by Anna Spoerre, Missouri Independent
April 22, 2025

Until April, much of the $5,000 a month in federal Title X family planning funding received by the Dent County Health Center went toward purchasing contraceptive devices for some of the 200 people they serve annually. 

But the health center’s administrator, Zachary Moser, said a recent decision to freeze family planning funds has the center fearful it won’t be able to continue covering family planning services for its rural southeastern Missouri population.

In late March, the Trump administration froze about $27.5 million in Title X funding to a number of states, including several million dollars to Missouri that are distributed by Missouri Family Health Council. 

The Title X program was created more than half a century ago as a funding stream to support access to family planning options, including contraceptives, testing and treatment for sexually transmitted infections and cancer screenings related to reproductive health. 

While some have speculated the administration was trying to target abortion providers, only seven of the 52 recipients of Title X grants through the Missouri Family Health Council are Planned Parenthood clinics. A breakdown of how funding is distributed between clinics was not made available.

The majority of the recipients are health centers like Moser’s. Moser said in the short-term, Dent County has redirected some general revenues toward family planning services and continues to offer them to patients for free.

“Will we be able to do that indefinitely?” he asked. “No.”

For example, instead of Title X funding covering the cost of an IUD — a contraceptive device that is inserted into the uterus to prevent pregnancy — the patient would instead have to foot the bill, choose a less-effective but more affordable or go without. 

Moser said some of the longer-lasting contraceptive devices can cost upwards of $1,000 out of pocket, a price that isn’t feasible for most of the people the center serves. 

Limiting or eliminating family planning services can impact entire communities and public health. 

Michelle Trupiano, executive director of the Missouri Family Health Council, said if the freeze continues, she anticipates immediate health consequences like increased unintended pregnancies, later-stage cancer diagnoses, more overall disease and worse maternal health outcomes. 

Missouri Family Health Council has been leading the state’s Title X planning program for nearly 45 years. Their network of 52 clinics includes health departments, community action agencies, federally-qualified health centers and hospital-based clinics. They also work with family planning clinics, including seven Planned Parenthood locations.

“The Trump administration and Elon Musk are using Title X to push their own political agenda and impose their personal beliefs on everyone at the expense of people who need critical access to care,” Emily Wales, president and CEO of Planned Parenthood Great Plains, said in a statement. ” …. If blocking health care for low-income patients is what the Trump administration means by ‘making America great again,’ then we want no part of it. It’s cruel, it’s calculated, and it won’t stop us from fighting for our patients.” 

Trupiano said she’s not sure why Missouri was targeted while other states with Planned Parenthood clinics were left untouched. But the letter Trupiano received announcing the freeze cited compliance concerns around diversity, equity and inclusion initiatives, or DEI. She said the grant they were awarded includes “access, quality and equity” among its priorities. 

Through Title X funding, Missouri clinics served nearly 34,800 patients in 2024. Of those, 83% were female, 75% were under the age of 34 and 45% were uninsured.

Last year, 58% of the patients served were white and 30% were Black. 

“We know the devastating impact and consequences that will result if this is not swiftly resolved,” Trupiano said.

The funding to Missouri Family Health Council was paused the day before year four of a five-year grant cycle began on April 1. 

The Dent County Health Center applied for Title X funding after hiring a full-time nurse practitioner in 2022. Not only does the grant help them increase health care access for patients, but Moser said it also backs up an ongoing effort to inform more young people on pregnancy prevention. 

In his corner of southeast Missouri there’s still a lot of stigma around premarital sex, Moser said, making it difficult to educate teenagers on pregnancy-prevention. Among those teens who do seek out contraceptive access at the health center, he said many don’t want to go through their parent’s insurance policy because they want to keep their choices private. 

“We won’t have any way to serve those patients,” Moser said. “It’s going to limit access for sure, which is going to drive up the teen pregnancy rate, drive up unwanted pregnancies and have other unintended consequences.”

Missouri’s teen pregnancy birth rate has steadily declined over the past several years, according to the Centers for Disease Control and Prevention, though it still remains among the highest in the country.

Stephanie Kraft Sheley, director of Right By You, a Missouri-based nonprofit that in part advocates for contraceptive access, said some of the most common calls to the organization’s hotline revolve around navigating birth control access.

She said a continued freeze could have “catastrophic” effects, potentially shuttering programs or clinics whose efforts help reduce unintended pregnancies.

If the freeze continues, Kraft Sheley said, that likely means navigating fewer people to pregnancy-prevention options and increasingly directing them to abortion options. While abortion is now legal in Missouri, access is still difficult for many people, as only three Planned Parenthood clinics have resumed procedural abortions and medication abortions remain unavailable.

Missouri abortion ban clears House, heads to Senate despite concerns from top Republican

Trupiano has spent the past few weeks helping clinics like Moser’s navigate the abrupt funding change as they work to determine how to stretch resources in order to continue providing free family planning services to patients. 

“They already were working in the leanest possible way to provide this critical care,” she said. “These cuts are very devastating, and for a lot of the health departments and other safety net clinics, this isn’t the only infrastructure cut that they are facing.” 

That rings true in Dent County, where Moser said Title X is one of a handful of programs under threat right now. He remains particularly concerned about continued federal funding for the county’s lead testing and vaccine programs, both of which rely entirely on grant funding.

Trupiano and others have been drawing attention to Missouri’s public health safety net for years, raising concerns that clinics and providers are stretched beyond capacity. Funding freezes such as this only cause longer wait times and more people who ultimately go without timely care as the burden shifts off one clinic and onto another, she said. 

For example, if a clinic relying on Title X funding were ultimately to close, those patients would be forced to find another provider. In many places, new patient wait lists are already months long. For those without reliable access to transportation, getting to a different clinic further away might be too much of a burden to continue care.

While the greatest harm will be inflicted on the most vulnerable Missourians, Trupiano said, “the impact is going to be borne by everybody.” 

Missouri Independent is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence. Contact Editor Jason Hancock for questions: info@missouriindependent.com.

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Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Assessment: Center-Left

The content in question demonstrates a Center-Left political bias. It focuses on the implications of funding cuts to the Title X family planning program, emphasizing the negative effects on public health services and low-income populations. The language reflects concern for access to contraceptive services and reproductive health, which are often prioritized by left-leaning policies and advocacy groups. The article includes quotes from health officials and advocates who express worry about the potential consequences of funding freezes, specifically tying the cuts to decisions made by the Trump administration. While it presents factual information, the overall tone and framing of the issue highlight a critical view of the administration’s actions, aligning more closely with a Center-Left perspective that advocates for expanded access to healthcare and reproductive services.