Three Groups Are Suing Trump for Dramatically Changing a Family Planning Program

Three reproductive rights groups announced today that they’re suing the Trump administration over what they say are illegal changes to the country’s only dedicated source of family planning funding, a program known as Title X.

Title X, which provides grant money that health centers compete for, was enacted by Congress and signed into law by President Richard Nixon in 1970. The program offers well-woman exams, birth control, STD screening and treatment, and cancer screenings for low-income people and people who don’t have insurance; funds cannot be used to provide abortions. The program serves 4 million patients every year, 89 percent of whom are women; more than half are women of color. Forty-one percent of Title X patients choose to get their care at Planned Parenthood.

In February, Trump’s Department of Health and Human Services made dramatic changes to the grant application requirements. The announcement for funding favors programs that prioritize abstinence and natural family planning methods like the rhythm method, while not mentioning the word contraception even once. It also removes the emphasis that applicants offer all 18 types of FDA-approved birth control, including long-acting reversible contraceptives like the IUD and implant, which are the most effective methods.

The upshot is that health centers that specialize in reproductive care would be less likely to get grants than community health centers, and crisis pregnancy centers might also be eligible for grant money.

In response, Planned Parenthood and the National Family Planning & Reproductive Health Association (a group that represents Title X recipients), today filed a pair of lawsuits in federal district court in Washington DC, alleging that the recent funding announcement drastically changes the program in direct conflict with the Title X statute and regulations, which make clear that the program is supposed to provide evidence-based contraceptive services.

“The Trump administration’s Title X funding announcement would undermine this public health program, putting their ideologically driven agenda above women’s health and preventive care,” says Ruth Harlow, senior staff attorney, American Civil Liberties Union Reproductive Freedom Project, which filed suit on behalf of the NFPRHA.

“From a legal standpoint, the Trump administration’s announcement contravenes Congressional intent and the fundamental purpose of the Title X program by reducing access to critical family planning and related preventive services.”

If HHS wished to change the intent of the program, the plaintiffs contend that the agency would need Congress to change the statute and publicly propose changes via the Federal Register, but they didn’t do that. “The administration is trying to sneak through major changes to Title X in the fine print of a grant application announcement and outside the public review of proper rulemaking,” Harlow says.

The groups are asking for an injunction to block the funding announcement from going into effect—that is, stop any review of applications, which are due this month, and block any grant awards—and to continue Title X patients’ current access to care by extending past grants. Additionally, “we’re asking the court to make the administration redo this announcement and refocus the program back on its original purposes,” Harlow says.

Clare Coleman, president and CEO of the NFPRHA, says that the changes shift the “program’s focus away from access to contraceptive care and its key, bedrock mission of providing voluntary, confidential services,” and “instead wedg[es] in new priorities and activities that are really focused on changing the way people live their lives.”

Gillian Dean, senior director of medical services at the Planned Parenthood Federation of America, underscored that the changes were designed to penalize reproductive healthcare providers, which has ripple effects in real people’s lives. “The Trump-Pence administration’s recent plans for the program endanger Title X patients by making it harder for them to access expert, evidence-based reproductive health care and the most effective methods of contraception,” Dean says.

Harlow says the grant announcement invites groups to push ineffective, abstinence-only programs for teens and adults, regardless of people’s health needs and desires. “These changes would mean using government funds to promote no-sex-outside-of-marriage ideology. Trading in FDA-approved contraceptive methods for shame and abstinence-based programs that we know don’t work is wrong, it’s bad for public health, and it’s outside the law,” she says.

Helene Krasnoff, senior director of public policy, litigation, and law at the Planned Parenthood Federation of America, called the Title X changes part of an “overarching agenda that is opposed to women being able to control their own bodies and opposed to science and evidence.” She says that since day one, the administration has been pushing policies that would take away women’s basic health rights and freedoms, citing the attempted rollback of the co-pay free birth control benefit, the shift of teen pregnancy program from an evidence-based program to one that promotes ineffective methods of education, and attempts to repeal Obamacare.

Update 7/17/18: A federal district court judge appointed by Trump ruled against the suit that sought to block the changes. District Court Judge Trevor McFadden, who Trump appointed in 2017, said in his ruling that courts can't require formal rulemaking via the Federal Register to change procedures. He added that if he could rule on the merits of the case, that the administration's changes align with the program goals of supporting “voluntary family projects…offering a broad range of acceptable and effective family planning methods and services.”

Ruth Harlow, senior staff attorney, ACLU Reproductive Freedom Project said in a statement: “We will keep fighting to stop the Trump Administration’s attempts to undermine our nation's family planning program. This suit reflects just one of several attacks on Title X’s vital services. Whatever this Administration may think, it is not above the law, and we will continue our work to show that. The Administration cannot put its ideologically-driven agenda above women’s health and disrupt this essential, highly successful program, enacted by a bipartisan Congress almost 50 years ago.”

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