Can State-Administered Programs Achieve the National Goal?

Abstract

The decision of the United States Government to delegate major responsibilities for administering family planning programs to the states through the welfare system starting in FY 1974 is assessed in regard to its chances for success and if successful what its net effect would be on the future pattern of federal financing of family planning services. It is shown that there are few advantages accruing to the state which uses Title IV-A of the Social Security Act to finance medical family planning services to current public assistance recipients. 1st there is a ceiling set on Title IV-A expenditures; and secondly a new program structure would have to be erected in most states to administer family planning through Title IV-A. Thus if a state decides to provide family planning services to welfare recipients it will most likely use Medicaid. The use of Title IV-A to provide family planning services to low-income persons without public assistance requires a different set of decisions that pose many obstacles for the states. In addition even if a state did decide to utilize Title IV-A to finance such family planning services to low-income persons the sharp differences in income eligibility criteria from state to state would impose gross inequities. It is concluded that Title IV-A would be a poor vehicle for provision by the states of family planning services.