By Pamela Fourtounis
BU News Service
BOSTON – Massachusetts Governor Charlie Baker announced February the allocation of $1.6 million to family planning and preventative health care services to cope with the potential loss of federal funding.
The federal government, through Title X, funds family planning clinics across the country that serve low income and uninsured women and families.
The state receives $6.4 million each year in Title X funds from the federal government. The money allows clinics to provide sexual education, STI/HIV testing, counseling, physical exams, contraception and reproductive cancer screenings.
At the time of Baker’s announcement, the federal government had yet to announce future funding for Title X. Funds were set to run out by March 31 and leave publicly funded family planning clinics in Massachusetts in jeopardy for the remainder of the fiscal year.
Title X grantees include the Massachusetts Department of Public Health (which receives $1.35 million annually), Planned Parenthood, Action for Boston Community Development, Health Quarters and Health Imperatives. The grantees operate clinics throughout the state.
“The Baker Administration’s commitment to step in with state funds if federal inaction creates gaps in care is a direct acknowledgement of the important role Title X plays in keeping people healthy and saving taxpayer money,” president and CEO of Planned Parenthood League of Massachusetts Dr. Jennifer Childs-Roshak said in a press release last month.
Childs-Roshak said despite Massachusetts being a leader in women’s funding for reproductive rights, the state alone would struggle to fund all of the services needed.
“[A cut in funding] would cost Mass. and every state huge amounts over the next few years in costs of unintended pregnancy and birth, supports for children born into low income families and additional costs for undetected STIs and breast cancer,” Lois McCloskey, professor in the Boston University School of Public Health, Department of Community Health Sciences.
McCloskey emphasized the unique value of the Title X program to fund all types of community health organizations.
“Many assume that community health centers and other primary care providers could simply fill in the gap of places like PP, offering family planning services,” McCloskey said. “Such providers are not prepared, not adequately trained in many cases and unable to absorb the extra demand for women’s health services.”
The Title X funding situation has been further complicated since the funding announcement by Baker when in late February the Trump administration addressed the future of Title X by announcing grantees must apply for funding by May. If approved, they will begin receiving funding in September.
The administration created new guidelines for grantees and favored some organizations over others. Namely, organizations providing abortions may apply under the new guidelines but cannot use the funds to provide abortions. The guidelines favor clinics that offer natural family planning methods over others.
These new specifications trouble women’s health and reproductive rights organizations throughout the nation.
“First, the announcement is designed to penalize reproductive health care providers and make it harder for women to access expert reproductive health care under the program,” said Johanna Kaiser, media relations manager for Planned Parenthood League of Massachusetts. “The announcement does this by attempting to block women from going to expert reproductive health care providers and instead pushing them to go to providers that emphasize abstinence-only and don’t provide the full range of birth control methods.”
Kaiser said the announcement from the federal government is intended to reduce access to the 18 FDA-approved safe and easily accessible birth control methods.
“Similarly, consistent with a leaked White House memo that promoted fertility awareness methods under the program, the term ‘natural family planning’— a reference to fertility awareness methods like the rhythm method or calendar method — appears 6 times but the term ‘Long Acting Reversible Contraceptives (LARC),’ the most effective methods of birth control that have been growing in popularity, doesn’t appear once,” Kaiser explained.
National women’s health organizations affirm this sentiment as well.
“We’re on the record in support of Title X, both last year when Congress passed measures to restrict women’s choices and most recently when the Department of Health and Human Services released new, distressing guidance for grant funding applications,” said Maggie McEvoy, a member of the American College of Obstetricians and Gynecologists. “I believe both of these provide quite a bit of substance to our view on the importance of this program.”
Kinsey Hasstedt, a senior policy manager at the Guttmacher Institute, a research and policy organization focused on advancing sexual and reproductive health and rights globally, condemned the Trump Administration’s decision.
Hasstedt said although Title X grantees won’t lose their funding by March 31 the funding announcement has dangerous consequences.
“It has the potential to seriously undermine people’s ability to obtain comprehensive, high-quality, affordable and confidential family planning care — all in favor of the administration pushing its socially conservative priorities,” Hasstedt said. “The funding announcement opens the door to fundamentally altering Title X by stacking the deck against providers who focus on providing high-quality reproductive health care, promoting natural family planning (or fertility awareness methods) over all other methods of contraception and pushing harmful abstinence-only-until-marriage messages to adolescents.”
Hasstedt said she isn’t sure what the result will be but she worries for Title X.
“The Title X program yields significant health and economic benefits for individuals, families and society and is good government at its best,” Hasstedt said. “Jeopardizing people’s ability to affordably obtain high-quality, comprehensive family planning care in the name of political ideology is unacceptable.”