RismadarVoice Reporters
August 27, 2026
Twenty-three US states have sued the administration of President Donald Trump over proposed changes to the federal Title X family planning programme, arguing that the new funding conditions unlawfully target states and healthcare providers whose programmes do not align with the administration’s policies.
The lawsuit was filed on Thursday at a federal court in Maryland by state officials, including Democratic attorneys general from New York, Maryland, Massachusetts, California, Illinois, Michigan, New Jersey and Virginia.
Democratic governors Andy Beshear of Kentucky and Josh Shapiro of Pennsylvania are also among those supporting the legal challenge.
The states are challenging a funding notice issued by the US Department of Health and Human Services (HHS) for the next five-year Title X grant cycle.
Title X is the only federally funded family planning programme in the United States. It provides free or subsidised services, including contraception, sexually transmitted infection testing, cancer screenings and other non-abortion reproductive health services, particularly for low-income Americans.
According to the lawsuit, the new funding requirements would force states and healthcare providers to modify existing programmes to comply with a range of administration priorities or risk losing federal funding.
The states specifically object to conditions concerning diversity, equity and inclusion programmes, contraception, gender and counselling on marriage and parenthood.
The lawsuit argues that some of the proposed conditions conflict with the statutory and regulatory requirements governing Title X.
The states also allege that HHS introduced the new conditions without following the notice-and-comment procedure required under the Administrative Procedure Act.
The legal challenge comes as Title X grantees approach the end of a five-year funding cycle awarded under criteria established during the administration of former President Joe Biden.
The Trump administration has sought to reshape the programme with a greater emphasis on pregnancy and family formation.
A similar set of restrictions introduced during Trump’s first administration resulted in nearly a quarter of Title X grantees leaving the programme, according to the lawsuit. The number of patients served by the programme subsequently fell by more than 60 per cent over two years.
The states warned that losing federal Title X funding could leave them with significant financial gaps and force them to use state resources to maintain services.
“With federal Title X funds in jeopardy … Plaintiff States will be forced to scramble to fill the funding gap from their own coffers to preserve these critical services,” the lawsuit stated.
The latest case is not the first legal challenge against the Trump administration’s proposed changes to Title X.
Two nonprofit organisations supporting family planning and preventive healthcare services have also filed a lawsuit in federal court in Pennsylvania, while Planned Parenthood filed another case in federal court in Washington, D.C., in July.
The cases are expected to determine whether the administration can impose the proposed conditions on Title X funding and how the changes will affect federally supported family planning services across the United States.
