Reproductive health care for women threatened in new Congress: Title X in jeopardy
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* Charlotte Tucker

Women’s reproductive health issues have been pushed back into the spotlight in recent months as members of the new conservative majority in the House of Representatives introduce bills that would affect funding for family planning and women’s health programs.

The bills have led some women’s reproductive health advocates to say they feel as though reproductive health is being threatened in a way that it has not been in the recent past.

“From the women’s health perspective, it’s quite striking that the new extremists in Congress are trying to undo both the health reform achievements of the last Congress and the long history of support for family planning services in our country,” said Lois Uttley, MPP, an APHA member and co-founder of Raising Women’s Voices, a national health care initiative.

In particular, several recent efforts have women’s reproductive health advocates concerned. H.R. 3, the No Taxpayer Funding for Abortion Act, introduced in January, would prohibit federal funds from being used for any health benefits coverage that includes coverage of abortion and would disallow tax benefits for the purchase of health insurance plans that cover abortion. Also introduced in the House in January was H.R. 358, the Protect Life Act. The bill would amend the Patient Protection and Affordable Care Act, otherwise known as the health reform law, to prohibit federal funds from being used to cover any part of the costs of any health plan that includes coverage of abortion services. Reproductive health advocates say the bill would allow hospitals to refuse life-saving abortion care to women.

Both H.R. 3 and H.R. 358 seek to revive parts of a failed 2010 amendment to the health reform law. The amendment, which was originally proposed by former Rep. Bart Stupak, D-Mich., would prohibit the use of Affordable Care Act funds from being used for abortions unless the pregnancies were the result of rape or incest.

Also troubling to reproductive health advocates are efforts to undermine Title X programs. On Feb. 18, the House of Representatives passed an amendent to H.R. 1, the continuing budget resolution, that would remove $300 million in funding for Title X family planning programs, most notably Planned Parenthood. The amendment passed with a vote of 240 to 185 on a largely party-line vote. The overall bill was headed for a vote in the Senate at press time.

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/41/3/1.2/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/41/3/1.2/F1)

Protesters show their support for funding for Title X and Planned Parenthood at a New York City rally in February.

Photo courtesy Eric Harvey Brown

The vote was met with widespread disapproval from women’s health advocates and led to public protests. Elimination of Title X would mean “basic life-saving health care would disappear if the anti-choice lawmakers in the House got their way,” Ted Miller, communications director for Naral Pro-Choice America, told *The Nation’s Health.*

“Title X is an American success story and it’s in jeopardy right now,” he said.

The Title X program was signed into law by President Richard Nixon in 1970, and Planned Parenthood is the largest recipient of Title X funds. Title X is the only federal grant program dedicated solely to providing comprehensive family planning and related preventive health services, according to the Department of Health and Human Services. By law, priority is given to people with low incomes. In fiscal year 2010, Congress appropriated nearly $320 million for family planning activities supported under Title X.

Although the law says no federal funds can be used for abortions, opponents contend that Title X funding provided to facilities that also perform abortions frees up money and allows them to continue performing abortions.

Stuart Schear, vice president of communications for Planned Parenthood, said the net result of doing away with Title X funding will be devastating to the 5 million women who benefit from low-cost health care. Planned Parenthood serves about one-third of all women who use Title X funding.

“We are the single largest heath care provider in the world of Title X,” Schear said. “We are literally what makes Title X work. If you stop allowing Planned Parenthood to receive Title X program money, there is nowhere else for these women to go.”

Schear said 97 percent of what Planned Parenthood does is related to preventive care, including family planning counseling, providing effective birth control, breast exams, Pap smears and testing for sexually transmitted diseases.

“The breakdown is really that most of what Planned Parenthood does has nothing to do with abortion,” Schear said.

Title X also funds training for family planning clinic personnel, data collection and community-based education and outreach activities, which means the disappearance of Title X funding would affect physician training, according to Lisa Maldonado, MPH, MA, a member of APHA’s Action Board and co-chair of the Abortion Task Force within the Association’s Population, Reproductive and Sexual Health Section.

Her organization, the Reproductive Health Access Project, focuses on training primary care physicians on family planning issues by conducting rotations in clinics.

“If Title X money goes away, not only do all these women who have no access to insurance lose, but how are these clinicians going to be trained?” Maldonado said.

The flurry of new bills may be a sign of things to come, given the political leanings of U.S. legislators. Of the 435 members of the House, more than half have shown opposition to abortion, Miller said. And there are 15 states in which both the governors and both chambers of the legislature have shown similar sentiments, according to Miller.

He said the numbers in the House of Representatives mean that reproductive health detractors can advance any legislation they want, “no matter how extreme.”

Overall, members of the Senate tend to be more moderate on women’s reproductive health issues, according to Miller. As of mid-February, Naral had channeled more than 250,000 messages opposing the bills to members of Congress.

Miller said he has seen more activity from reproductive-health advocates recently than in past years in response to the bills that have been introduced, which makes him hopeful that those bills will not make it past the Senate or the president.

“I can say that the pro-choice base is becoming more and more fired up,” Miller said. “Defunding Planned Parenthood is a watershed moment. It’s clearly galvanizing Americans in a way that we haven’t seen in years.”

APHA has long supported women’s access to reproductive health servcies. In November, the Association approved a policy statement supporting abortion coverage in health reform. To take action in support of reproductive health via APHA, visit [http://action.apha.org/site/PageNavigator/Advocacy](http://action.apha.org/site/PageNavigator/Advocacy).

For more information visit [www.naral.org](http://www.naral.org).

*   Copyright The Nation’s Health, American Public Health Association