Background: The Title X family planning program provides affordable access to a range of sexual and reproductive health services, with a priority for low-income people. The disproportionate burden of unintended pregnancy, breast and cervical cancer, and sexually transmitted diseases among minority groups, teens, and young adults in the US underscore the need for affordable access to such services. However, increased access to sexual and reproductive health services, resulting from the Affordable Care Act (ACA) create questions regarding the continued need for this program. Methods. A study was conducted to assess clients' perceptions of Title X-funded family planning clinics and their preferences for these clinics for a range of sexual and reproductive health services. An anonymous, self-administered, paper-and-pencil survey was administered to 696 clients who received services from one of eight Title X-funded family planning clinics in Northeast Ohio. Results: The majority of participants stated very positive perceptions of the Title X-funded clinics; that they "Always" go to the Title X-funded clinic for birth control, STD/HIV testing, and pregnancy testing; and that the Title X-funded clinic was their regular source of health care. Females were more likely than males to prefer the Title X clinic for birth control, physical exams, pregnancy testing, and health information and more teens under the age of 18 preferred to use the Title X clinic for STD/HIV testing, physical exams, pregnancy testing, and health information. Conclusions: Findings indicate that these Title X-funded family planning clinics successfully reached populations in need of sexual and reproductive health services and suggest that these facilities can help play an important role in reducing disparities even after full implementation of the Affordable Care Act. However, more research is needed to fully quantify the need and value of Title X-funded family planning clinics and its relation to the changing health care environment in the US. © 2014 Oglesby; licensee BioMed Central Ltd.