A group of 23 mostly Democratic-led states filed a lawsuit on Thursday to prevent the Trump administration from implementing new requirements for federal family planning grants. The legal challenge, filed in Maryland federal court, targets changes to Title X funding that would link the distribution of money to the adoption of specific administration priorities.
Title X was established in 1970 to provide grants for family planning and preventative health services, including cancer screenings and treatment for sexually transmitted infections. The program currently distributes approximately $286 million in annual grants, though federal law prohibits these funds from being used for abortion services.
The lawsuit, led by New York, Maryland, and Massachusetts, claims the Department of Health and Human Services (HHS) is unlawfully penalizing states that refuse to discourage contraception or provide gender-affirming care. The states argue the new policy conflicts with the original Title X law, which requires providers to offer a broad range of counseling and prohibits discrimination against patients. The lawsuit also alleges the administration bypassed the formal rulemaking process, which requires public notice and comment periods.
According to the office of New York Attorney General Letitia James, losing the funding would have devastating consequences. In New York, the funding supports 165 clinics that provide services to more than 250,000 patients, most of whom are low-income. The administration's policy seeks to shift focus toward "natural family planning" and abstinence rather than standard contraception.
For providers, the new conditions represent a choice between maintaining federal support and following medical protocols that may conflict with the administration's mandates, such as the requirement to recognize only two sexes and eliminate diversity, equity, and inclusion programs. A similar lawsuit filed by Planned Parenthood, which manages dozens of affected clinics, is currently pending in a Washington, D.C. federal court.
Currently, the U.S. Department of Health and Human Services has not responded to a request for comment.