Family planning and health organizations that serve tens of thousands of people across Pennsylvania could see federal funding delayed or denied by a new Trump administration policy, a new lawsuit alleges.
The suit, which includes the Cumberland County-based Family Health Council of Central Pennsylvania as a plaintiff, takes aim at a step added this year by the U.S. Department of Health and Human Services to applications for Title X grants, which provide local agencies with funds to aid low-income and uninsured patients with family planning and related health services.
That new process is detailed in the Title X published in April. It states that before applicants are assessed on their merits, a group of presidential appointees will conduct an 鈥渁lignment review鈥� to determine whether each application matches the agency鈥檚 鈥減riorities.鈥� The plan offers no opportunity to appeal the group鈥檚 decision.
To the plaintiffs in , that sounded like code for evaluating applicants based on politics.
鈥淭he Trump administration鈥檚 attempt to condition Title X funding on political allegiance is a grave threat to public health,鈥� Sara Rose, deputy legal director at ACLU of Pennsylvania and attorney on the case, said in a statement. 鈥淕rant decisions must be guided by objective standards to ensure that taxpayer money is spent fairly and efficiently without regard to the ideology of its recipients.鈥�
Created during the Nixon administration to help low-income people prevent unwanted pregnancies, Title X funding has long drawn opposition from anti-abortion activists.
The Trump administration has also attempted to shift the focus of the program . Officials earlier this year to block Title X funding from reaching Planned Parenthood facilities.
The suit is filed in the federal Middle District of Pennsylvania. It names HHS, Secretary Robert F. Kennedy Jr., and other agency staff as defendants.
There are in the commonwealth, each serving a specific region: in central Pennsylvania, in Philadelphia, in the west, and in the northeast.
Combined, they receive more than $12.6 million in Title X funds annually to serve more than 160,000 patients in Pennsylvania, according to their grant details listed on HHS鈥� website. (AccessMatters is by far the largest, working with more than 90,000 people.)
These organizations offer everything from fertility care and access to contraception to screenings for cancers and sexually transmitted infections.
Nationwide, the from HHS shows Title X grantees served nearly 2.8 million people.
Also at issue in the lawsuit is that HHS already has a set of regulations, put in place during President Joe Biden鈥檚 administration, that govern Title X applications 鈥� and many of them directly conflict with stated Trump administration priorities.
The suit highlights, for instance, that currently states that ending 鈥渋deologically-laden concepts like health equity鈥� is a priority, while Title X rules simultaneously require grantees to 鈥渁dvance health equity.鈥�
Another alleged conflict stems from the Trump administration鈥檚 opposition to diversity, equity, and inclusion initiatives, especially for transgender people. Current Title X regulations mandate that grantees ensure transgender people have access to their programming.
Brigitte Amiri, deputy director at the ACLU鈥檚 Reproductive Freedom Project, told Spotlight PA that the Trump administration could overturn the Biden-era regulations by undertaking a public notice and comment rulemaking process.
鈥淏ut you can鈥檛 just do it by a funding announcement,鈥� she said.
The new review step 鈥渟ubverts the integrity鈥� of the Title X grant application process, the lawsuit argues, and enables HHS 鈥渢o hijack鈥� the Title X program to fund organizations furthering the agency鈥檚 鈥減olitical agenda.鈥�
The lawsuit also notes that Title X funds are prohibited from being used for abortions.
Federal Judge Jennifer Wilson, who was nominated to the bench by Trump in 2019, will hear the case.
Spotlight PA sought a comment on the lawsuit from HHS, but did not receive a response.
The Family Health Council of Central Pennsylvania was selected to join the lawsuit because it has received Title X funding since the establishment of the program in 1970, and it serves a large area, the chief executive of the National Family Planning & Reproductive Health Association told .
Patricia Fonzi, president and CEO of the Family Health Council, said in a statement that her organization serves more than 31,000 people across a 24-county region.
鈥淲e welcome a competitive grant process and believe every applicant should be evaluated on its ability to effectively serve communities, responsibly steward federal resources, and demonstrate the experience and capacity necessary to carry out the Title X statute,鈥� Fonzi said.
鈥淎t the end of the day, the success of Title X is measured by whether people can access the care they need in their own communities 鈥� and that depends on funding decisions grounded in experience, proven performance, and the ability to deliver comprehensive care where it is needed most.鈥�
The plaintiffs are urging the court to vacate the Trump administration鈥檚 new Title X rule and declare it 鈥渦nlawful.鈥�
Title X funds are issued to agencies on a five-year basis, with annual renewal requirements. The new rule at issue was included in the process for grants under fiscal year 2027, which will begin a new five-year cycle.
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