Attorney General James Joins Lawsuit to Protect Title X Family Planning Services

 

New Federal Requirements Threaten Access to Reproductive Health Care, Cancer Screenings, and Affordable Contraception for Millions of Americans 

New York Attorney General Letitia James today was part of a coalition with 22 other states in suing to block a new federal policy that threatens to strip federal family planning funding from states and providers unless they align with the Trump administration’s political views and priorities. The lawsuit, filed today in the U.S. District Court for the District of Maryland, challenges new conditions on Title X funds, which support reproductive health care, family planning, cancer screenings, and other critical preventive care for millions of Americans nationwide. The new conditions will penalize states and providers that refuse to abandon nondiscrimination protections or conform their Title X programs to the administration’s ideological vision of family planning, which includes discouraging the use of contraceptives. The coalition is asking the court to block the unlawful and discriminatory conditions and protect Americans’ access to affordable, high-quality health care.

“We fought to protect Title X during the first Trump administration, and today we are going back to court to defend it again,” said Attorney General James. “The administration keeps trying to use federal funding to force states to carry out its agenda, and time and again, we have stopped them. They may think the eighth time will be the charm, but New York will keep fighting back and protecting every patient’s right to access the care they need.” 

Title X is the only federal grant program dedicated specifically to family planning and related preventive health services. For more than 50 years, Title X has helped millions of low-income patients access contraception, cancer screenings, sexually transmitted infection testing and treatment, pregnancy testing and counseling, and other preventive health care. 

In July, the U.S. Department of Health and Human Services (HHS) published a new funding notice for the next five-year grant cycle that, for the first time, requires 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, excluding and stigmatizing transgender people, discouraging the use of contraception in favor of natural family planning, requiring clinics to counsel all patients toward marriage and parenthood rather than providing neutral, patient-centered guidance, and complying with unrelated political priorities like "ending crime and disorder on America's streets.” Providers who don't comply risk losing their funding altogether. 

Losing Title X funding would have devastating consequences for patients and providers. In New York alone, Title X funds support 165 health centers that serve more than 250,000 patients, over two-thirds of whom received care at no cost because their incomes fell below the federal poverty line. Title X funding is routed to providers and other subgrantees by the New York State Department of Health (DOH), which receives approximately $11.1 million a year, and Public Health Solutions, a New York City nonprofit that has been a Title X recipient since the early 1980s. If New York loses this funding, DOH could be forced to reduce staff and cut contracts starting April 1, 2027.

This is not the first time restrictive federal rules have devastated the Title X program. A similar policy imposed during the president’s first term caused nearly a quarter of the program's grantees nationwide to drop out. Six states, including New York, lost more than half of their Title X clinics, and nationally, the number of patients served by Title X fell by more than 60 percent in just two years. In 2019, Attorney General James led a lawsuit challenging the policy, but the Biden administration later rescinded the rule before the Supreme Court decided the case.  

Attorney General James and the coalition argue that the new HHS conditions directly conflict with Title X’s governing statute and regulations, which require providers to offer a broad range of contraceptive methods, provide nondirective counseling, and serve all patients, including LGBTQ+ individuals, in an inclusive and nondiscriminatory manner. The states also argue that HHS unlawfully imposed the new conditions without the notice-and-comment process required under the Administrative Procedure Act. Additionally, the coalition argues that the conditions are so vague that providers cannot reasonably determine what compliance requires, in violation of the Constitution's Spending Clause, which limits the government's ability to attach unclear or unrelated strings to federal funding.

The states are asking the court to declare the administration’s new political conditions unlawful, block HHS from enforcing them, and preserve access to Title X funding for state health agencies and other qualified providers under the program’s existing, longstanding rules.

Attorney General James joins in filing this lawsuit, which was co-led by the attorneys general of Maryland and Massachusetts, are the attorneys general of California, Colorado, Connecticut, Delaware, Hawai’i, Illinois, Maine, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Virginia, Washington, and Wisconsin, as well as the governors of Pennsylvania and Kentucky.