Cards on a table at West Alabama Women’s Center in Tuscaloosa. The Trump administration could change rules around a federal program that currently requires health care providers to provide counseling and referrals on all pregnancy options, including abortion. (Vasha Hunt/Alabama Reflector)
A federal program provides grants to clinics that offer family-planning services at little to no cost for patients. The first Trump administration barred providers that receive Title X funding from offering abortion referrals, but the Biden administration reversed that policy.
Under President Joe Biden, health officials denied Title X funding to states that did not comply with the new rule to provide abortion referrals or counseling. Funds from the program are not used to pay for abortions, which has been the case since Title X’s inception in 1970.
Oklahoma sued the federal government over the action last year. But the U.S. Supreme Court denied an emergency appeal from the state in September to reclaim a $4.5 million family-planning grant, Oklahoma Voice reported.
Tennessee rejected $7 million in funding to avoid telling pregnant patients at federally funded clinics about all their options, including abortion. The state also sued federal health officials over the rule, but in August the U.S. 6th Circuit Court of Appeals ruled against the challenge, Tennessee Lookout reported.
It’s unclear if Alabama, another state with a near-total abortion ban, offers abortion referrals through the Title X program. But the current rule could be nixed after President-elect Donald Trump takes office, Alabama Reflector’s Alander Rocha reports:
The Alabama Department of Public Health (APDH) has been silent on whether it is following current federal rules requiring health care providers to provide counseling and referrals on all pregnancy options, including abortion.
But it may soon be a moot point.
A second Trump administration could reverse those rules and affect reproductive health policy in Alabama, which according to the U.S. Centers for Disease Control and Prevention has the 7th highest teen birth rate nationwide, at 20.9 per 1,000 females aged 15–19.
The state health department also reports that rates of sexually transmitted diseases (STIs) have been rising, with a significant increase among people aged 15-24, and Black individuals being almost three times more likely to be diagnosed with HIV than white individuals.
“Just as during the first Trump administration, President-elect Trump could again harm the Title X program through the regulatory process, without legislative action,” said Anna Bernstein, principal federal policy advisor for the Guttmacher Institute.
Title X, a federal family planning program, funds low-cost reproductive services, including birth control and STI testing, for low-income individuals. Alabama received $5.5 million from the program in fiscal year 2024, which is administered by ADPH. As Alabama’s only Title X grantee, ADPH could risk losing federal funding if it is found out of compliance with current regulations, which mandate comprehensive pregnancy counseling.
Bernstein said that Trump could reinstate the so-called “domestic gag rule,” which imposed additional requirements on Title X grantees, mandating a physical and financial separation of services for clinics that provide abortion care outside of Title X funds.