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  • Title: Public funding for contraceptive, sterilization and abortion services, 1994.
    Author: Sollom T, Gold RB, Saul R.
    Journal: Fam Plann Perspect; 1996; 28(4):166-73. PubMed ID: 8853282.
    Abstract:
    In 1994, federal and state funding for contraceptive services and supplies reached +715 million. Funding totaled +148 million for contraceptive sterilization and +90 million for abortion services. According to a survey of state health, Medicaid and social service agencies, reported spending on contraceptive services and supplies increased by 11% between 1992 and 1994. In the same period, spending under Title X rose by 37%, making it the third largest public funding source for contraceptive services and supplies. The largest source of public funds for family planning services continues to be the joint federal-state Medicaid program. Medicaid family planning expenditures increased by only 4% between 1992 and 1994, a sizable decrease in growth from previous years. State funds continue to be the second largest source, providing almost one-quarter of reported public expenditures in 1994. The maternal and child health and social services block grants remain relatively minor sources of support nationally, although in a handful of states they provide the majority of public-sector funds. State governments were virtually the sole source of public support for the 203,200 abortions provided in 1994 to low-income women. Despite the loosening of federal abortion funding criteria in FY 1994 permitting payment in cases of rape and incest, federally funded abortions numbered only 282. A survey of public funding in the US for contraceptive, sterilization, and abortion services during fiscal year 1994 identified an upswing in Title X funding accompanied by a leveling off in Medicaid support. In 1994, federal, state, and jurisdictional governments reported spending $715 million on reversible contraceptive services and supplies; Medicaid contributed 46% of total expenditures, while Title X provided another 21%. 13% of all women receiving family planning care under Medicaid obtained this benefit as a result of the recent expansion of the program to cover low-income pregnant women not otherwise eligible. Overall, public expenditures for contraceptive services and supplies increased by 11% between 1992 and 1994; during this period, Title X funding increased by 37%, while Medicaid support rose by only 4%. Public expenditures on sterilization services totaled $148 million in 1994, 94% of which was provided through Medicaid. However, less than 1% of the $90 million spent on abortions in 1994 was provided by the federal government. In that year, states spent over $89 million to finance 202,918 abortions for low-income women. Title X is one of the few federally funded health and social programs able to rebound from the cuts implemented during the Reagan administration. The lack of expansion in Medicaid expenditures for family planning reflects both the slowdown in overall Medicaid spending and the trend toward enrolling recipients in managed care plans. Current attempts to restructure and restrict coverage of federal programs such as Title X and Medicaid risk leaving large numbers of low-income women without access to family planning services.
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