More than 40 years old, Title X has long been the nation's only federal grant program that provides family planning and preventative health services to roughly 4 million people across the U.S. Perhaps the best-known organization funded by Title X is Planned Parenthood. It, along with other health care providers, has received funding via Title X since it was passed in 1970 and today, of the 4 million people who benefit from Title X funding, the century-old Planned Parenthood serves 1.5 million across roughly 1,600 clinics, providing regular health services like ultrasounds, prenatal care, birth control and STD testing. However, due to the Trump administration's recent passage of a Reagan-era gag rule that bans Title X funds from reaching service providers who provide abortion services, the myriad other services Planned Parenthood provides are at risk. At the beginning of the month, Planned Parenthood filed a lawsuit against the rule.
"The Trump-Pence administration's gag rule is unethical, illegal and harmful to public health, which is why Planned Parenthood is joining together with the American Medical Association to sue to protect patients' rights and access to health care," said Dr. Leana Wen, president of Planned Parenthood. "… Title X serves women and families with low incomes, the majority of whom are people of color, Hispanic or Latino, and the gag rule will worsen existing racial, socioeconomic and geographical health disparities."
In total, of the $286 million Title X distributes to providers, Planned Parenthood receives almost $60 million annually. In a previous article for BTL on the same issue, Planned Parenthood of Michigan Director of Media and Communications Ruth Lednicer said that what many who support the Trump administration's push to end Title X funding for Planned Parenthood might not understand is that there are already processes in place that prevent public funding from being used for abortion services.
"There is a law in place called the Hyde Amendment which prohibits federal funds to be used to pay for abortion. So, whether you're on Medicaid, Title X or privately insured, you're going to be paying out of pocket for that. What federal funds do pay for is all the things that President Nixon put in place, which is for people to have control over reproduction and to have access to family planning," Lednicer said. "We actually see 70 percent of the Title X patients in the state of Michigan. So, without us here there's nowhere else they can go."
Misconceptions
And that's not the only confusion surrounding Title X funding. Emily Clancy is Planned Parenthood's East Michigan community organizer. She said that frequently she talks with people who are completely unaware of Title X's impact on their own health.
"People are often surprised to learn that, 'Oh, I probably used Title X when I went to Planned Parenthood because I couldn't pay for my visit,'" Clancy said. "It's not something like Medicaid and health insurance that you know that you're utilizing those services. So, when I go into what Title X is and how it really helps our patients who can't afford our whole visit, then people see how they may have benefitted as well."
Lednicer added that confusion about the abortion services provided by Planned Parenthood is frequent, too.
"Abortion is less than 5 percent of what we do. The number one thing that people come to us for is birth control followed very closely thereafter by STI testing and treatment. We also do cancer screenings and pap smears, breast exams, HIV testing," Lednicer said.
However, the biggest difference between most other providers is that Planned Parenthood provides abortion as an option when pregnant patients come in to use services.
"We do all the things that people need for reproductive health and well-being," Lednicer said. "I said to someone recently, 'Can you imagine, as a man, going to see a doctor for treatment and there's three options for treatment and you're only told two?' That says so much about how we value women."
LGBTQ Impact
Angela Vasquez-Giroux is the communications and media specialist for Planned Parenthood Advocates of Michigan. She said that as of May 3, 2019, the rule will officially take effect, but Planned Parenthood won't be affected until the 2020 fiscal year begins.
"So it wouldn't mean that on May 4 our doctors would have to stop offering services, it's just that it would take effect for the next fiscal year of funding, Vasquez-Giroux said. "We still have the funding for this year, it's in the bank account, but for the following year. One thing we do want to stress is that we're not closing, we're not going away. There's no danger to anyone's care at this moment and at the moment that there is, we will do everything in our power to make sure that everyone who needs care will still get it."
While that is good news for those who utilize the organization's services in the short-term, Vasquez-Giroux pointed out that there are six rural Michigan counties where Planned Parenthood is the only Title X provider. Should lack of funding shutter those locations, she said that filling that gap with another provider won't be simple.
"So, people will say, 'Oh, some other provider will step in,' but they won't because that's a very difficult program to administer and that's why there's not a great diversity of organizations who participate in this program because it's not easy to do," she said. "The other thing is that, we are the only Title X provider in the city of Detroit and we're talking about problems of access. And [when] you think of access in terms of income and then being part of marginalized group like the LGBT community and about things like transportation, in Detroit, all those things kind of intersect. The thought of someone having no other place to go for basic reproductive health care in the city of Detroit, it terrifies me."
Planned Parenthood is also a provider of Pre-Exposure Prophylaxis pills which are used to treat HIV. As of 2018, the city had an infection rate that was four times that of other counties in Michigan which could increase should the Detroit location close its doors.
Getting Involved
When asked how supporters of Planned Parenthood's overall services could get involved, Clancy cited an upcoming Lansing event designed to bring awareness about the issue to the public and to the Michigan legislature.
"Right now I am really kind of spending the next couple of weeks planning for our big Powering Change Action Summit that's going to take place in Lansing on April 16," Clancy said. "Title X will definitely be a huge part of the conversation and the way we're envisioning this day going is gathering hundreds of our supporters in Lansing to hear from our champions, our community leaders and our legislative champions and then going through a series of breakout sessions on a whole variety of our issues."
Those breakout sessions will include the topics of abortion, birth control, Title X and more.
"We'll be dissecting all the information surrounding it because I think it's really kind of a confusing rule and people aren't sure about how they can help and we'll be giving people some tips for how they can take action," she said.
Clancy added that for those who might not be able to attend the event but would like to stay informed, she recommended texting "STAND" to 22422.
"That is just a text update system and when something moves around the ruling and it will alert you when new messaging material is available," she said. "[Planned Parenthood also] created this whole website dedicated to Title X and patients sharing their stories and videos that really just kind of break it all down. I highly recommend our supporters breaking that down and taking time to educate themselves on what this is."
Lastly, Vasquez-Giroux recommends reaching out to local politicians to inform them of the multi-state lawsuit and spreading awareness.
"We've talked to a lot of elected people at the capitol and in Washington and it's not a partisan issue, this is something that everyone recognizes is an accessible program. So hearing from constituents I think is really important," she said. "The other thing is that one of the best ways that people at large can support Planned Parenthood is to come see us for services, we take insurance and we are a quality health care provider. That's another way to just show your support and get your exam taken care of in one fell swoop."
Visit istandwithpp.org to find out more about Planned Parenthood's national awareness campaign, or go online to plannedparenthoodaction.org for more information about the organization.
