Contact: Audrey Sandusky, (202) 344-5805,

NFPRHA petitions US Supreme Court to strike down administration’s Title X restrictions

WASHINGTON, DC – The National Family Planning & Reproductive Health Association (NFPRHA) today petitioned the US Supreme Court to strike down a 2019 Trump administration rule that imposed drastic changes on the Title X family planning program. NFPRHA’s petition was joined by the American Civil Liberties Union (ACLU) Reproductive Freedom Project, the American Medical Association (AMA), Planned Parenthood Federation of America (PPFA), Essential Access Health, the Oregon Medical Association, and others.

The petition asserts that the high court’s review is warranted following conflicting decisions by the Fourth Circuit and Ninth Circuit, leaving unresolved questions of federal law about an essential federal health care program. The Fourth Circuit found the Title X rule invalid, while the Ninth Circuit upheld the rule.

The petitioners argue that unless the Ninth Circuit’s erroneous decision is corrected, the administration’s gag rule will harm patient care and violate ethical obligations by preventing family planning providers in Title X health centers from providing full information to patients about all reproductive care options. This marks the first time in recent history the AMA has petitioned the US Supreme Court in such a manner, further underscoring the government’s significant overstep in issuing the rule.

“At stake for our nation is the reproductive health of millions, the majority of whom already face inequities in their lives. Every person deserves high-quality family planning care, and we are committed to restoring Title X’s integrity. We will fight the Trump administration’s unlawful and dangerous Title X rule to the very end,” said Clare Coleman, President & CEO of NFPRHA.

"The Trump administration's Title X rule was a lawless attack on this vital public health program, and must be rejected,” said Ruth Harlow, Senior Staff Attorney at the ACLU Reproductive Freedom Project. “We call on the Supreme Court to uphold its role as an essential check on unlawful agency actions, hear this vitally important case, and restore the full range of clinical family planning care that millions nationwide have historically relied upon."

“The Trump administration’s Title X regulations are another flagrant example of the federal government prioritizing politics over public health. The unlawful regulations deny women complete and unbiased information about their pregnancy options and dictate a lower standard of care for low-income and uninsured patients,” said Julie Rabinovitz, President and CEO of Essential Access Health. “We are committed to halting implementation of the regulations nationwide and ensuring that Title X patients across the country can receive the care they want, when they need it.”

Since its inception a half century ago, Title X has served as a vital public health program, ensuring vulnerable populations — especially low-income women — have access to basic, preventive reproductive health care. In addition to restricting physicians and other health care professionals from providing complete information and appropriate referrals for care to their Title X patients, the administration’s rule withholds federal funding from providers that do offer the full range of family planning services, much to the detriment of the millions of Americans who depend on Title X for reproductive care.

“The AMA feels strongly that our nation’s highest court must step in to remove government overreach and interference in the patient-physician relationship. Restricting the information that physicians can provide to their Title X patients blocks honest, informed conversations about all health care options — an unconscionable violation that is essentially a gag rule,” said AMA President Susan R. Bailey, M.D. “As physicians and leaders in medicine, we are fighting against the government’s intrusion in the exam room while protecting open communication between patients and physicians, which is the foundation of high-quality medical care.”

“The Title X gag rule is designed to take away access to reproductive health care, like birth control and life-saving cancer screenings, by forcing safety net providers like Planned Parenthood out of the program,” said Alexis McGill Johnson, president and CEO of Planned Parenthood Federation of America. “Before this rule was put in place, Planned Parenthood health centers proudly served about 40% of the 4 million patients who got care through the Title X program each year. Since our health centers and others have been forced out, people who have always faced systemic barriers to health care — including those in rural areas, as well as Black, Latino, and Indigenous communities — have suffered the most. Health care should never come down to how much you earn or where you live. We are proud to join with our partners in taking this fight to the highest court.”

The petition states that “the consequences of the rule are clear and stark — and already occurring.” Roughly one in every four Title X providers has withdrawn from the program in response to the rule’s implementation last year, ultimately jeopardizing care for 1.6 million patients nationwide. A recent U.S. Health and Human Services (HHS) estimate supports these figures, acknowledging that Title X services sites decreased by 945 sites and the number of annual patients served in 2019 fell by 21% — despite the Title X rule being in effect for only a few months. In California, for example, it is projected that in 2020, there will be an almost 75% reduction in the number of patients served by Title X in the state. As of August 2020, six states are without any Title X site at all.

Over the course of its 50-year history, Title X has been an enormous success for patients, their communities, and our country — serving more than 4 million patients a year with critical, often life-saving reproductive care. Without Title X, the rates of unintended pregnancy and abortions would have been 31% higher, according to estimates. Most of the patients served by Title X are economically disadvantaged and live in areas where there are few health care options.

In emphasizing Title X’s immense impact, the petition notes that “for six in 10 women who obtain contraceptive care at a Title X-funded site, that provider was their only source of medical care over the past year.” The petition stresses that patients, physicians, and the health of the nation will be irreparably harmed without the Supreme Court’s review of the case.


NFPRHA is a membership organization representing publicly funded family planning providers and administrators nationwide. NFPRHA advances and elevates the importance of family planning in the nation’s health care system and promotes and supports the work of family planning providers and administrators, especially those in the safety net. For more information, visit

National Family Planning & Reproductive Health Association

1025 Vermont Ave. NW, Suite 800, Washington, DC 20005
Phone: 202-293-3114  |

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