AG Nessel Challenges Title X Funding Conditions

LANSING – Michigan Attorney General Dana Nessel today joined a multistate coalition in suing to block unlawful grant conditions that threaten to strip federal funding for family planning services from states and providers. The lawsuit (PDF), filed today in the U.S. District Court for the District of Maryland, challenges new conditions on Title X funds, which support reproductive health care, family planning, cancer screenings, and other critical preventive care for millions of Americans nationwide. The new conditions will penalize states and providers that refuse to abandon anti-discrimination initiatives or fail to conform their Title X programs to the current federal administration’s ideological preferences for family planning. The states are asking the court to block the unlawful and discriminatory conditions and protect Americans’ access to affordable, high-quality health care.

“The Trump administration is unlawfully attacking funding for family planning and preventive care to once again push political ideologies and preferences,” said Attorney General Nessel. “While the federal government continues to disrupt the lives of everyday Michiganders, even at the expense of public health, I remain committed to fighting illegal conditions placed on critical funding to protect vital services across our state.”

Title X is the only federal grant program dedicated specifically to family planning and related preventive health services. For more than 50 years, Title X has helped millions of low-income patients access contraception, cancer screenings, sexually transmitted infection testing and treatment, pregnancy testing and counseling, and other preventive health care.

In July, the U.S. Department of Health and Human Services (HHS) published a new funding notice for the next five-year grant cycle that, for the first time, requires applicants to align their programs with a sweeping set of political priorities as a condition of receiving or keeping federal funds. The priorities include the elimination of diversity, equity, and inclusion practices; the exclusion and stigmatization of transgender people; the discouragement of the use of contraception in favor of natural family planning; a requirement that clinics counsel all patients toward marriage and parenthood rather than providing neutral, patient-centered guidance; and a requirement that recipients comply with unrelated political priorities like “ending crime and disorder on America's streets.” Providers who don't comply risk losing their funding altogether.

In 2025, Michigan’s Family Planning Program served nearly 40,000, 65% of whom were at or below 150% of the federal poverty level. To operate the program, the State of Michigan receives over $7 million in Title X funding. Without this funding, Michigan’s Family Planning Program could operate for only four months at current levels and the majority of Michigan’s local health departments with a family planning clinic would stop providing those services.

Attorney General Nessel and the coalition argue that the new HHS conditions conflict with Title X’s governing statute and regulations which require providers to offer a broad range of contraceptive methods; provide nondirective counseling; and serve all patients, including LGBTQ+ individuals, in an inclusive and nondiscriminatory manner. The states also argue that HHS unlawfully imposed the new conditions without the notice-and-comment process required under the Administrative Procedure Act. Additionally, the coalition argues that the conditions are so vague that providers cannot reasonably determine what compliance requires, in violation of the Constitution’s Spending Clause, which limits the government’s ability to attach unclear or unrelated strings to federal funding.

The coalition is asking the court to declare the administration’s new political conditions unlawful, block HHS from enforcing them, and preserve access to Title X funding for state health agencies and other qualified providers under the program’s existing, longstanding rules.

Joining Attorney General Nessel in filing this lawsuit are the attorneys general of California, Colorado, Connecticut, Delaware, Hawai’i, Illinois, Maine, Maryland, Minnesota, Massachusetts, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Virginia, Washington, and Wisconsin, as well as the governors of Pennsylvania and Kentucky.

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