Title X, Birth Control, and Politics

The Obama administration last month announced that employers would have to cover contraception in full for employees as part of their health plans.  The rule exempts houses of worship, however other nonprofits with religious affiliations will have to comply.

This has prompted Catholic church leaders, and others, to attack the administration.  During Sunday services across the country they were read a letter claiming, among other things, that the administration has launched an assault on religious liberty.  It also made a very political statement by calling on members to contact Congress and support legislation to reverse the decision.  The bill is the Religious Freedom Restoration Act of 2012 by Republican Sen. Marco Rubio of Florida.

That combined with the recent Susan G. Komen issue has brought the debate over birth control and Title X front and center.

Title X

In 1970 Title X otherwise known as the Public Health Services Act was enacted.  The program provides individuals with comprehensive family planning and related preventative health services.  It is designed to provide access to information, services, and supplies to low income families.

Title X provides:

  • Contraceptive Services and Counseling
  • Patient education and counseling
  • Breast and Pelvic Examinations
  • Breast and Cervical cancer screenings
  • Sexually transmitted Disease (including HIV) prevention education, testing and referral, counseling
  • Pregnancy diagnosis and counseling

What it does not do:

  • Provide abortions

The family planning program is intended to, ” assist individuals in determining the number and spacing of their children. This promotes positive birth outcomes and healthy families.”

Title X is not the same as Medicaid.  Women and men who do not qualify for Medicaid can still get these vital services under Title X.

Clare Coleman President and CEO of the National Family Planning and Reproductive Health Association stated:

“In 2009, 5.2 million patients sought care through this program, and we’re expecting to see higher numbers for 2010 because of the recession.  Congress doesn’t get it. This battle over Title X will not save the government any money. It will cripple systems that are already scraping by on very little money and doing everything they can to help people in the recession.”

A review of the policy by Guttmacher Institute found that health departments comprise more than half of the Title X supported sites nationwide.  Title X supported centers account for:

  • 2.5 million clients tested for STD’s
  • Six in ten women obtain health care for: Cancer Screenings, Breast exams, preventative health care at Title X supported centers.  Those centers are their usual source of health care.
  • One fourth of all poor women go to a Title X supported center for contraceptive services
  • Two thirds of the 7.1 million women obtaining care at publically funded family planning centers received them at more than 4,000 Title X supported sites nationwide.
  • Out of the 17 million women who are in need of publically supported contraceptive services, seven in 10 of those clients live below the federal poverty level.
  • 973,000 unplanned pregnancies were avoided meaning that 433,000 unplanned births and 406,000 abortions did not happen.
  • Title X supported centers saved the government and states: $3.4 billion in costs that Medicaid would have picked up for: prenatal care, delivery, and infant care.  That is $3.74 saved for every $1 spent on contraceptive care.

Birth Control Uses and Facts:

It is used:

  • To prevent pregnancy
  • For reducing cramps or menstrual pain
  • For menstrual regulation
  • To prevent migraines and other painful side effects of menstruation
  • For the treatment of acne
  • For the treatment of Endometriosis

A study by the Guttmacher Institute indicates that 762,000 women who have never had sex use the pill 99% exclusively for non contraceptive reasons.  The study only focused on oral contraceptive pills and not other hormonal methods.  It estimates that the number of women who rely on the Pill for non-contraceptive reasons is higher than the total 1.5 million estimated.

The Guttmacher Institute also found that due to birth control usage birth and abortion rates among U.S. teens fell to record lows in 2008.  Teen pregnancy is at the lowest level since at least 1972.

The Polls:

In a poll released Tuesday Feb 7, 2012 by the Public Religion Institute found that the majority of Catholics think employers should be required to provide health care plans that cover birth control at no cost.  The numbers:

  • All Americans: 55% Agree, 40% Disagree
  • Unaffiliated: 61% Agree, 32% Disagree
  • Catholic: 58% Agree, 37% Disagree
  • White Mainline: 50% Agree, 47% Disagree
  • White Evangelical: 38% Agree, 56% Disagree

When it came to Religiously Affiliated Colleges and Hospitals being required to provide their employees with health care plans that cover contraception or birth control at no cost the numbers were:

  • All Americans: 49% Agree, 46% Disagree
  • Catholics: 52% Agree
  • Catholic Voters: 45% Agree, 52% Disagree
  • White Catholics: 41% Agree, 58% Disagree
  • Unaffiliated: 59% Agree
  • White Evangelical Protestants: 31% Agree
  • White Mainline Protestants: 45% Agree, 48% Disagree
  • Millennials: 58% Agree
  • Seniors: 33% Agree
  • Women: 54% Agree
  • Men: 43% Agree

Those that support exemptions and say that churches and other places of worship should not be required to provide health insurance plans that cover contraception or birth control at no cost:

  • All Americans: 57% Agree with 36% Disagreeing and saying they should be required to provide the birth control and contraception in the health care plans.
  • Catholic: 59% Agree
  • Catholic Voters 68% Agree
  • White Catholics: 72% Agree
  • White Evangelicals: 73% Agree
  • White Mainline Protestants: 64% agree
  • Catholics: 59% Agree

A Poll by Lake Research Partners found:

  • That American’s by a margin of two to one side with the view that everyone has the right to safe, affordable family planning services.
  • A significant proportion (40%) of Americans are willing to penalize any elected official who votes to defund family planning programs, including birth control and contraception.
  • American’s are tired of the polarizing abortion debate.
  • American’s overwhelmingly agree with the idea to engage in a broader discussion that includes greater access to birth control, teaching comprehensive sex education, and improving maternal health and childbirth outcomes.

In a poll by Thomson-Reuters they found:

  • 77% of people said that insurance (private or employer based) should cover all or some of the cost of contraceptives.
  • 74% said that even if someone got help by the government to pay for insurance contraceptives should be covered
  • 3/4 of American’s support federal subsidies at clinics for low income people to cover birth control and family planning–excluding abortions.

Redefining Personhood:

The founder and President of Personhood USA, Keith Mason, wants to change the laws and constitutions of every state and some countries to, “recognize someone as a person exactly at creation.  Its fertilization; it’s when the sperm meets the egg.”  Even though doctors and scientists say that it is not until implantation inside of the uterus that life begins.  They are working to get proposals on the ballot in half the states in the US by 2012.  To his organization those laws should recognize every fertilized egg as an individual and complete human being.

Bachmann, Santorum, Gingrich, Perry, and Ron Paul (with his own addendum) have signed the Personhood Republican Presidential Candidate Pledge.  From their website:


I __________________ proclaim that every human being is created in the image and likeness of God, and is endowed by our Creator with the unalienable right to life.

I stand with President Ronald Reagan in supporting “the unalienable personhood of every American, from the moment of conception until natural death,” and with the Republican Party platform in affirming that I “support a human life amendment to the Constitution, and endorse legislation to make clear that the 14th Amendment protections apply to unborn children.”

I believe that in order to properly protect the right to life of the vulnerable among us, every human being at every stage of development must be recognized as a person possessing the right to life in federal and state laws without exception and without compromise. I recognize that in cases where a mother’s life is at risk, every effort should be made to save the baby’s life as well; leaving the death of an innocent child as an unintended tragedy rather than an intentional killing.

I oppose assisted suicide, euthanasia, embryonic stem cell research, and procedures that intentionally destroy developing human beings.

I pledge to the American people that I will defend all innocent human life. Abortion and the intentional killing of an innocent human being are always wrong and should be prohibited.

If elected President, I will work to advance state and federal laws and amendments that recognize the unalienable right to life of all human beings as persons at every stage of development, and to the best of my knowledge, I will only appoint federal judges and relevant officials who will uphold and enforce state and federal laws recognizing that all human beings at every stage of development are persons with the unalienable right to life.

Ron Pauls Personhood Statement can be read here:  http://www.personhoodusa.com/files/Keith%20Ashley/Ron%20Paul%20Personhood%20Statement_0.pdf

A spokesperson for the American Congress of Gynecologists and Obstetricians said that pregnancy is not scientifically established until the fertilized egg is implanted in the lining of the uterus.  However Mason responded with, “The question of personhood is not when life begins — that is a settled scientific fact.  The question is whether we believe that all human beings have human rights.”

Critics of Personhood USA’s have pointed out that if the definition of life begins at the moment of fertilization then not only would abortion be illegal so would birth control.  They also point out that this would put many women in legal jeopardy through no fault of their own.  Also if one defines life at fertilization and recognize the life as its own human being at that moment then it opens up a lot of other questions.  For example: Carpool lane, Filing for Social Security Number, Dependent Status for taxes, property rights, heir status, etc.

On to the candidates/elected politicians/states/groups:

Mitt Romney states on his website that he would, “Eliminate Title X family planning programs benefiting abortion groups like Planned Parenthood.”  He has also stated “life begins at conception.  Birth control prevents conception.”  When asked if he would support a constitutional amendment that would establish the definition of life at conception he answered “absolutely.”

Mitt Romney’s plan in Massachusetts is “virtually identical” to the Obama birth control coverage mandate.

House Republicans Rep. Denny Rehberg Republican from Montana proposed a bill for Fiscal year 2012 that “eliminates 79 wasteful programs” including Title X.  It would defund Planned Parenthood and cut funding for teen pregnancy prevention initiatives.  The GOP Communications Director said, “It reflects the Republican position on those issues….it reflects the opinions of our members”.  House Republicans already cut funds to Title x by 5.5% during budget negotiations in 2011.

Draft 2012 Budget drafted by the Republicans on the House Appropriations Committee would reduce or cut:

  • Cut Title V Maternal and Child Health Services Block Grant funding by another $1.8 million from the 2011 level.
  • Cut the entire $350 million Title V Maternal, Infant, and Early Child Health Home Visiting Program,
  • Cut the entire $25 million pregnancy assistance fund
  • Cut the entire $337 million in Title X Family Planning Grants, eliminating Title X altogether.
  • Reduce funding for Teen Pregnancy Prevention Initiative by $64.79 million

Rep. Hal Rogers Republican from Kentucky, chairman of the committee, defended the cuts as necessary to get spending under control.  “While making these cuts is hard, we have a unique opportunity to right our fiscal ship.”

Gingrich has said he would eliminate the entire Title X program and defund Planned Parenthood.  He has also said, “Part of what I would like to explore is whether or not you could get Congress to pass a law, which simply says, ‘Personhood begins at conception,’ and in the same law you could block the court and say, ‘This law will not be subject to review,’” Gingrich said. “You would therefore not have to have a constitutional amendment because the Congress would have exercised its authority under the Fourteenth Amendment to define life and to therefore undo all of Roe v. Wade, for the entire country.”  He then clarified that he meant, “successful implantation,” not fertilization.”

Ron Paul believes that he would, “veto any spending bill that contains funding for Planned Parenthood…and all government family planning schemes.”  He has also said, “Not all Americans are comfortable with the Obama administration’s decision to mandate coverage of birth control and morning-after pills, and the considerations of these people, many of them Christian conservatives, are worthy of careful consideration — not mockery.”

Rick Santorum is opposed to all family planning programs and believes that schools should be forbidden to teach students about contraception.  He voted for the “family cap” and the “illegitimacy cap” that would have financially penalized low income women for having children and penalized states for children born out of wedlock.  He believes Planned Parenthood is motivated by racism and eugenics.  He also favors allowing states to decide whether to ban birth control, and that Health Insurance plans should not be required to cover birth control.  His website states he would, “Eliminate funding for Planned Parenthood and use half of the dollars to support adoption instead.”

State of Texas they passed a law that prohibits patients on Medicaid Womens Health Program from using family planning clinics that are “affiliated” with abortion clinics.  They also cut two-thirds from the state family planning budget for the next two years.  All to dismantle Planned Parenthood.  Despite the Federal Law saying that patients are free to go to any clinic they want.  The Federal Government picks up 90% of the bill in Texas.

Rick Perry released the statement:

“We are committed to protecting life in Texas, and state law prohibits giving state dollars to abortion providers and affiliates — a fact the Obama administration ignores. I strongly urge the administration to do the right thing and grant this waiver, so Texas women can access critical preventative health services, including breast and cervical cancer screenings, rather than making them pay the price for its pro-abortion agenda.”

States: In April 2011 49 states had a total of 916 measures related to reproductive rights.  All of them related to abortions and offer little in the way of proactive initiatives aimed at expanding access to reproductive health-related services.

Sen. Barbara Boxer, Democrat from California said:

“Women in this country are tired of being treated like a political football by Republicans in Congress who have tried continually and are continuing to try to take away their benefits – to take away their rights.  We will use every legislative tool at our disposal to protect the women of America. We’ve done it before and we’ll do it again.  It is a very serious issue: We’re here to stand up for the women of America who deserve to have access to free preventative care through their health insurance, and we want to thank President Obama for making that possible.  It’s medicine – and women deserve their medicine.  This is a health benefit and everyone has a right to their view on it, but at the end of the day, we’re here to say, we support the right of women in this country to have access to birth control through their insurance policies and anyone who stands in the way is going to have to deal with us.”

Sen. Frank Lautenberg, D-N.J., accused Republicans of exploiting Republican ideology to attack women’s health, and called for an end to what he described as the “male-igarchy.”  “Republican politicians need to stop meddling in the lives and the health of women in our country, and it’s time to tell those Republicans, mind your own business.”


The White House is going to announce a change to this plan to move the coverage requirement to Health Insurance Companies, if their employers object to birth control on religious grounds.  The insurance companies will have to provide workers the opportunity to obtain contraceptive coverage directly at no additional charge.  Church’s would remain exempt as would their workers.  The announcement will come on February 10, 2012.

Links in Article:

[vi] Title X Family Planning (http://www.hhs.gov/opa/title-x-family-planning/)

[vii] Title X Family Planning (http://www.hhs.gov/opa/title-x-family-planning/)

[viii] House GOP Targeting Title X In Push To Axe Family Planning Programs (http://www.huffingtonpost.com/2011/10/04/title-x-republicans-planned-parenthood-family-planning_n_993957.html)

[ix] The Numbers Tell the Story: The Reach and Impact of Title X (http://www.guttmacher.org/pubs/gpr/14/2/gpr140220.html#6)

[x] Many American Women Use Birth Control Pills for Noncontraceptive Reasons (http://www.guttmacher.org/media/nr/2011/11/15/index.html)

[xi] U.S. Teen Pregnancy Rate at Lowest Level in Nearly 40 Years (http://www.guttmacher.org/media/nr/2012/02/08/index.html)

[xii] Survey | Majority of Catholics Think Employers Should Be Required to Provide Health Care Plans that Cover Birth Control at No Cost (http://publicreligion.org/research/2012/02/january-tracking-poll-2012/)

[xiii] Lake Research Partners Key Findings on Public Attitudes on Family Planning (http://www.nationalfamilyplanning.org/document.doc?id=213)

[xvi] Personhood Republican Presidential Candidate Pledge (http://www.personhoodusa.com/blog/personhood-republican-presidential-candidate-pledge)

[xviii] Newt Gingrich: Life Begins At Implantation, Not Fertilization (http://www.huffingtonpost.com/2011/12/02/newt-gingrich-life-begins-implantation_n_1125810.html)

[xix] Anti-Abortion Groups Push To Outlaw Contraceptives By Redefining Personhood (http://thinkprogress.org/justice/2011/06/03/235552/personhood-bills-attack-contraception/?mobile=nc)

[xxi] Mitt Romney Does Not Understand His Own Position on Birth Control!  (http://www.dailykos.com/story/2011/10/21/1028848/-Mitt-Romney-Does-Not-Understand-His-Own-Position-on-Birth-Control!)

[xxii] Obama Attacks Mitt Romney On Birth Control (http://www.huffingtonpost.com/2012/02/08/obama-attacks-mitt-romney_n_1263485.html)

[xxiii] House GOP Targeting Title X In Push To Axe Family Planning Programs (http://www.huffingtonpost.com/2011/10/04/title-x-republicans-planned-parenthood-family-planning_n_993957.html)

[xxv] GOP Spending Plan: X-ing Out Title X Family Planning Funds (http://blogs.wsj.com/washwire/2011/02/09/gop-spending-plan-x-ing-out-title-x-family-planning-funds/)

[xxvii] Gingrich clarifies stance on personhood (http://floridaindependent.com/59319/newt-gingrich-personhood)

[xxviii] Newt Gingrich: Life Begins At Implantation, Not Fertilization (http://www.huffingtonpost.com/2011/12/02/newt-gingrich-life-begins-implantation_n_1125810.html)

[xxx] Ron Paul: Greater Access To Birth Control Makes A ‘Mockery’ Of Christians (http://thinkprogress.org/health/2011/10/06/338285/ron-paul-greater-access-to-birth-control-makes-a-mockery-of-christians/?mobile=nc)

[xxxii] Ruling on Contraception Draws Battle Lines at Catholic Colleges (http://www.nytimes.com/2012/01/30/health/policy/law-fuels-contraception-controversy-on-catholic-campuses.html?_r=2)

[xxxiii] Spending Cuts and Entitlements Reform (http://www.ricksantorum.com/spending-cuts-and-entitlements-reform)

[xxxiv] A Successful Health Program May End Thanks to Texas’s Quest to Kill Planned Parenthood (http://blogs.dallasobserver.com/unfairpark/2011/12/in_utero_news_medicaid_womens.php)

[xxxv] State Legislative Trends: Hostility to Abortion Rights Increases (http://www.guttmacher.org/media/inthenews/2011/04/12/index.html)


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