The Trump administration has stalled a critical funding opportunity for family planning providers for four months, leaving many concerned the application requirements will have changed for the worse.
The application process for Title X grants, which provide funding for a range of family planning and preventive health services for low-income and uninsured individuals, was supposed to begin November 1, with applications due in January and grants awarded in April. But instead, the application process hasn’t even started, leaving many providers whose Title X funding exhausts in March especially concerned about the quick turnaround.
“How do we keep doors open past March 31st? How do I maintain services,” said Kristin Adams, president and CEO of Indiana Family Health Council. Her organization, which represents 35 clinics statewide, was awarded a three-year Title X grant a little over a year ago, but the contract was terminated in July with the change in administration.
With a new administration, comes a change in priorities, Adams figured at the time. But now, the delay is making her anxious. Adams is especially concerned for her family planning clinics whose total funding comes from the grant. Her clinics have already had tough conversations about potential hiring freezes and layoffs.
“[Indiana has] a high infant mortality rate, a high STD rate … interruption of services to Title X will not improve public health outcomes,” Adams told ThinkProgress. “We are finding ourselves in uncharted territory.”
The Office of Population Affairs (OPA), a division within the federal health department, provides Title X grants to about 90 plus agencies, supporting roughly 4,000 service delivery sites. At the helm of the Title X program is Valerie Huber, who was the former president and CEO of a large pro-abstinence association. On Tuesday, the acting deputy secretary for OPA finally reached out to the Title X network after months of little-to-no communication.
“[T]he Title X Program is important to this Administration,” said Huber in the statement. “We are committed to the women and men who depend upon Title X services and efforts are already underway to ensure that there will be no gaps in service while the funding announcement is finalized.”
It’s still not abundantly clear how clinics will be able to avoid a lapse in service. For instance, while Indiana provides other pass-through funding support to the Indiana Family Health Council, it’ll be nowhere near sufficient. And it’s difficult to see how the Trump administration will be able to review and decide on dozens of applications by April 1. “Our applications run 150 pages,” Adams said. History suggests that when providers apply, applications take months to review, she said.
The Trump administration is also having all Title X applicants apply at the same time for funding, meaning they’ll have to review even more applicants. Normally, there are different grant cycles, but this is not the case this time around. Director of Advocacy and Communications at the National Family Planning and Reproductive Health Association, Audrey Sandusky, is concerned that the shortened application period jeopardizes the quality and competitiveness of the applicants. Her organization represents the majority of current Title X grantees.
Current Title X grantees say this administrative change and overall announcement delay signals the Trump administration is rewriting family planning policies.
Grantees and reproductive rights advocates fear the administration is going to target abortion providers by reinstating a Reagan-era domestic gag rule that prohibited Title X centers from counseling or referring abortion services. Another concern expressed was the administration would prioritize providers that emphasize fertility awareness programs over other contraceptive methods.
“There is no reassurance that this is business as usual,” Sandusky told ThinkProgress. “We might see in the actual announcement an attempt to undermine the integrity of the program.”
The Trump administration has said the Title X program, created under the Nixon administration, is critical to family planning services. When the administration rolled back the birth control mandate, they said Title X and community health centers would provide subsidized or free contraceptives to low-income women if employer-based health plans refuse to. But both programs’ funding are currently in limbo.
Planned Parenthood affiliates, family planning clinics, and hospitals make up some of the current Title X grantees. They provide necessary services to the country’s most vulnerable. Majority of Title X patients have incomes at or below the federal poverty level, and most are disproportionately Black or Latinx.
“Any attempt to undermine that diversity will compromise how millions of people have their preventative care needs met,” Sandusky said.