Overview
A coalition of 23 mostly Democratic-led states filed a lawsuit in federal court in Maryland on Thursday seeking to prevent the U.S. Department of Health and Human Services (HHS) from applying new conditions to Title X family planning grants. The states say the revised conditions would strip funding from states and providers that do not conform to the Republican administration's policy preferences, harming low-income and uninsured people who rely on those services.
Who is leading the challenge
The litigation is spearheaded by New York, Maryland and Massachusetts and includes participation from states such as California, Illinois, Michigan, New Jersey and Virginia, among others. The complaint was filed in Maryland federal court and contends the new HHS policy unlawfully penalizes states and providers that oppose elements of the administration's agenda.
Allegations in the suit
The states assert that the new HHS requirements conflict with the statute that established Title X, which they say obliges providers to deliver a broad array of counseling and forbids discrimination against patients. They further allege the administration imposed the policy without completing the formal rulemaking procedures mandated by federal law - specifically, publishing a proposed rule and seeking public comment - before adopting the changes.
Policy changes at issue
HHS, which administers Title X, announced in April that it would require applicants for Title X grants to align their programs with the administration's priorities for the first time. That framework, the lawsuit notes, includes directives to eliminate diversity, equity and inclusion programs; to recognize only male and female as the two sexes; and to promote abstinence and "natural family planning" in place of contraception.
Potential impact cited by states
State officials warn that the loss of Title X funding would have severe consequences for both providers and patients. New York's attorney general's office supplied a concrete example, saying the funding supports 165 clinics in the state that have served more than 250,000 patients, most of whom are low-income.
Legal context and related cases
The litigation by the states follows a separate lawsuit filed last month by Planned Parenthood, which manages dozens of clinics that depend on Title X funds. Planned Parenthood's case, which raises similar legal objections, is pending in federal court in Washington, D.C.
Responses
The U.S. Department of Health and Human Services, the agency responsible for the Title X program, did not immediately respond to a request for comment on the lawsuit.
What the states say
In their complaint, the states contend the HHS policy would effectively coerce states and community providers to change their counseling practices and program structures or face termination of grants designed to support family planning and related preventive health services.
Background on Title X
Title X, established in 1970, provides roughly $286 million per year in grants aimed at family planning and associated health services, including cancer screenings and treatment for sexually transmitted infections. Federal law bars the use of Title X funds to pay for abortion services.
The legal challenge will test whether the administration's revised grant conditions are lawful and whether HHS followed required procedural steps in implementing the changes.