The Trump Administration is withholding millions of dollars allocated for family planning services from more than a dozen organizations.
Enacted in 1970, the federal family planning program known as Title X makes millions of dollars available to clinics that provide health care services like birth control, cancer screenings, and STI testing for people from low-income households. On March 31, Planned Parenthood—one of the largest Title X providers—said in a press release that nine of its affiliates received notices from the federal government that their Title X funding would be withheld starting April 1.
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According to Planned Parenthood, more than three-quarters of its affiliates receive Title X funding, and in 2023, there were more than 1.5 million visits to Planned Parenthood health centers that received Title X funding.
One of the nine affiliates affected is Planned Parenthood Great Northwest, Hawai’i, Alaska, Indiana, Kentucky (PPGNHAIK), which serves those four states as well as Idaho and western Washington. Its CEO, Rebecca Gibron, estimates that, as a result of the freeze, about $3 million a year will now be withheld from five of the six states PPGNHAIK serves: Idaho, Indiana, Kentucky, Alaska, and Hawaii. Gibron says that over half of PPGNHAIK’s health centers across six states serve more than 40,000 patients a year through Title X.
“In our states, we are a safety net provider providing affordable birth control, cancer screenings, STI testing, and treatment,” Gibron says. “These patients rely on Title X for their health care, and without this program, patients may have no access to this care at all.” Planned Parenthood Action Fund President and CEO Alexis McGill Johnson said in a press release that if people aren’t able to access this care, cancers could go undetected, access to birth control could be reduced, and sexually transmitted infections could increase.
A spokesperson for the U.S. Department of Health and Human Services (HHS) told TIME in an email that the department is withholding Title X funds from 16 organizations “pending an evaluation of possible violations of their grant terms, including based on Federal civil rights laws and the President’s Executive Order 14218, ‘Ending Taxpayer Subsidization of Open Borders,’” which Trump signed on Feb. 19. The Executive Order declares that undocumented immigrants are prohibited “from obtaining most taxpayer-funded benefits.”
“HHS is conducting this evaluation to ensure these entities are in full compliance with Federal law and applicable grant terms, and to ensure responsible stewardship of taxpayer dollars,” the spokesperson said. They did not respond to questions about the details of the “possible violations,” how much money was being withheld from the affected organizations, and which organizations were being impacted by the funding freeze.
On March 25, the Wall Street Journal reported that HHS was considering freezing $27.5 million out of the more than $200 million allocated for Title X’s annual budget.
Gibron calls the withholding of funds “politically motivated.” She accuses the Trump Administration of wanting to “shut down Planned Parenthood health centers to appease their anti-abortion backers,” saying that the Title X freeze is the “latest attempt” by the Administration to defund Planned Parenthood.
“The fact is that Planned Parenthood health centers across the country serve millions of patients every year, regardless of their immigration status, political affiliation, race, or gender—everyone is welcome in a Planned Parenthood health center,” Gibron says. “Access to fundamental reproductive and sexual health services is health care that everyone needs.”
In 2019, during the first Trump Administration, the federal government implemented a new restriction on Title X recipients, barring them from providing abortion referrals (Title X dollars don’t fund abortion services). The Guttmacher Institute, which researches and supports sexual and reproductive health and rights, found that that the restriction—often referred to as the“domestic gag rule”—combined with the COVID-19 pandemic, led to the loss of 981 health care centers from the Title X program and resulted in about 2.4 million fewer patients receiving care through the federal program in 2020 compared with 2018. The Biden Administration rescinded the domestic gag rule in 2021.
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Essential Access Health, which distributes Title X funds to clinics in California and Hawaii, said in a press release shared with TIME that it also received a notice that its Title X funds were being temporarily withheld while the group responds to “an inquiry regarding compliance with federal policy and practices related to civil rights and Executive Orders focused on DEI activities within 10 days.” The day he took office, Trump signed an Executive Order aimed at dismantling diversity, equity, and inclusion (DEI) efforts.
“This unprecedented, arbitrary, and immediate pause in distribution of critical resources is harmful to patients and providers,” Essential Access Health said in a press release shared with TIME. “Any funding delay is detrimental, and an extended delay would devastate our family planning safety net.”
Reproductive rights experts have condemned the Trump Administration’s move to freeze Title X funds. Amy Friedrich-Karnik, director of federal policy at the Guttmacher Institute, says she wasn’t shocked by the move, but that it is “absolutely devastating.” According to Friedrich-Karnik, early estimates from Guttmacher Institute experts indicate that between 600,000 and 1.25 million people could be impacted by this funding freeze annually, based on the most recently available data on Title X from 2023.
“The impact of that program on people’s access to needed reproductive health care services is so clear—how people have benefitted from that access and how it is a program that fills a very important gap for folks who can’t get health care elsewhere,” Friedrich-Karnik says. “Not only are reproductive health care services like contraception, STI testing, cancer screenings at risk, [but] for many people, this is their only touchpoint with the health care system at all.”
According to data from the HHS Office of Population Affairs, about 83% of patients who received care from clinics that received Title X funding in 2023 had family incomes at or below 250% of the federal poverty level. Friedrich-Karnik says data also shows that people of color are disproportionately likely to access Title X services. She calls the freeze “a direct attack on health equity,” adding that Title X was established “to ensure that historically underserved communities were able to access health care and reproductive health care,” and the Trump Administration’s actions are penalizing Title X recipients “for doing exactly what the program is set up to do.”
Friedrich-Karnik says that the freeze is “definitely an attack” on people from low-income households, “who already have the most barriers to accessing health care services.”