Recent efforts by the Trump administration to undermine the federal Title X family planning program could significantly impede access to essential preventive health services for low-income patients across the state of California and throughout the country.
Patients like Salina, a 38-year-old mother of three, whose early-stage cervical cancer was detected during her women’s health visit at a St. John’s Well Child and Family Center in South Los Angeles. Title X helps fund the preventive health services that detected Salina’s abnormal cells early, which meant she was able to get critical treatment before the cancer could spread.
For almost 50 years, Title X has provided a critical funding source to ensure that patients like Salina have access to quality reproductive health services they want, and when they need them. Established by Congress with bi-partisan support and signed into law by then-President Richard Nixon in 1970, Title X is the federal government’s only dedicated source of family planning funding for low-income and uninsured patients.
Today, more than four million people nationwide, including 22 percent of patients who identify as Black or African American, and 33 percent who are Hispanic or Latino, depend on Title X for health services. Many view this family planning program as their only source of preventive care. In 2018, Title X supported access to birth control, STD testing and treatment, life-saving cancer screenings and other essential services for 1 million Californians at over 260 health centers in 38 counties. Locally, over 260,000 people, including more than 28,000 African Americans and 53,000 Latinx individuals, received family planning and related care at Title X-funded health centers in Los Angeles County.
Title X funding, coupled with the California’s Family Planning, Access, Care, and Treatment program and public policies in the state that expand – rather than restrict access – have helped reduce unintended pregnancy rates to a historic 30-year low.
But our ability to maintain this significant public health achievement, and the future of the Title X program are now in question because the Trump administration imposed the most sweeping and extreme changes introduced in the history of the program. These harmful and unlawful changes put political ideology over public health by enacting regulations that go against clinical best practices and medical ethics. The regulations seek to deny patients comprehensive information about their pregnancy options, and if allowed to stand, will establish a two-tiered health system and a lower standard of care for low-income patients – disproportionately impacting communities of color and individuals living in rural regions.
The Trump administration’s regulations, which took effect on July 15, have forced some Title X providers to make the difficult decision to leave the program, as legal challenges to the regulations advance through the judicial process. During this interim period, others like Essential Access Health, California’s statewide Title X grantee, and clinics such as St. John’s Well Child and Family Center, have chosen to continue participating in Title X, to limit disruptions in patient care and maintain the robust Title X infrastructure in California, while efforts continue to halt implementation in the Courts.
Without critical Title X funding, 2,000 patients at St. John’s and thousands more throughout California will face delays in receiving comprehensive family planning services, including access to all FDA-approved methods of birth control. Without Title X, St. John’s would have to curtail essential outreach and education activities that connect nearly 7,000 women, men and teens to reproductive health services in their local communities.
For nearly 50 years, Essential Access Health has built the largest and most comprehensive Title X provider network in the nation. Today, California’s robust Title X network remains committed to ensuring that low-income patients across the state have access to essential health services that are provided with dignity, and respect.
This fight isn’t over. It’s just beginning.