Last month, the Department of Health and Human Services announced proposed changes to the rules governing the Title X program. Created in 1970, Title X is the only federally funded grant program exclusively dedicated to providing low-income patients, including adolescents, with essential family planning and preventive health services and information.
The Title X program is an important thread in the fabric of women’s health care. As the only federal grant program of its sort, Title X plays a vital role in ensuring that safe, timely, and evidence based care is available to every woman regardless of her financial circumstances. However, the proposed changes fundamentally change the nature of the Title X program by restricting access to essential preventive care, interfering in the patient-physician relationship and making it harder for women to make timely, informed decisions about their care. These limitations and restrictions undermine our ability to offer patients medically accurate, comprehensive care.
As ob-gyns, we know the essential role contraception plays in our patients’ lives. Contraception is cost-effective, reduces unintended pregnancy and abortion rates, and allows women to have more control over their reproductive health. It also allows women and their families to achieve greater educational, financial, and professional success and stability. Title X plays an essential role in ensuring these choices are accessible to every woman. No patient should have to sacrifice safety or efficacy because no better options are available to her.
Moreover, Title X does not just address family planning needs, but also routine preventive care. Health centers that receive Title X funds also provide services like well woman exams, breast and cervical cancer screenings, screening and treatment for sexually transmitted infections, testing for HIV, pregnancy testing and counseling, and other patient education and/or health referrals. These services save women’s lives.
The proposed changes also raise specific concerns about government interference in the practice of medicine. While Title X funds have never been permitted to be used for abortion care, the proposed changes take a further step to exclude qualified providers from participating in the Title X program. This puts access to essential care at risk for 40 percent of Title X’s four million patients. ACOG opposes any effort to exclude qualified providers from federal programs.
We oppose political efforts to direct health care providers to withhold information or rely on non-evidence based counseling methods. We consider any effort to move away from science-based principles to be interference in the patient-physician relationship. Women count on their providers for clear medical information. The government should not limit what information women can know or what kinds options she should be given.
This level of interference in the practice of medicine would set a dangerous precedent for all areas of medicine.
In practice, these changes will have the most profound impact on low income women and women of color, the very patients this program was created to serve. We cannot accept less access or fewer options for some patients simply by circumstances of their geography or finances.
Your voice can make a difference on this important issue. Over the course of the next few weeks, we will be asking you to engage in advocacy on this issue, including submitting comments. In July, ACOG members will receive a sample comment template to use.
Thank you in advance for joining me in ensuring that women have continued access to high quality, medically accurate reproductive and preventative health care through Title X. It’s essential to women’s health.