Maryland Attorney General Anthony G. Brown has co-led a coalition of 21 attorneys general and two governors in a lawsuit challenging new federal conditions tied to Title X family planning funding.
The lawsuit was filed in the U.S. District Court for the District of Maryland. It challenges conditions announced by the U.S. Department of Health and Human Services for the next five-year Title X grant cycle.
Title X provides federal funding for family planning and preventive health services, including contraception, cancer screenings, sexually transmitted infection testing and treatment, pregnancy testing and counseling.
According to the lawsuit, the new funding conditions require applicants to align their programs with several federal policy priorities. Those include eliminating diversity, equity and inclusion practices, changing policies related to transgender patients, emphasizing natural family planning, counseling patients toward marriage and parenthood, and complying with other administration priorities.
The coalition argues the conditions conflict with existing Title X laws and regulations requiring providers to offer a broad range of contraceptive methods, provide nondirective counseling and serve patients without discrimination.
The lawsuit also argues that HHS imposed the conditions without the notice-and-comment process required under the Administrative Procedure Act and that some requirements are too vague for providers to determine how to comply.
The Maryland Department of Health has participated in Title X for more than 50 years. Maryland currently receives about $3.7 million in Title X funding in addition to approximately $6.3 million in state funding. The money supports family planning services through 19 local health departments and four private nonprofit organizations.
During State Fiscal Year 2025, providers receiving Title X funding through the Maryland Department of Health served 51,561 people. More than 60% received family planning services at no cost.
The Maryland Family Planning Program estimates that without Title X funding, it would provide 1,447 fewer Pap smears annually, which it projects could result in 25 high-grade cervical precancers going undetected each year.
The coalition is asking the court to declare the new conditions unlawful and prevent HHS from enforcing them.
Brown is co-leading the lawsuit with the attorneys general of New York and Massachusetts. Attorneys general from California, Colorado, Connecticut, Delaware, Hawaiʻi, Illinois, Maine, Michigan, Minnesota, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont, Virginia, Washington and Wisconsin also joined the case, along with the governors of Pennsylvania and Kentucky.
