Delaware AG Leads Multi-State Legal Challenge Against New Title X Funding Restrictions

The complaint, filed in the U.S. District Court for the District of Maryland, argues that the administration's conditions unlawfully penalize healthcare providers offering comprehensive contraceptive care and could strip funding from clinics serving millions of low-income patients.

The new conditions at issue

In July, HHS published a funding notice for the next five-year Title X grant cycle that, for the first time, requires applicants to align their programs with a set of political priorities as a condition of receiving or keeping federal funds. According to the state's announcement, those priorities include eliminating diversity, equity, and inclusion practices, excluding and stigmatizing transgender people, discouraging the use of contraception in favor of natural family planning, requiring clinics to counsel patients toward marriage and parenthood rather than offering neutral, patient-centered guidance, and complying with unrelated political directives such as "ending crime and disorder on America's streets." Providers that don't comply risk losing their funding altogether.

Jennings characterized the move bluntly: "Like many other attempts by this Administration to cut off our federal funding, this is extortion, plain and simple… they're trying to force us to throw LGBTQ+ Delawareans under the bus – but our response here is the same as it's always been: we'll see you in court."

The legal grounds

The coalition's complaint attacks the conditions on three fronts. First, the states argue the new requirements 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. Second, they contend HHS imposed the conditions without the notice-and-comment process required under the Administrative Procedure Act. And third, they say the requirements are so vague that providers cannot reasonably determine what compliance means, in violation of the Constitution's Spending Clause, which limits the federal government's ability to attach unclear or unrelated strings to grant money.

What this means at the clinic door

Title X is the only federal grant program dedicated specifically to family planning and related preventive services, and it has operated for more than 50 years. It underwrites contraception, cancer screenings, STI testing and treatment, pregnancy testing and counseling, and other preventive care for low-income patients nationwide. For readers weighing where to seek care — or wondering whether a trusted local clinic will lose staff, hours, or whole service lines — the outcome of this case will shape which doors stay open and what those doors still offer. The coalition is asking the court to declare the political conditions unlawful, block HHS from enforcing them, and preserve Title X funding under the program's existing rules.

Early filings to watch: the scheduling order from the District of Maryland, any motion for a preliminary injunction, and whether the administration moves to dismiss before merits briefing. Those first steps will set the timeline for whether the contested conditions take effect for the upcoming grant cycle.