States sue Trump administration over family planning grant changes

A coalition of states sued the Trump administration Thursday to block changes to a family planning grant program that it alleges would strip federal funding from states and providers unless they align with the administration’s political views and priorities.

The lawsuit by officials from 23 states, filed in Maryland federal court, argues that new conditions on Title X funding will unlawfully penalize states and providers that offer gender-affirming care or refuse to adhere to the administration’s ideology on contraception.

The lawsuit is led by the Democratic attorneys general of New York, Maryland, Massachusetts, California, Illinois, Michigan, New Jersey and Virginia, among other states. The attorneys general were joined by Democratic Govs. Andy Beshear of Kentucky and Josh Shapiro of Pennsylvania.

Title X is the nation’s only federally funded family planning program providing free and subsidized birth control, sexually transmitted infection tests, cancer screenings and other nonabortion sexual health services to low-income Americans.

Participating Title X grantees are in the final year of a five-year funding cycle that was awarded based on Biden administration criteria. The Trump administration has been attempting to overhaul the program with a much more conservative focus on promoting pregnancy and families.

Similar restrictions on Title X policy imposed during the first Trump administration caused nearly a quarter of the program’s grantees nationwide to drop out. Nationally, the number of patients served by Title X fell by more than 60 percent in just two years.

The complaint takes issue with the Department of Health and Human Services (HHS) funding notice for the next five-year grant cycle, which was posted in April.

For the first time, the program would require applicants to align their programs with a sweeping set of political priorities as a condition of receiving or keeping federal funds.

The priorities include eliminating diversity, equity, and inclusion practices, discouraging the use of contraception in favor of abstinence and “natural family planning,” recognizing that male and female are the only two genders and requiring clinics to counsel all patients toward marriage and parenthood.

States and providers must either commit to alter their current Title X programs to conform with the administration’s changes, which the lawsuit said are inconsistent with Title X’s core statutory and regulatory requirements, or submit applications based on their existing programming and risk rejection.

“With federal Title X funds in jeopardy … Plaintiff States will be forced to scramble to fill the funding gap from their own coffers to preserve these critical services; many will not be able to continue funding these programs at the same level using state-only dollars,” the lawsuit alleges.

The states also argue the HHS unlawfully imposed the new conditions without the notice-and-comment process required under the Administrative Procedure Act.

A similar lawsuit challenging the changes was filed in federal court in Pennsylvania by two nonprofit organizations that support family planning and preventive health care services, and then in July by Planned Parenthood , which was filed in federal court in Washington, D.C.