Maine sues U.S. health officials over threats to Title X funding for family planning
Maine has joined 22 others in suing the U.S. Department of Health and Human Services, challenging new conditions attached to a long-standing federal family planning program that funds clinics serving low-income and underinsured patients across the country.
The lawsuit, filed by 21 Democratic attorneys general and two Democratic governors, asks a federal judge in Maryland to declare the new requirements unlawful and block them from taking effect. Among the plaintiffs are the top law enforcement officers of states stretching from coast to coast, with Maine Attorney General Aaron Frey among them.
At the center of the dispute is Title X, a federal grant program created more than 50 years ago to ensure that people who could not otherwise afford care could access pregnancy testing, contraception, testing for sexually transmitted diseases, and cervical cancer screening. In 2026, the Family Planning Association of Maine received more than $1.78 million in Title X funds, which supported services at 63 locations around the state, according to the complaint.
When HHS recently opened the application process for the next five-year funding cycle, the lawsuit alleges, the department folded in several new conditions. Among them, the complaint says, are requirements that recipients abandon diversity, equity and inclusion policies and that they recognize patients by biological sex rather than gender identity.
The states also argue that the conditions seek to place additional limits on referrals for abortion services. Federal law already prohibits Title X dollars from paying for abortions and requires grantees to offer what the law describes as "nondirective" pregnancy counseling. The lawsuit contends the new rules push beyond those boundaries by requiring "neutral counseling" and forcing providers to steer patients toward abortion services on request, an arrangement the states say conflicts with both Title X's own framework and their own program rules.
The complaint describes the conditions as "unlawful several times over," saying they run counter to the "core statutory and regulatory requirements" of Title X.
The stakes for Maine are concrete. Under state law, Maine is required to backfill any reduction in Title X funding, meaning the state treasury — not the federal government — would have to absorb the loss. The lawsuit warns that clinics in all 23 states could close, services could end, and states would face "the substantial costs of increased health care needs caused by worsened immediate and long-term health outcomes."
HHS declined to discuss the litigation. In a statement Thursday, a spokesperson said the department could not comment on pending lawsuits.
In Maine, the Family Planning Association of Maine issued its own statement Thursday, sharply criticizing the new framework. Olivia Pennington, the group's associate vice president of public affairs, said the conditions would "set reproductive freedom back decades" and hurt the very patients the program was designed to reach.
"The vision for Title X laid out in the funding announcement would erase patients' contraceptive choice, create more barriers to care, and lower the standard of health care services that patients have always received through the family planning program," Pennington said. "The Trump administration's reimagined Title X program is not what's best for our patients, our communities or our country."
The lawsuit asks the court not only to strike down the new conditions but to bar HHS from enforcing them, leaving the future of Title X funding in Maine and the other plaintiff states tied to the outcome of the case.
