Dear Member of Congress:

The undersigned organizations are writing to ask that you include the Title X national family planning program among your list of funding priorities for FY 2007. Specifically, we ask that Title X be funded at $375 million, which is $92 million above its current funding level. Furthermore, we urge you to reject efforts to extend the “Federal Refusal Clause,” that presents a direct and serious threat to women’s reproductive health.

Title X Family Planning Program: Vital Health Care Safety Net for Low-income Women
That OMB Recognizes as One That is “Performing”

Widespread use of birth control continues to be a critical component of basic preventive health care for women and has been the driving force in reducing national rates of unintended pregnancies, STDs, and abortion. Contraceptive use has also led to dramatic declines in maternal and infant mortality rates and has vastly improved maternal and infant health. Unfortunately, many American women do not have access to birth control services.

Today, almost 17 million women need publicly supported contraceptive care—a number which continues to grow due to a rising uninsured population. Many of these women rely on Title X to provide high-quality family planning services and other preventive health care they could otherwise not afford and would not get. Title X is a vital part of our nation's public health infrastructure, serving over five million low-income women and men at 4,500 clinics nationwide. Title X services help women and men to plan the number and timing of their pregnancies, thereby helping to prevent approximately one million unintended pregnancies, nearly half of which would end in abortion.

In addition to providing contraceptive services and supplies, Title X clinics provide basic preventive health services, making women healthier. In 2004 alone, Title X funded clinics provided 2.8 million Pap tests, 2.7 million breast exams, 5.4 million STD tests, and 530,569 HIV tests. Were it not for Title X, many low-income women would have no other source of care and would simply do without, endangering their health as well as the nation’s public health.

A just-released government review of Title X family planning services confirms that the program serves a unique and valuable purpose, is cost-effective, and is effectively managed.[i] However, current funding is inadequate to keep up with inflation, medical advances and a growing population of uninsured Americans. Had Title X funding kept up with inflation it would now be funded at nearly $700 million.

While Title X is one of the nation’s best and most cost-effective public health success stories, without additional funding, Title X clinics will be unable to both meet the growing demand for care and provide quality preventive services, such as rapid HIV tests and chlamydia screening – key public health priorities identified by the Bush Administration. Therefore, we urge you to invest in programs like Title X that promote public health and at the same time save tax dollars. For every public dollar invested in family planning, three dollars are saved in Medicaid costs for pregnancy and newborn care alone.

Federal Refusal Clause Policy Rider: Threat to Health Care Access

In addition to funding shortages, the “Federal Refusal Clause” – also known as the Weldon Amendment – threatens efforts to improve access to deliver high-quality services, information, and referrals to Title X patients. As you know, current law strictly prohibits the use of Title X dollars to pay for abortion care. However, Title X guidelines clearly state that women facing an unintended pregnancy are entitled to nondirective options counseling and referral for services – including abortion care. Although this requirement is consistent with medical ethics, it nevertheless appears to be contradicted by the newly-enacted “Federal Refusal Clause,” which prohibits a federal, state, or local government from requiring any institutional or individual health-care provider to provide, pay for, or even refer for abortion, even in cases of medical emergencies – including when a woman’s life may be at stake.

The penalty for violating this provision is unnecessarily harsh - the loss of all federal funds appropriated under the Labor, Health and Human Services and Education appropriations act. Supporters of the “Federal Refusal Clause” claim that doctors and other healthcare providers are being “forced” to provide abortions against their will. However, these arguments have no basis in fact and conveniently fail to acknowledge carefully crafted “refusal clauses” or “conscience clauses” already in many states’ laws that allow certain types of individuals and institutions to opt out of providing abortion services or referrals on more specific grounds or in narrower circumstances.

We thank you for your past support for efforts to improve health care access for all women. We hope that you will continue to work towards improving women’s health by providing $375 million in funding for the Title X family planning program as a minimal investment in basic health care for low-income women, and by rejecting efforts to extend the “Federal Refusal Clause.” Thank you for your consideration.

American Academy of Pediatrics
American Association of University Women
American Civil Liberties Union
Americans for Democratic Action
American Public Health Association
American Medical Women's Association
American Social Health Association
American Society for Reproductive Medicine
Association of Reproductive Health Professionals
Association of Women’s Health, Obstetrics and Neonatal Nurses
Center for Reproductive Rights
Center for Women Policy Studies
Coalition of Labor Union Women
Guttmacher Institute
Healthy Teen Network
NARAL Pro-Choice America
National Abortion Federation
National Association of Nurse Practitioners in Women's Health
National Alliance of State & Territorial AIDS Directors
National Council of Jewish Women
National Family Planning & Reproductive Health Association
National Partnership for Women & Families
National Women's Health Network
National Women’s Law Center
People For the American Way
Planned Parenthood Federation of America
Physicians for Reproductive Choice and Health
The Reproductive Health Technologies Project
Sexuality Information and Education Council of the United States
Society for Adolescent MedicineUnitarian Universalist Association of Congregations