Fiscal prudence requires spending more, not less, on family planning

February 20, 2011

Within the next several days, legislation to cut the Title X (ten) family planning grant program will be considered by the U.S. House of Representatives. As pediatricians and adolescent health specialists, we are very concerned about the repercussions of this legislation on the health of our population. In our primary care clinic, Title X ensures that all of our patients regardless of insurance status receive reproductive healthcare. Recently, for instance, follow-up care provided a 21-year-old (financed by Title X because she had aged out of Medicaid eligibility) revealed a high-grade cervical lesion, a significant precursor to cervical cancer.

Among our Title X patients, about one-half are similarly uninsured and one-third are seeking confidential services. Nationally, about 7% of clients are men. In our clinic, close to 20% of our Title X patients are men. Young men are even more likely than young women to be uninsured and they often ignore symptoms and do not seek the healthcare they need.

Our patients are just like the millions across the country who have received critical prevention services from Title X over the 41 years since it became law. Research has demonstrated the crucial role Title X serves play in ensuring access to a broad range of family planning and related preventive health services for millions of low-income or uninsured individuals and others.

 According to an analysis by the Guttmacher Institute, investing in Title X saves money in the near and long term. Cutting support for Title X this year ensures only that the public sector will have to pay more next year and in the future, for unplanned births to women and for the complications that result from inadequate screening and testing for other major health issues. If Congress really wants to see reductions in the deficit, spending more on Title X would be the fiscally prudent approach. 

Arik V. Marcell, MD, MPH, Baltimore

Abigail Donaldson, MD, Baltimore

The writers are employed at Johns Hopkins University

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