WASHINGTON — The National Family Planning and Reproductive Health Association (NFPRHA), the lead national advocacy organization for the Title X family planning program, and the American Civil Liberties Union and the ACLU of the District of Columbia sued the Department of Health and Human Services (HHS) today over its unlawful withholding of $65.8 million in Title X federal family planning grants. Title X is the country’s only dedicated federally funded family planning program that provides access to effective contraceptive methods, cancer screenings, testing and treatment for STIs, and other preventive services, with priority given to patients with low incomes.
The lawsuit was filed in the U.S. District Court for the District of Columbia on behalf of the NFPRHA and its members. As a result of the Trump administration’s unlawful actions, at least seven states — California, Hawaii, Maine, Mississippi, Missouri, Montana, and Utah — have been left without any Title X-funded family planning services.
“The unprecedented action by the Trump Administration to withhold 22 federal Title X grants—25% of the Title X network—leaves approximately 842,000 people across the United States without access to Title X-funded services,” said Clare Coleman, president & CEO, National Family Planning and Reproductive Health Association (NFPRHA). “The consequences of withholding funding are devastating. The loss of Title X means hundreds of thousands of patients are at risk of losing access to critical health care, including contraception, testing and treatment for sexually transmitted infections, and cancer screenings. Affected grantees and their health centers simply do not have the resources to operate for weeks or months without Title X funding. NFPRHA is taking legal action to defend its members, the essential health care they provide access to, and the patients they serve.”
On March 31 — one day before the grants were set to be awarded — 16 Title X grantees were informed of HHS’s decision to withhold funds pending investigation. This decision is seemingly based on the grantees’ public statements supporting diversity, equity, and inclusion (DEI) and opposing racism, which HHS claims amount to a “possible violation” of federal civil rights law, and a desire to ensure the grantees’ compliance with an anti-immigration executive order (Executive Order 14218, “Ending Taxpayer Subsidization of Open Borders”). Grantees were given only 10 days to produce extensive documentation from their service sites and subgrantees, and funding has yet to be released.
“Withholding Title X funding for critical reproductive health care is the latest Trump administration attack on our communities,” said Brigitte Amiri, deputy director of the Reproductive Freedom Project at the ACLU. “In its zeal to take away reproductive health care from the most marginalized communities, the federal government violated its own laws, and it must be held accountable. The harm caused by the Trump administration's actions will fall disproportionately on Black and Latina people, people in rural areas, young people, immigrants, and people with low incomes. The ACLU will use every lever we have to fight for reproductive freedom and defend the Title X program.”
The lawsuit argues that HHS violated its own rules and a federal statute that together govern how HHS can ensure compliance with grant terms and federal civil rights laws. The lawsuit also argues that HHS acted arbitrarily and capriciously by, among other things:
- Providing no reasonable explanation or justification for its decision to select these grantees for fund withholding and investigation;
- Targeting the grantees based on statements that align with the requirements of the Title X program; and
- Suddenly departing from its own prior understanding of Title X and federal civil rights law, without any acknowledgment of or explanation for that departure.
“Title X provides a pathway to essential and time-sensitive health care for millions of patients across the country, including more than half a million patients in California and Hawaii served at nearly 380 health centers,” said Nomsa Khalfani, Ph.D., co-CEO, Essential Access Health. “In California, nearly half (48%) of Title X providers report that there would be immediate or likely layoffs and more than 60% (62%) reported that they would have immediate reductions in family planning services they could offer without Title X funding. Loss of Title X funding would result in the closure of a service site altogether. In Hawaii, without Title X funding, some of our agencies will have immediate layoffs and more than half will have immediate reductions in sexual and reproductive health services.”
“Withholding Title X funding threatens the essential sexual and reproductive healthcare communities depend on. Clinics across Missouri will be forced to lay off staff, scale back services, or shutter their doors altogether,” said Michelle Trupiano, executive director of Missouri Family Health Council, Inc. “Tens of thousands of patients will lose access to birth control, cancer screenings, and essential care, all of which will have devastating, life-altering consequences. Missouri Family Health Council has led the federal Title X family planning program in Missouri since 1981 and in Oklahoma since 2023, supporting a network of 55 total clinics that delivered healthcare to 43,926 individuals in 2024.”
“The Trump administration is stripping people of essential health care—and it’s causing real harm,” said Arthur Spitzer, Senior Counsel at ACLU-D.C. “Withholding Title X funds blocks access to cancer screenings, STI tests, and birth control. Preventive care works, and communities suffer without it.”
Title X grantees are crucial health care providers in their communities. Read more from National Family Planning and Reproductive Health Association members from across the country:
“The Administration’s dangerous decision to freeze Title X funds from Maine Family Planning jeopardizes access to health care services for our most vulnerable neighbors,” said George Hill, president & CEO of Maine Family Planning. “Withholding health care funding that Mainers have relied on for 50 years leaves thousands of Mainers in danger of losing the critical, time-sensitive sexual and reproductive care they trust and rely on. Maine’s family planning care infrastructure of 63 health centers serves nearly 30,000 patients every year, a majority of whom qualify for free or reduced health care. We will fight any attacks on the vital health care we provide Mainers with every tool at our disposal.”
“Operating in the vast and rural landscape of Montana, our network of 20 Title X clinics serves communities where healthcare resources are already scarce and budgets stretched thin,” said Stephanie McDowell, executive director, Bridgercare. “The majority of our clinics provide essential reproductive healthcare in designated Health Professional Shortage Areas. After three weeks without federal funding and no communication from HHS about when—or if—our Title X funds will be released, these already vulnerable rural clinics face mounting uncertainty. The continued silence from HHS threatens access to critical healthcare services for thousands of Montanans who have few, if any, healthcare alternatives.”
“We are devastated when thinking about the systemic implications this action may have on the health and wellbeing of Pennsylvanians who rely on Title X-funded services for their healthcare needs,” said Ayana Bradshaw, AccessMatters’ president & CEO. “The implications of withholding of funding for Southeastern Pennsylvanians are severe and far reaching. Without these funds, people will lose access to essential health care, health disparities will increase, and if the funds are not restored immediately, the impact will be felt in communities across the state and throughout the nation for years to come.”
The complaint can be found online here.