Attorney General Bonta Co-Leads Multistate Coalition in Urging Trump Administration to Restore Title X Funding

Today marks one month since HHS suddenly decided to withhold vast amounts of Title X funding

OAKLAND — California Attorney General Rob Bonta today announced that he is leading, alongside Hawai‘i Attorney General Anne E. Lopez, a coalition of 21 attorneys general in sending a letter to the Trump Administration to express serious concern with the U.S. Department of Health and Human Services’ (HHS) decision to withhold tens of millions of dollars in Title X funding. Signed into law by President Richard Nixon, Title X is the nation’s only federal program dedicated to family planning for low-income and uninsured individuals. On March 31, HHS issued letters to a wide range of grant recipients that fund nearly 25% of all Title X clinics, indicating that these grantees’ Title X grants were being withheld. In today’s letter, the attorneys general write that the withholding of funds will lead to more unintended pregnancies, more sexually transmitted infections (STIs), increased rates of undiagnosed HIV, increased rates of cervical cancer, and a higher burden on over-stretched state budgets. The attorneys general urge HHS Secretary Robert F. Kennedy, Jr. to immediately reverse this decision and fully fund these critical programs.   

“Exactly one month ago, the Trump Administration decided to withhold tens of millions of dollars in Title X funding. Today, my fellow attorneys general and I are urging the Trump Administration to do the right thing. HHS Secretary Kennedy claims to want to ‘Make America Healthy Again’ — restoring Title X funding would do just that,” said Attorney General Bonta. “Our letter underscores the many important services that Title X funding helps to make possible for low-income households across the United States. We are committed to protecting those services and will continue to monitor the Trump Administration’s future actions.” 

In certain States — including California, Hawai‘i, and Maine — all Title X funds were withheld, meaning that Title X funding has now completely ceased in those States. If funding is not restored, in California, nearly half of Title X providers report that there will be immediate or likely layoffs and more than 60% report that they will have immediate reductions in family planning services. One service site anticipates closing. Everywhere, States must scramble to fill the gaps as healthcare providers who have long been a cornerstone of the Title X program have been suddenly shut out. If State and local governments are not able to make up for the federal shortfall, patients will see a reduction in services as clinics close and providers are terminated. This will fall particularly hard on poor and rural communities that are the primary beneficiaries of the Title X program. In many areas, a Title X clinic is the only source of pre-natal services and screening for STIs.  

In the letter, the attorneys general write that:

• Recent history demonstrates that cutting Title X grantees will worsen care. In 2019, the Trump Administration changed the rules governing Title X, leading to a mass loss of healthcare providers. As a result, the number of patients receiving Title X services fell drastically. Nationwide, the number of Title X patients fell more than 60%, from 3.9 million to 1.5 million. This recent history demonstrates what happens — and how quickly — when the federal government slashes access to Title X. Unfortunately, there is every reason to think that the Trump Administration’s recent withholding will have at least as bad an impact on patient care. In total, the Guttmacher Institute estimates that as a direct result of HHS’s action in withholding funds, at least 834,000 patients, representing 30% of the total population served, will lose care in the first year alone.
• The States will be harmed by HHS’s decision. While the 2019 rule was in effect, many States were forced to make emergency appropriations to cover for the loss of providers. The States made these expenditures because Title X programs are a critical component of vital public health infrastructure. An important example is the role of Title X programs in detecting and preventing STIs. Between 2006 and 2010, 18% of all women who were tested, treated, or received counseling for an STI did so at a Title X clinic, as did 14% of women tested for HIV. Now, the States are once again faced with an impossible choice: dip once again into depleted public coffers to make up the difference, or deal with a surge in new STIs and unintended pregnancies.  
• There is no justification for the terminations. Although HHS suggested Title X grantees violated federal civil rights laws, HHS has provided absolutely no evidence supporting this suggestion.  

Joining Attorneys General Bonta and Lopez in sending today’s letter are the attorneys general of Arizona, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, and Washington.  

A copy of the letter can be found here.