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Lawsuits Challenge Trump Administration’s Changes to Title X Family Planning Program

Jessica Mason Pieklo

The lawsuits filed in federal court claim the administration acted arbitrarily and capriciously when it announced changes to how grants are awarded under the federal family planning program.

Reproductive rights advocates filed two lawsuits Wednesday challenging the Trump administration’s latest efforts to undermine the federal Title X family planning program by prioritizing abstinence programs.  

The lawsuits were filed by attorneys on behalf of three Planned Parenthood affiliates and the National Family Planning & Reproductive Health Association (NFPRHA). They name Health and Human Services (HHS) Secretary Alex Azar and Valerie Huber, the acting deputy assistant secretary for the Office of Population Affairs—the HHS office that administers the Title X program—as defendants.

The lawsuits claim the administration’s proposed changes to the Title X program violate the Administrative Procedure Act because they were made in an arbitrary and capricious manner and without notice to the public and the opportunity to comment on the proposed changes.

The Trump administration is looking to “shift the Title X program away from its core statutory purpose by dramatically altering the criteria that determine who can participate in the program,” according to the allegations in one of the complaints. The lawsuits allege that the administration is making this shift by changing the criteria HHS uses to evaluate which health care providers are awarded Title X grants. 

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The lawsuits seek to block the administration’s changes to the program and require that HHS provide any continuation funding necessary to ensure that Title X projects remain funded until the agency issues new Title X grants pursuant to a lawful funding formula.

HHS announced in 2017 that it was terminating all multi-year grants under Title X. As a result of this announcement, even though competitive Title X grants had been awarded on overlapping three-year cycles, all Title X grantees would need to submit a new application for Title X funds in 2018, according to allegations in one of the complaints. 

Then in February 2018, HHS announced dramatic changes to the longstanding Title X grantmaking criteria. The fiscal year 2018 funding opportunity announcement for Title X funds shifts the “application review criteria” on which funding decisions are based away from what the statute and regulations require. Under HHS’s changes, those “application review criteria” now give the most weight to new “program priorities” and “key issues,” such as placing “meaningful emphasis” on abstinence as an approach to birth control, even for adults, and cooperating with faith-based organizations, according to the allegations in the complaints. 

“Yet again, the Trump administration is putting ideology ahead of the health and well-being of the American people,” Ruth Harlow, senior staff attorney with the ACLU Reproductive Freedom Project, said in a statement. “This time, they’re undermining a decades-old public health program in order to spread their ideologically driven vision of how people should live their lives,” Harlow continued.

“They can’t ignore the rules as they make sweeping changes to a program started by Congress nearly 50 years ago to make critical health care accessible,” she said. “Not on our watch.” 

The new funding opportunity announcement released by the Trump administration omits any reference to contraception or HHS’s previously published standards for evidence-based family planning care. Advocates said those changes are designed to disadvantage reproductive health-care providers like the Planned Parenthood affiliates named as plaintiffs in the lawsuit.

“It’s hard to believe that a federal program that is dedicated to family planning does not mention the words ‘contraception’ or ‘prevention’ even once in a 60-page funding announcement,” said Clare Coleman, president and CEO of NFPRHA in a statement following the announcement of the lawsuits. “This administration has set aside the program’s core mission in favor of endorsing ‘no sex outside of marriage.’”

In 2016, Title X centers served 2.8 million contraceptive patients. About two-thirds of people receiving preventive care through the Title X program live in poverty and 88 percent have incomes that are at or below 250 percent of the federal poverty level.

The Trump administration has not yet responded to the lawsuits.

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