Funding for Family Planning: Comparing Title X and Family Planning SPAs
Family Planning SPAs and Title X both provide funding for family planning health care. This post shows the differences in these programs and how they work together to protect access to preventative care.
Patients:
Title X Family Planning Program:
- Access care with any Title X grantee: all birth control methods, STI and related gynecological care (pap), care coordination for other reproductive and primary care services.
- Household income <100% FPL for no-cost care, sliding fee scale 101%-250% where services are provided at a discount.
- Can enroll with any Title X grantee for immediate care.
- Coverage for all genders and to individuals age 12+, including non-citizens.
Medicaid Family Planning Spas:
- Access care at any health entity that accepts Medicaid: all birth control methods, STI care, preventive services (repro vaccines), gynecological care (pap, colpos), often covered.
- Household or individual income equaling the eligibility limits for pregnant people under Medicaid or CHIP for no-cost care.
- Can enroll in ongoing coverage usually through the state’s Medicaid application, or, in some states, enroll in immediate, temporary coverage with a provider.
- Coverage often open to people of all genders and ages who are US citizens or qualified immigrants for 5+ years.
Payors:
Title X Family Planning Program:
- Grant awarded annually from federal Title X and state General Revenue Funds.
- Title X grantees accept all insurance, applying Title X funds as a payor of last resort. Can draw down on TX grant even if covered by Medicaid/private insurance.
Medicaid Family Planning Spas:
- Ongoing Medicaid coverage at 90% federal/10% state for family planning services billed directly to state Medicaid as fee-for-service w/o a cap.
- Often can qualify with private insurance that patient can not/does not want to apply because of confidentiality concerns or restrictions on coverage of reproductive services.
Providers:
Title X Family Planning Program:
- Confidential care for all, nobody turned away due to inability to pay when seeking covered services with Title X grantees.
- Dispensing of no-cost or sliding fee scale supplies/meds at Title X grantee clinic site.
- Grant administrative tasks for funding compliance.
Medicaid Family Planning Spas:
- Confidential care for all, nobody turned away due to inability to pay when seeking covered services at a community health/safety nets.
- Dispensing of no-cost supplies/meds at patient’s pharmacy of choice.
- Same administrative tasks for compliance as full Medicaid plans.
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