Florida Anti-Abortion Funding History
As the Florida Department of Health notes, comprehensive family planning services decrease the rate of unintended pregnancies and the incidence of abortion. Still, on November 4, 2004, then-Governor Jeb Bush signed an executive order bringing Florida Pregnancy Support Services Program to fruition. Florida first allocated state funding to the program through the 2006 state budget via the funding allocated to the Department of Health (DOH).[1] The same year, Florida Pregnancy Care Network was contracted to manage the program.
The Florida Legislature allocated funding for the program in the state budget for the first time in 2006 at $2 million.[2] Allocations continued at a rate of $2 million per year, until funding was increased to $4 million in 2015. Funding remains at $4 million per year.[3]
From 2011 to 2019, $1.5 million to $2 million of the Florida Pregnancy Support Services Program’s allocation came from the state’s rape crisis program trust fund. This fund was created within DOH “for the purpose of providing funds for rape crisis centers in the state.” Despite rape crisis funds being funneled to the Florida Pregnancy Support Services Program, none of its local programs or the network that oversees it promote, nor seem capable of, providing rape crisis services. Former Governor Rick Scott vetoed additional funding for Florida’s Rape Crisis Centers in 2014.[4] The Florida Council Against Sexual Violence, Inc. is currently contracted with the State to oversee the network of rape crisis centers. These centers are required to have an independent on-site review every other year to ensure compliance. Services at a rape crisis center can include forensic exams, support groups, and therapy, services that are far more advanced than those provided at anti-abortion pregnancy centers.
Despite lax State requirements, the Florida Pregnancy Support Services Program continuously receives more funding through the state legislature’s budget. This stands in stark contrast to how the Florida government handles comprehensive family planning funding, which has stringent requirements and is primarily funded through federal Title X funds. Family planning services consist of “access to FDA-approved contraceptive methods,” pregnancy testing and options counseling, and preventative services, such as “screening for hypertension, breast and cervical cancer, and sexually transmitted diseases, including HIV.” As noted by the Florida Department of Health, comprehensive family planning services, like contraception and preventative care, prevents the rate of unintended pregnancy, which “reduces the incidence of abortion.”
Family planning funding in Florida has relied primarily on the federal government, specifically the Title X Family Planning Program: a federal grant program to provide comprehensive family planning services and preventative health care. President Richard Nixon signed the Title X program into law in 1970,[5] and for 50 years it has been the only federally funded program solely dedicated to funding family planning services for uninsured or underinsured people and people with no or low incomes.
Title X grantees are subject to federal scrutiny and are required to report patient socioeconomic information as well as data on services performed. Patient socioeconomic information includes:
- Age Group
- Sex of Family Planning Users
- Race
- Ethnicity
- Income level
- Health insurance coverage status
- Language
Title X recipients are required to report the services they provide to family planning users. Services include a range of hormonal contraception, sterilization, abstinence education, and pregnancy testing. Title X recipients can perform cervical and breast cancer screenings, in addition to sexually transmitted disease and sexually transmitted infection testing.
Title X funds are awarded directly to organizations that provide comprehensive family planning services and to local and state governments. Florida DOH was the only Title X grant recipient in Florida until March 2017, when Community Health Centers, Inc. and Planned Parenthood of South Florida and the Treasure Coast, Inc. became additional recipients. Current Title X grantees are DOH, funding 142 health centers, Primary Care Medical Services of Poinciana, Inc. and Community Health Centers of Pinellas, Inc., together funding 15 federally qualified health centers that offer family planning and sexual health services. Planned Parenthood of Southwest and Central Florida and Planned Parenthood of South, East and North Florida were forced to leave the Title X program due to the Trump administration’s domestic gag rule – a rule prohibiting Title X grant recipients from referring patients for abortion care, even if the patient requests it.[6] The Florida Department of Health currently receives $11.2 million in Title X grants, making up the majority of Florida’s Title X funding. Primary Care Medical Services of Poinciana, Inc. and Community Health Centers of Pinellas, Inc. both receive $300,000 respectively.
In addition to Title X funds, Florida’s Agency for Health Care Administration (AHCA) and DOH implemented the Family Planning Waiver (FPW) program in October 1998 to provide comprehensive family planning services. The program aimed to provide family planning services to women ages 14-55 losing Medicaid coverage who have family income below 185 percent of the Federal poverty level. Women are eligible for FPW coverage up to two years, subject to an annual redetermination. In 2018, 48 percent of births of Florida were funded by Medicaid. Currently in Florida there are 703,008 “women of reproductive age” who are uninsured, and 1,750,000 “women of reproductive age” have household incomes at or below 250 percent of the federal poverty level.
The FPW program was set to expire on December 31, 2013. In June 2013, the federal Centers for Medicare and Medicaid Services issued Florida an automatic one-year temporary extension for the FPWs. FPW has since been extended and renewed – most recently through June 30, 2023. The program covers services and supplies directly related to family planning, including:
- Family planning examinations;
- Family planning counseling;
- Approved methods of contraception;
- Sexually transmitted infection (STI) testing;
- Sexually transmitted disease (STD) testing;
- Pap smears and pelvic exams;
- Approved sterilizations;
- Colposcopies;
- Various methods of contraception and other family planning pharmaceuticals;
- Service provider supplies.
[1] http://laws.flrules.org/2006/25 pg. 105
[2] House Bill No. 5001, 105 (2006), http://laws.flrules.org/2006/25; Senate Bill 2800, 109 (2007), https://www.flsenate.gov/Session/Bill/2007/2800/BillText/er/PDF; House Bill No. 5001, 93 (2008), http://laws.flrules.org/2008/152; Senate Bill 2600, 93 (2009), https://www.flsenate.gov/Session/Bill/2009/2600/BillText/er/PDF; House Bill 5001, 98 (2010), https://www.flsenate.gov/Session/Bill/2010/5001/BillText/er/PDF; Senate Bill 2000, 83 (2011), https://www.flsenate.gov/Session/Bill/2011/2000/BillText/er/PDF; Senate Bill 5001 (2012), https://www.flsenate.gov/Session/Bill/2012/5001/BillText/er/HTML; Senate Bill 1500 (2013), https://www.flsenate.gov/Session/Bill/2013/1500/BillText/er/HTML; Senate Bill 5001 (2014), https://www.flsenate.gov/Session/Bill/2014/5001/BillText/er/HTML.
[3] Senate Bill N. 5001 (2016), https://www.flsenate.gov/Session/Bill/2016/5001/BillText/er/HTML; Senate Bill 2500 (2017), https://www.flsenate.gov/Session/Bill/2017/2500/BillText/er/HTML; Senate bill 5001 (2018), https://www.flsenate.gov/Session/Bill/2018/5001/BillText/er/HTML; Senate Bill 2500 (2019), https://www.flsenate.gov/Session/Bill/2019/2500/BillText/er/HTML; Senate Bill 5001 (2020), https://www.flsenate.gov/Session/Bill/2020/5001/BillText/er/HTML.
[4] Phoenix Network, Gov. Scott vetoes Rape Crises Center Funding, Phoenix Network (Apr. 27 2012).
[5] Family, Planning Services and Population Research Act of 1970. US Public Law 91-572, 84 Stat. 1504 (1970) available at https://uscode.house.gov/statutes/pl/91/572.pdf; Bailey MJ. Fifty Years of Family Planning: New Evidence on the Long-Run Effects of Increasing Access to Contraception. Brookings Pap Econ Act. 2013; 2013:341-409. doi:10.1353/eca.2013.0001.
[6] Bad News for Women in Florida and Nationwide Planned Parenthood Leaves Federal Family Planning Program, News Talk Florida (Aug. 20, 2020), available at https://www.newstalkflorida.com/featured/bad-news-for-women-in-florida-and-nationwide-planned-parenthood-leaves-federal-family-planning-program/; Damien Filer, Florida Planned Parenthood Denounces Trump Administration’s Title X Gag Rule, Planned Parenthood Action (Feb. 22, 2019), available at https://www.plannedparenthoodaction.org/florida-alliance-planned-parenthood-affiliates/press-releases/florida-planned-parenthood-denounces-trump-administrations-title-x-gag-rule.