February 16, 2017
Dear Members of Congress:
We, the undersigned public health organizations, respectfully request that you demonstrate your support for public health by opposing H.J.Res. 43 and S.J.Res. 13. As representatives of diverse areas of the nation’s public health infrastructure, we urge you to support another critical piece of that infrastructure: Title X, the nation’s only dedicated source of public funding for family planning. These resolutions would overturn an important rule finalized in December 2016 that protects the ability of local communities to develop family planning networks that work best for them.
Family planning was deemed one of the top ten public health achievements of the 20th century and remains the cornerstone for progress on the shared national health goal to reduce unintended pregnancy. And thanks in large part to Title X, the nation’s family planning program that ensures access to high-quality family planning care to 4 million people nationwide every year, the nation’s sexual health outcomes are improving. The unintended pregnancy rate in the US is at a historic low and teen birth rates have been at a record low each year since 2009.
In 2015, Title X resources supported more than 3,900 service sites in the 50 United States, the District of Columbia, and eight U.S. territories and Freely Associated States. These service sites are divided evenly between public entities, such as a state and local health departments, and private entities, such as specialized non-profit family planning providers.i Each piece of this network is critical to maintaining contraceptive access for poor and low-income patients. Indeed, 60% of women who use Title X service sites for health care identify that provider as their primary source of health care services.ii When providers are forced out of the network, patients lose access to their trusted providers and may have no other family planning provider in their area that accepts patients regardless of their ability to pay.

For example, after Texas imposed tiering requirements targeting all specialized family planning clinics in 2011, 25% of family planning providers closed. These closures, along with reduced hours and resources at remaining service sites, led to the loss of 54% of patients in just two years. Providers report that many of those patients were not able to find other health centers that could meet their reproductive health care needs and thus went without basic health care, such as contraceptive counseling and methods, breast and cervical cancer screenings, and sexually transmitted infection testing and treatment.iii
Given this public health challenge, the Obama Administration promulgated “Compliance with Title X Requirements by Project Recipients in Selecting Subrecipients,” the rule that H.J.Res. 43 and S.J.Res. 13 would overturn.iv The rule protects patients by ensuring that high-quality providers can continue to provide family planning services without being subject to additional requirements that are unrelated to their ability to effectively fulfill the high-quality standards required by the program.
If this rule is overturned, many states may feel emboldened to limit access, which in turn, could have wide-ranging consequences for public health. We ask you to prevent such a disaster for public health
from happening across the country. Thank you for your support in this critical moment for the nation’s publicly funded family planning safety network.
Abortion Care Network
American Academy of Pediatrics
American Association of University Women (AAUW)
American Congress of Obstetricians and Gynecologists
American Psychological Association
Association of Reproductive Health Professionals
Association of Women's Health, Obstetric and Neonatal Nurses
Cascade AIDS Project
CHOICES. Memphis Center for Reproductive Health
Hadassah, The Women's Zionist Organization of America, Inc.
HIV Medicine Association
Institute for Science and Human Values
NARAL Pro-Choice America
Nashville CARES
National Abortion Federation
National Association of County and City Health Officials
National Association of Nurse Practitioners in Women’s Health (NPWH) National Coalition of STD Directors
National Council of Jewish Women
National Family Planning & Reproductive Health Association
National Health Law Program
National Latina Institute for Reproductive Health
National Partnership for Women & Families
People For the American Way
Physicians for Reproductive Health
Planned Parenthood Federation of America
Population Institute
Positive Women's Network - USA
Project Inform
Sexuality Information and Education Council of the U.S. (SIECUS)
Society for Adolescent Health and Medicine
i Christina Fowler et al, “Family Planning Annual Report: 2015 National Summary,” RTI International (August 2016). https://www.hhs.gov/opa/sites/default/files/title-x-fpar-2015.pdf.
ii Jennifer Frost, “U.S. Women’s Use of Sexual and Reproductive Health Services: Trends, Sources of Care and Factors Associated with Use, 1995–2010,” Guttmacher Institute (May 2013). https://www.guttmacher.org/sites/default/files/report_pdf/sources-of-care-2013.pdf.
iii Kari White et al, “The Impact of Reproductive Health Legislation on Family Planning Clinic Services in Texas,” American Journal of Public Health 105, issue 5 (2015).
iv “Compliance with Title X Requirements by Project Recipients in Selecting Subrecipients, Final Rule.” Federal Register 81 (December 19, 2016) p. 91853.

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