Trump Overhauls Federal Family Planning Program To Favor Clinics That Help Patients Achieve Pregnancy, Resolving Long-Standing Concern That A Contraception Program Was Still Helping Americans Avoid It

WASHINGTON. The Department of Health and Human Services confirmed this week that applicants for Title X family planning grants must now pass an "alignment review" with administration priorities before they can be considered for funding, resolving a long-standing concern that the nation's only federal program dedicated to contraception was still being used, in some cases, to provide contraception.

Title X, created by Congress and signed into law by President Richard Nixon in 1970, distributes grants to clinics that serve low-income and uninsured patients who might not otherwise afford birth control, pregnancy tests, screening for sexually transmitted infections, or routine wellness exams. Under the new 2027 funding notice, a clinic's eligibility now turns first on whether it has ended its diversity, equity, and inclusion efforts and ceased offering gender-affirming care, a determination the agency has specified cannot be appealed.

Accompanying guidance redirects the program away from the prevention of unintended pregnancy and toward "family formation" and helping clients achieve "healthy pregnancies," instructing clinics to prioritize and promote natural methods such as menstrual cycle tracking. The American College of Obstetricians and Gynecologists notes that such methods are less effective at preventing pregnancy than contraception, a feature officials declined to characterize as a drawback.

"The goal has always been to support the family planning decisions Americans make, provided they make the correct one," said a senior official within the administration, who explained that the revised priorities would simply ensure grant dollars flow to providers whose mission aligns with the President's. "A program this important should not be in the hands of just anyone willing to do the work well."

The National Family Planning and Reproductive Health Association and the Family Health Council of Central Pennsylvania, a network that has held Title X grants since the program began in 1970 and now serves more than 31,000 low-income residents a year, sued HHS on Thursday with the American Civil Liberties Union, arguing that the notice picks winners and losers by political alignment rather than the ability to deliver care. Reproductive health advocates said the criteria appeared designed to steer funding toward religiously affiliated clinics and crisis pregnancy centers, which do not typically prescribe the contraception the program exists to provide.

At press time, the administration confirmed that a federal program established to help Americans plan whether and when to have children would continue to do so, having narrowed the menu of acceptable answers to one.