The XX Factor

America Used to Agree on Public Funding for Family Planning. What Happened?

In 1969, an enthusiastic supporter of publicly-funded family planning services sent a message to Congress. “It is clear that the domestic family planning services supported by the Federal Government should be expanded and better integrated,” he wrote . “It is my view that no American woman should be denied access to family planning assistance because of her economic condition.”

These words did not come from a Planned Parenthood official or a radical feminist. They came from President Richard Nixon, and at the time they were hardly revolutionary. The following year, Nixon signed a law that became known as Title X, dramatically expanding federal government funding for family planning services for low-income women.

Title X’s passage capped a brief moment in the late 1960s and early 1970s when there was a bipartisan consensus that access to family planning was a “universal human right,” as the proposed Title X legislation said. Politicians in both parties celebrated the public-private partnership that linked government funding with non-profit organizations to provide services for poor women. In 1967, Congressman George H.W. Bush urged federal agencies to “work even more closely with going private agencies such as Planned Parenthood” to provide access to birth control for all American women.

Last week the House of Representatives voted along party lines to defund Title X. When Congress enacted Title X in 1970, though, the vote was bipartisan and overwhelming: The Senate voted unanimously in favor of the law, and there were only 32 dissenting votes in the House.

So what happened to that consensus? Basically, the social meaning of family planning changed as abortion became a polarizing political issue. When Title X became law, most Americans believed that the ability to prevent unwanted pregnancies promoted stable families, healthy mothers, and happy children, while helping to reduce poverty among women and children. Efforts to liberalize abortion laws also had popular support: In June 1972, a Gallup poll showed that 64 percent of respondents-including 68 percent of Republicans and 56 percent of Catholics-agreed with the statement that “the decision to have an abortion should be made solely by a woman and her physician.”

But abortion opponents quickly ramped up their organizing efforts, especially in the wake of the 1973 Roe v. Wade decision. They linked abortion to the breakdown of the nuclear family and to women’s abdication of their maternal roles, and by portraying women’s reproductive choices as anti-family, they tarred all family planning programs with the same critique. Not a single Title X dollar has ever been spent on abortion care, but opponents succeeded in convincing many Americans that women’s reproductive autonomy was a threat to the family and to society at large. That meant that contraception, not just abortion, was the real target. Federal funding for Title X and other family planning programs peaked in the early 1970s, declined into the early 1980s, and has remained basically steady ever since.

Although the Republicans who led the charge against Title X last week claimed that they wanted to defund Planned Parenthood’s abortion services, the outcome of their effort would be much larger: If it passes in the Senate it would undermine basic gynecological and preventive health care for nearly 5 million women across the country. Clearly, then, the Republican House leadership has no problem with obliterating all family-planning services for low-income women, not just abortion services.

In the late 1960s, Americans supported family planning programs because they believed that birth control supported important social values: It enhanced public health, promoted self-determination, and reduced poverty. Today, thanks to 40 years of conservative activism, too many people see a clash between their values and publicly-funded family planning. We must fight today’s fight to protect Title X, but in the long run we have to promote the social values that underlie these family planning programs. We must convince the broader voting public that poor women’s health and autonomy are worthy of all Americans’ support, and that we cannot have a healthy society without them.

Photograph of pregnant woman by iStockphoto.