throughout the country.
I encourage you to join me in sending the below letter to the House Appropriations Committee supporting $327 million in Fiscal Year 2019 funding for the Title X program. To sign on, or if you have any questions, please contact Kripa Sreepada in my office
at Kripa.Sreepada@mail.house.gov by March 12, 2018.
Dear Chairman Cole and Ranking Member DeLauro:
As you work to develop the Fiscal Year 2019 Labor, Health and Human Services, and Education Appropriations bill, we request that you include $327 million for the Title X family planning program. This funding is critical to allow Title X health centers to
continue providing preventive health and family planning services to millions of low-income individuals as part of the health care safety net.
Title X is the only federal program dedicated to providing family planning services for low-income patients, but beyond that, it is the primary source of health care for six in ten women who see a provider within the program. Title X supports nearly 4,000
health centers, from specialized family planning providers, to federally qualified health centers, to public health departments. Because of this funding, these centers can remain a lifeline in their communities and continue to provide high-quality reproductive
and sexual health care, including cancer screenings, testing and treatment for sexually transmitted infections, contraceptive services and supplies, and pregnancy testing to more than 4 million mostly low-income individuals each year.
Unfortunately, these services are in serious jeopardy because of funding cuts and attacks on the Title X program. The FY 2017 funding levels were $31 million below FY 2010 levels. These cuts have forced health centers to scale back hours, limit services,
lay off staff, and even shutter their doors. The result is nearly 1.2 million fewer patients served by the program in just a six-year period.
We hope you will recognize that a greater investment in the program is seriously needed to help health centers restore and expand access to essential services, allowing them to help meet the needs of millions of people who rely on the program. In fact, a
2016 study published in the American Journal of Public Health found that to support
all women in need of publicly funded family planning services, Title X would need at least $737 million, and a 2016 analysis by the Guttmacher Institute found that more than 20 million women are in need of publicly funded contraceptive services and supplies.
In 2015 alone, the contraceptive services supported by Title X helped women avoid 822,000 unintended pregnancies, which would have resulted in 387,000 unplanned births and 278,000 abortions.
Beyond these fiscal challenges, Title X is facing administrative threats to the integrity of the program and the provider network. For example, in the recently released FY 2018 Funding Opportunity Announcement (FOA), the administration removed all references
to and requirements for Title-X funded providers to follow the nationally recognized clinical standards for family planning care, known as the Quality Family Planning guidelines, which were jointly developed by the Office of Population Affairs and the CDC
in 2014. It also eliminated all mentions of contraception, the provision of which is central to the mission of Title X. On top of these noteworthy changes, the administration made a number of troubling amendments to the FOA’s selection criteria aimed at making
it more difficult for reproductive health-focused providers to participate in the program while potentially opening the door for the participation of ideologically-motivated organizations with little or no experience in providing health care. The administration’s
approach, in short, threatens access to basic, preventive health care for millions of individuals in communities across the country.
Furthermore, Title X is facing challenges from states seeking to exclude trusted providers from the program—threats now supported by the current administration. Despite what opponents of the program claim, the need for publicly funded family planning care
cannot simply be absorbed by other medical providers – and certainly not in a way that meets both the widespread need and the intricacies of providing appropriate and culturally competent care for the population seeking these services.
Supporting Title X is not only the right thing to do, it is also the fiscally responsible thing to do. Every dollar invested in Title X saves more than seven dollars in Medicaid-related costs. Supporting and strengthening the program is a smart investment
in public health – a fact that has been recognized by members of both parties for over 45 years. However, a renewed commitment is needed to allow this critical component of our nation’s safety net to continue its mission and deliver the health, social, and
economic benefits that have made such a difference in the lives of so many.
We ask that you protect this critical program and support the health needs of millions of women and men by providing $327 million in FY 2019 for the Title X program. We thank you for your consideration of this request.
e-Dear Colleague version 2.0