Abstract
BackgroundTitle X of the Public Health Service Act provides funding for a range of reproductive health services, with a priority given to low-income persons. Now that many of these services are provided to larger numbers of people with low-income since the passage of the Affordable Care Act and Medicaid expansion, questions remain on the continued need for the Title X program. The current project highlights the importance of these safety net programs.MethodsTo help inform this policy issue, research was conducted to examine the revenue and service changes for Title X per state and compare those findings to the states’ Medicaid expansion and demographics. The dataset include publicly available data from 2013 and 2014 Family Planning Annual Reports (FPAR). Paired samples differences of means t-tests were then used to compare the means of family planning participation rates for 2013 and 2014 across the different categories for Medicaid expansion states and non-expansion states.ResultsThe ACA has had an impact on Title X services, but the link is not as direct as previously thought. The findings indicate that all states’ Title X funded clinics lost revenue; however, expansion states fared better than non-expansion states.DiscussionWhile the general statements from the FPAR National surveys certainly are supported in that Title X providers have decreased in number and scope of services, which has led to the decrease in total clients, these variations are not evenly applied across the states. The ACA has very likely had an impact on Title X services, but the link is not as obvious as previously thought.ConclusionTitle X funded clinics have helped increase access to health insurance at a greater rate in expansion states than non-expansion states. There was much concern from advocates that with the projected increased revenue from Medicaid and private insurance, that Title X programs could be deemed unnecessary. However, this revenue increase has yet to actually pan out. Title X still helps fill a much needed service gap for a vulnerable population.
Highlights
When it comes to improving the reproductive health of the population, the United States confronts multiple persistent issues
Title X is a key source of public funding to support family planning services and Medicaid is an very important source of revenue at Title X service sites [1]
While there was an increase in revenue from both private and other third-party payers, it was not enough to offset the losses from Medicaid of $27.6 million, a loss of almost $18 million in client services fees, a total loss of $28.8 million from state and local governments, $10.2 million from Title X, and a loss of $11.5 million from block grants and other revenue sources [7]
Summary
When it comes to improving the reproductive health of the population, the United States confronts multiple persistent issues. Almost half (49 %) of all pregnancies in the United States are unintended This number is even higher for adolescent and young women, women of color, and women with low income and education levels [15]. Title X of the Public Health Service Act provides funding for a range of reproductive health services, with a priority given to low-income persons. That many of these services are provided to larger numbers of people with low-income since the passage of the Affordable Care Act and Medicaid expansion, questions remain on the continued need for the Title X program. Under the Affordable Care Act, after the 2012 Supreme Court decision, states have the option to expand Medicaid coverage to non-parents under the age of 65 who have incomes below 138 % of the Federal Poverty Line [19]. Alaska (129 %) is the only non-expansion state that has adult income criteria that is over 100 % of the Federal Poverty Line [13]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
