Title X (Public Health Service Act) Family Planning Program (CRS Report for Congress)
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| Release Date |
Revised Aug. 31, 2017 |
| Report Number |
RL33644 |
| Report Type |
Report |
| Authors |
Angela Napili, Information Research Specialist |
| Source Agency |
Congressional Research Service |
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Summary:
The federal government provides grants for family planning services through the Family Planning
Program, Title X of the Public Health Service Act (42 U.S.C. §§300 to 300a-6). Enacted in 1970,
it is the only domestic federal program devoted solely to family planning and related preventive
health services. In 2015, Title X-funded clinics served 4.0 million clients.
Title X is administered through the Office of Population Affairs (OPA) in the Department of
Health and Human Services (HHS). Although the authorization of appropriations for Title X
ended with FY1985, funding for the program has continued through appropriations bills for the
Departments of Labor, Health and Human Services, and Education, and Related Agencies (LaborHHS-Education).
The Consolidated Appropriations Act, 2017 (P.L. 115-31) provided $286.5 million for Title X, the
same as the FY2016 level. The FY2017 act continued previous years’ requirements that Title X
funds not be spent on abortions, that all pregnancy counseling be nondirective, and that funds not
be spent on promoting or opposing any legislative proposal or candidate for public office.
Grantees continued to be required to certify that they encourage “family participation” when
minors seek family planning services and to certify that they counsel minors on how to resist
attempted coercion into sexual activity. The appropriations law also clarified that family planning
providers are not exempt from state notification and reporting laws on child abuse, child
molestation, sexual abuse, rape, or incest.
The President’s FY2018 budget request includes $286.5 million for Title X, the same as the
FY2017 enacted level. The House-reported FY2018 Labor-HHS-Education Appropriations bill,
H.R. 3358, would provide no funding for the Title X program in FY2018. The House Rules
Committee has announced that H.R. 3354, the Make America Secure and Prosperous
Appropriations Act, 2018, would be the legislative vehicle for several FY2018 appropriations
bills, including the House Labor-HHS-Education appropriations bill. H.R. 3354, as posted on the
House Rules Committee website on August 16, 2017, would provide no funding for the Title X
program in FY2018. As of this writing, an FY2018 Labor-HHS-Education Appropriations bill has
not been introduced in the Senate.
In December 2016, OPA released a final rule to limit the criteria Title X grantees could use to
restrict subawards: “No recipient making subawards for the provision of services as part of its
Title X project may prohibit an entity from participating for reasons other than its ability to
provide Title X services.” On April 13, 2017, the President signed P.L. 115-23, which nullified the
rule under the Congressional Review Act.
Federal law (42 U.S.C. §300a-6) prohibits the use of Title X funds in programs where abortion is
a method of family planning. According to OPA, family planning projects that receive Title X
funds are closely monitored to ensure that federal funds are used appropriately and that funds are
not used for prohibited activities such as abortion. The prohibition on abortion does not apply to
all the activities of a Title X grantee, but only to activities that are part of the Title X project. A
grantee’s abortion activities must be “separate and distinct” from the Title X project activities.
