HHS Quietly Restores Title X Abortion Funding
The American Civil Liberties Union (ACLU) has withdrawn its legal challenge to the Trump administration after federal health officials reversed course and released tens of millions of dollars in previously frozen Title X “family planning” funds. The money, held back for most of last year, flowed largely to Planned Parenthood and several allied clinics. The funding reversal became public through reporting by Politico on Tuesday.
The funds were disbursed by the Department of Health and Human Services (HHS) in December, long after the lawsuit was filed and without any public announcement. According to the Catholic News Agency, the administration seemed unaware of the news:
When asked about the report on Wednesday, Trump told reporters: “I don’t know anything about that.”
“I have not heard that,” HHS Secretary Robert F. Kennedy Jr. added.
The lawsuit had centered on HHS’s authority to suspend Title X grants over alleged civil rights and compliance violations. While the legal action is now closed, the episode serves as yet another reminder of the unconstitutional nature of the federal healthcare apparatus.
Funding Freeze
In March of last year, HHS notified more than a dozen Title X grantees that their funding would be temporarily withheld pending investigation. According to the Urban Institute:
Under this freeze, 16 Title X grantees, including 9 Planned Parenthood affiliates, did not receive scheduled payments. This action leaves seven states — California, Hawaii, Maine, Mississippi, Missouri, Montana, and Utah — without any Title X funding because these grantees were the only Title X providers in the state.
HHS cited potential violations of federal civil rights law and executive orders issued by President Donald Trump. As reported by Politico at that time:
HHS spokesperson Andrew Nixon said the agency is withholding payments … “to ensure these entities are in full compliance with Federal law and applicable grant terms, and to ensure responsible stewardship of taxpayer dollars.”
Nixon confirmed that “grants comprising $27.5 million out of Title X’s more than $200 million annual budget [were] frozen and under review.”
Over the following months, clinics submitted documents and responses disputing the allegations. They argued that their programs complied with federal law and that the funding freeze was punitive and politically motivated. Several providers saw their funding restored during the summer; others remained under review until mid-December.
The Court Case
Following the HHS freeze, the ACLU, together with the National Family Planning and Reproductive Health Association (NFPRHA), which represents most Title X providers nationwide, sued. The lawsuit alleged that the HHS unlawfully withheld congressionally appropriated Title X funds without completing a formal enforcement process or making final compliance findings. The plaintiffs argued that the funding freeze amounted to an informal defunding carried out through administrative delay.
Politico reported that the case was heard in federal district court in Washington in August, although the court did not deliver the ruling then. Proceedings slowed during a prolonged federal government shutdown, which disrupted both court operations and agency filings. While declining to rule on the merits at that stage, the court issued an interim order requiring HHS to place the disputed funds into escrow. The order ensured the grants would not expire at the end of the fiscal year on October 1 while the case remained pending.
The government soon finalized its review, apparently finding no violations from the abortion providers:
In a court filing on Dec. 19, shared with POLITICO, U.S. Attorney Jeanine Pirro told the court “the review is completed, and all grants at issue for Plaintiff’s members have been restored.” She provided no further details, but asked the challengers to consider whether “this matter can be voluntarily dismissed in light of the restoration of the remaining grants.”
And so they did.
Title X, Medicaid, and Unfinished Fights
Title X does not directly pay for abortions. By statute, the program funds “a broad range of family planning and preventive health services.” Those include contraception, pregnancy testing and counseling, infertility-related services, and screening and treatment for sexually transmitted infections, among others.
Yet Planned Parenthood remains the largest recipient of Title X funds, and federal funding streams are fungible. Pro-life advocates argue that public financing for other services indirectly supports abortion operations by freeing internal resources.
The dismissal of the Title X lawsuit does not resolve a larger dispute over Medicaid. Last summer, Congress enacted a one-year defunding provision aimed at abortion providers as part of the One Big Beautiful Bill Act (OBBB).
The provision bars federal Medicaid payments under Title XIX of the Social Security Act to defined “prohibited entities” for one year. It applies to nonprofit organizations primarily engaged in “family planning” and “reproductive health” that also provide abortions, but allows for limited exceptions such as rape, incest, or life endangerment for the mother. The statute sets a financial threshold, targeting entities that exceeded $800,000 in combined federal and state Medicaid expenditures in fiscal year 2023. That restriction covers payments made directly and through managed care arrangements.
This approach goes beyond long-standing federal policy — the Hyde Amendment — which already bars Medicaid from paying for abortions themselves. Instead, it cuts off all Medicaid reimbursements to qualifying providers, even for non-abortion services, for a limited period.
The OBBB provision was challenged in court, and in December, a federal judge blocked enforcement. However, the First U.S. Circuit Court of Appeals later allowed the defunding to proceed.
The Medicaid restriction is set to expire this summer unless Congress acts again. Pro-life groups are pressing for permanence. The administration has not committed to extending the provision.
Growing Tension With Pro-lifers
Moreover, amid the intense healthcare debate in Congress, Trump has called on Republican lawmakers to be “a little flexible on Hyde.”
As reported by Fox News:
Republicans want to keep the Hyde Amendment protections part of healthcare negotiations, while Democrats are opposed to including the amendment.
Politico followed with a piece titled “Abortion opponents threaten to withhold midterm support amid rift with Trump.” The article documents growing dissatisfaction among the activists who once viewed Trump as their most effective ally. Some groups are now signaling they may scale back campaign spending or volunteer mobilization in the midterms if their priorities are sidelined.
Beyond the immediate political fallout, the episode highlights a deeper constitutional concern. Title X disputes, Medicaid defunding fights, and recurring litigation all stem from the same problem. The federal government has assumed an expansive — and expensive — role in healthcare that the Constitution does not authorize.
