West Des Moines, IA – The HHS Office of Population Affairs (OPA) has released the Title X (ten) Family Planning Annual Report (FPAR) 2023 National Summary*, highlighting critical data and insights on family planning services across the nation. This year’s report reveals significant progress and ongoing challenges in reproductive health services.
Title X is the only federal grant program dedicated solely to supporting the delivery of family planning and related preventive health services for all people. Title X providers ensure equitable and quality service delivery consistent with nationally recognized standards of care. Title X clinics play a critical role in providing affordable family planning and preventive health services to clients in families with low incomes and those without private insurance. In 2023, Title X continued to rebuild the network after the COVID-19 pandemic and federal policy changes. Health centers funded by Title X provided services to diverse clients nationwide.
Nationally, Title X provided services to 2.8 million clients in 2023, a 7% increase from 2022. Title X providers leveraged additional public and private funding sources, including Medicaid, reimbursement from third-party payers, health education grants, STI screening and treatment grants, and more, to deliver services. The Title X program provided clients access to a wide range of contraceptive methods to meet individual needs and allow clients to choose the method that works best for them. In 2023, 72% of all users reported using a contraceptive method for family planning. Title X was also an essential resource for STI and HIV testing and cancer screening.
Title X services were provided at no cost for 60% of users nationally because they were below 101% of the federal poverty level (FPL), which equates to $0-$30,000 annual income for a family of four. Another 23% of users with incomes 101-250% of FPL ($30,001 – $75,000 annual income for a family of four) were provided discounted services on a sliding fee scale.
In 2023, The Family Planning Council of Iowa (FPCI) Title X network covered 55 of Iowa’s 99 counties and included 8 agencies with 13 health center locations.
Key Iowa Highlights
Increased Service Utilization: Iowa experienced a notable increase in the number of clients served through Title X-funded clinics. In 2023, 27,858 clients across the state accessed essential Title X family planning services, an increase of 21% over 2022. The FPCI network health centers saw a total of 21,482 unique users, an increase from 15,278 in 2022.
Diverse Services Offered: Title X clinics in Iowa provided a comprehensive range of services, including contraceptive counseling, STI testing and treatment, and preventive health screenings. Approximately 88% of clients requested contraceptive services, highlighting the role of Title X in promoting reproductive autonomy.
Outreach and Accessibility: Efforts to enhance outreach in underserved communities led to an increase in service provision and Iowa clinics reported successful partnerships with local organizations serving people with low incomes. Fifty-four percent of clients were under 101% FPL and received services at no cost. Another 27% were between 101% and 250% FPL, making them eligible for discounted services. 41% of users had public insurance coverage (primarily Medicaid) and 20% of users were uninsured. The Iowa population as a whole has an uninsured rate of 5.4%.
Contraceptive Method Selection: The Title X program provides users with access to a wide range of contraceptive methods so users can choose the method that works best for them. Iowans selected methods that are most effective and moderately effective at a higher rate than the US.
The most effective permanent methods include female sterilization and vasectomy (male sterilization). The most effective reversible methods include implants and intrauterine devices/systems. Moderately effective methods include injectable contraception, vaginal ring, contraceptive patch, and pill. Less effective methods include external condoms, non-spermicidal gel (used alone), fertility awareness-based or lactation amenorrhea methods, sponge, diaphragm or cervical cap, withdrawal, internal condom, spermicide (used alone), and other methods not listed.
Challenges Ahead: Despite these successes, the report identifies ongoing challenges, including funding constraints and the need for expanded educational resources on reproductive health. Continued advocacy for robust funding and comprehensive education is essential to sustain and enhance these vital services. Title X funding accounts for just 17% of grantees’ total revenue. Nationally, Title X has been funded at the same amount ($286,479,000) since 2015, despite the increasing costs of medical care.
The 2023 FPAR National Summary highlights the pivotal role of Title X family planning services in promoting reproductive health in Iowa. As we celebrate the successes of the past year, we must remain vigilant in addressing the challenges ahead to ensure that all Iowans have access to essential family planning services.
For more information on the Title X Family Planning Annual Report, please visit https://opa.hhs.gov/research-evaluation/title-x-services-research/family-planning-annual-report-fpar. For more information about the FPCI network and 2023 outcomes, please visit https://fpcouncil.org/2023-fact-sheet/ or contact the Family Planning Council of Iowa.
*Pending final review for Section 508 compliance.
Contact:
Allison Smith, Executive Director, Family Planning Council of Iowa
(515)288-9028