Sending Office: Honorable Ben Ray Lujan
Current Cosigners (53): Al Green, Alcee L. Hastings, Ann Kirkpatrick, Ann McLane Kuster, Antonio Delgado, Bennie G. Thompson, Bill Foster, Bobby L. Rush, Brian Higgins, C.A. Dutch Ruppersberger, David E. Price, Debbie Wasserman Schultz, Diana DeGette, Donald
M. Payne, Jr., Donald S. Beyer Jr., Eleanor Holmes Norton, Emanuel Cleaver, II, Filemon Vela, Gerald E. Connolly, Grace F. Napolitano, Gwen Moore, Jan Schakowsky, Jerrold Nadler, Jerry McNerney, Jim Cooper, Jimmy Panetta, John P. Sarbanes, John Yarmuth, Joseph
D. Morelle, Julia Brownley, Kathleen M. Rice, Kim Schrier, Linda T. Sánchez, Lisa Blunt Rochester, Lloyd Doggett, Max Rose, Mike Thompson, Paul Tonko, Peter Welch, Raúl M. Grijalva, Rick Larsen, Ron Kind, Ruben Gallego, Salud O. Carbajal, Seth Moulton, Stacey
E. Plaskett, Susan A. Davis, Suzanne Bonamici, Theodore E. Deutch, Thomas R. Suozzi, Tom O’Halleran, Val Butler Demings
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Please join us 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 family planning services, as well as services like breast and cervical cancer screenings, HIV testing, and STD treatments. Title X has is a critical lifeline for more than 4 million patients 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. Every $1 invested in Title X saves $7 in Medicaid costs.
Title X providers are a lifeline in their communities, providing high-quality reproductive and sexual health care, including cancer screenings, testing and treatment for sexually transmitted infections, contraceptive services and supplies, pregnancy testing,
complete and medically accurate information about all pregnancy options, and other basic health care. Title X centers serve populations that often face severe barriers to accessing quality health care such as people with low incomes, people of color, people
in rural areas, and LGBTQ people.
Unfortunately, access to these services is under threat by funding cuts and attacks on the integrity of the Title X program by the Trump administration. Recent years have brought severe cuts to Title X’s funding and administrative threats to the quality
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 is essential to meet the critical need of patients throughout the country.
We encourage you to join us in sending the below letter to the House Appropriations Committee supporting $400 million in Fiscal Year 2020 funding for the Title X program. If you have any questions, please contact Kimberly Espinosa at Kimberly.Espinosa@mail.house.gov
with Rep. Lujan or Ellen Hamilton at ellen.hamilton@Mail.house.gov with Rep. Chu by March 22, 20189.
To sign on, please fill out the Google form here.
Ben Ray Luján Judy Chu
The Honorable Rosa DeLauro The Honorable Tom Cole
Chairman Ranking Member
Appropriations Subcommittee on Appropriations Subcommittee on
Labor, Health and Human Services Labor, Health and Human Services
and Education and Education
Dear Chairman DeLauro and Ranking Member Cole
As you work to develop the Fiscal Year 2020 Labor, Health and Human Services, and Education Appropriations bill, we request that you include $400 million for the Title X family planning program. This funding is critical for Title X health centers
to continue providing essential preventive health and family planning services to millions of low-income individuals as a vital part of the health care safety net.
Title X is the only federal program dedicated to providing family planning services for low-income patients and serves more than 4 million people at nearly 4,000 health centers around the country each year. Because of this funding, these centers
are a lifeline in their communities, providing high-quality reproductive and sexual health care, including cancer screenings, testing and treatment for sexually transmitted infections, contraceptive services and supplies, pregnancy testing, complete and medically
accurate information about all pregnancy options, and other basic health care. Title X centers offer care to populations that often face severe barriers to accessing quality health care such as people with low incomes, people of color, people in rural areas,
and LGBTQ people.
Unfortunately, access to these services has been seriously jeopardized by funding cuts and attacks on the Title X program by the Trump administration. In 2016, researchers from the Centers for Disease Control and Prevention, the Office of Population Affairs,
and George Washington University estimated that Title X would need $737 million annually to deliver family planning care to all low-income uninsured women in the United States. The
gap between funds appropriated and funds needed has continued to grow in recent years: between 2010 and 2014, Congress cut Title X’s funding by $31 million, even though the number of women in need of publicly funded family planning care grew by 1 million in
that period. Funding losses have caused Title X health centers to limit services, lay off staff, and scale back hours, all contributing to a dramatic
reduction in the number of patients Title X serves.
Furthermore, supporting Title X is fiscally responsible. Research estimates that every dollar invested in Title X saves more than seven dollars in Medicaid-related costs, a net savings of $7 billion a year for federal and state governments.Moreover,
75% of American adults—including 66% of Republicans, 75% of Independents, and 84% of Democrats—support the program. Supporting and strengthening the
program is a smart investment in public health, a fact that has been recognized by members of both parties for nearly 50 years. A renewed commitment to Title X is needed to allow this critical component of our nation’s safety net to continue to fulfill its
mission and deliver the health, social, and economic benefits that have made such a difference in the lives of millions.
Over the last two years, Title X has also faced continuous threats to the program’s integrity and its provider network. On March 4, the Trump administration published a final rule that
would detrimentally impact the Title X network and restrict the care that people can receive within program, ultimately harming patients and communities. The administration’s new policy includes a domestic “gag rule” that prohibits health care providers from
referring patients for all reproductive health options available, even when a patient makes a specific request, and allows health centers to opt out of pregnancy counseling altogether. Additionally, the rule opens the door for under-qualified providers by
eliminating the longstanding requirement that Title X providers offer a broad range of medically approved contraception further undermining the integrity of Title X services and eroding the trust of patients; coerces patients to receive prenatal care referrals
regardless of their wishes; imposes onerous physical and financial separation requirements for abortion-related activities; and undermines confidentiality, particularly for minors . The administration’s policy disregards medical ethics by directing what providers
can offer their patients and threatens access to basic, preventive health care for millions of individuals. As separate efforts progress to stop implementation of this devastating rule, it is critical that Congress unequivocally demonstrate its support for
the Title X program in its current form and increase funding for the program.
We ask that you protect this critical program and support the health of millions of Americans by providing $400 million in FY 2020 for the Title X program. We thank you for your consideration of this request.
Ben Ray Luján Judy Chu, Ph.D.
Assistant Speaker Member of Congress
 Euna August, et al, “Projecting the Unmet Need and Costs for Contraception Services After the Affordable Care Act,” American Journal of Public
Health (February 2016): 334-341.
 Jennifer Frost, Lori Frohwirth and Mia Zolna, “Contraceptive Needs and Services, 2014 Update,” Guttmacher Institute (September 2016). https://www.guttmacher.org/report/contraceptive-needs-and-services-2014-update.
 Frost JJ et al., Return on investment: a fuller assessment of the benefits and cost savings of the US publicly funded family planning program, The
Milbank Quarterly, 2014, doi: 10.1111/1468-0009.12080, http://onlinelibrary.wiley.com/enhanced/doi/10.1111/1468-0009.12080/.
 Survey Says: Birth Control Support. The National Campaign to Prevent Teen and Unplanned Pregnancy (2017). https://thenationalcampaign.org/resource/survey-says-january-2017.
 Department of Health and Human Services. Final Rule. “Compliance with Statutory Program Integrity Requirements.” Federal Register 84 (March
4, 2019): 7714-7791.
e-Dear Colleague version 2.0