Community health centers are poised to make significant changes in Title X program participation, according to a new report which comes at a time of heightened concern over access to primary health care during the COVID-19 pandemic. The authors surveyed community health centers to assess their current and future Title X participation plans, ahead of the March 4th, 2020 date on which the administration’s rule took full effect. Among the rule’s key provisions are major new restrictions on how Title X clinics counsel pregnant women and new financial management rules.
The survey found that two-thirds of all community health center respondents either were not participating in Title X and had no plans to do, or else were previous participants that had already left the program. Another one-third either were current participants that planned to remain, or were non-participants that were considering applying. The survey also found that community health centers that were not participating in the program but planned to apply in the future were more likely to be located in the south or in the western regions of the country. Among those health centers that planned on leaving the Title X program or that had already done so, 70 percent cited concerns that the new requirements would compromise quality of care, and 66 percent said they were worried that restrictions could negatively affect their patients’ health. While one third of all respondents anticipated a major surge in need in their communities, only 9 percent reported that their health center would be able to accept an increase of 50 percent or more in new family planning patients. This estimate of additional treatment capacity came before the surge in needs related to the COVID-19 pandemic, which can be expected to intensify resource strains on health centers.
In 2018, community health centers served more than 6 million low-income women of childbearing age. The new Title X rule is threatening to drive away the nation’s premier primary care network from participating in the program. Coupled with the loss of other providers, the exit of health centers from the Title X program could have dire consequences for medically underserved communities.
The report is authored by researchers at the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University Milken Institute School of Public Health (Milken Institute SPH).