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  • Title: Direct and indirect financing of family planning programs: project grants and reimbursement mechanisms.
    Author: Shultz CS, Martin ML.
    Journal: Fam Plann Perspect; 1973; 5(4):202-8. PubMed ID: 4618205.
    Abstract:
    This article is an analysis of the likely consequences of one proposed mechanism for implementing new federal policy in the delivery of family planning services by tying the financing into state-administered public welfare systems, specifically through SSA Titles XIX and IV-A. These were amended by Congress in 1972 to provide federal reimbursements for 90% of all expenditures related to the offering, arranging and furnishing of family services and supplies. Title IV-A is intended primarily for support of social services; whereas Title XIX is intended for support of medical services. However, regulations permit financing of family planning medical services under Title IV-A. Under these regulations, the states must provide family planning services for all current AFDC recipients (married or unmarried, including sexually active minors) who want these services. The minimum number eligible for AFDC and at risk of unwanted pregnancy is probably an average of 1.8 million women. Table 1 presents the maximum annual income levels that families of 1, 2 and 4 could have in each state and still be potentially eligible for Title IV-A family planning services; Table 2, distribution of states according to annual family income cutoffs; Table 3, the estimated maximum number of women ages 15-44 at risk of unwanted pregnancy and potentially eligible under Title IV-A regulations. The number of eligible individuals under Medicaid (Title XIX) is smaller because elibility requirements are stricter. The future impact of these mechanisms cannot be gauged accurately because it depends on the ability and willingness of the states to utilize these reimbursement mechanisms effectively.
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