Trump’s elimination of the Title X Family Planning Program as we know it is not an isolated policy shift, but part of a broader effort to dismantle reproductive healthcare while redirecting public resources toward ideological programs and priorities.
This essay is part of an ongoing Ms. series examining the real-world impact of President Donald Trump’s proposed fiscal year 2027 budget. Across sectors—from healthcare and childcare to immigration enforcement and food assistance—the series explores what the administration’s funding priorities reveal about who government serves, and who it leaves behind.
Title X is the federal program that funds family planning and reproductive health services nationwide—and under President Donald Trump’s proposed budget for 2027, it would be effectively eliminated, reshaping access to care for women across the country.
Passed in 1970, Title X has supported free and low-cost FDA-approved contraceptives, natural family planning, basic infertility services and preventive care ever since. The program has been enormously successful in reducing unintended pregnancy and child poverty, and enormously cost-effective: Every dollar spent on family planning saves $7 in Medicaid costs.
On April 3, 2026, the Trump White House released its FY 2027 budget, with no funding for family planning. The proposed federal budget includes only one mention of Title X, referencing Planned Parenthood LGBTQ services as “radicalized DEI ideologies” funded under the program, and it mentions contraception only once, decrying a “ContraceptionForAll” tool for transgender females as “radical gender ideology.”
What is perhaps most jarring, on close reading, is not only what the budget proposes, but how it speaks. The language throughout the administration’s budget and HHS documents departs from traditional bureaucratic norms, adopting a tone that is at times openly mocking and vilifying. Programs serving women, LGBTQ people and marginalized communities are described in terms that signal not just opposition, but disdain. It is a stark reminder that federal budgets do more than allocate resources—they reflect who this government is for, and who it is not.
Trump’s Department of Health and Human Services (HHS) released its agency budget on the same day as the White House: a 475-page document with no mention of contraception, not even in the 67 pages addressing maternal and child health.
New Title X grant guidelines also posted that day make only one mention of contraception—in a section on “overmedicalization in health care.”
The last round of Title X grants under the Biden administration supported 86 state agencies and nonprofit health clinics, including Planned Parenthood centers, “to deliver equitable, affordable, client-centered, and high-quality family planning and preventive health services across the United States.”
Under the Trump administration, Title X grants will instead fund “fertility awareness,” and “root causes” and “restorative approaches” to reproductive and fertility care—and expand eligibility to unregulated pregnancy clinics (UPCs), also known as crisis pregnancy centers, that oppose abortion, contraception (including for STI prevention), and comprehensive, evidence-based sexual and reproductive health education.
“Root cause” and “restorative reproductive medicine” (RRM) are infertility approaches endorsed by conservative groups opposed to vitro fertilization (IVF) including Project 2025, its sponsor the Heritage Foundation, and the UPC industry—all three major UPC networks offer RRM training at their national conferences.
The American College of Obstetricians and Gynecologists (ACOG) denounces RRM as “non-medical.” The American Society for Reproductive Medicine warns that “what distinguishes RRM is not medical practice but ideology. It typically excludes IVF and related treatments on moral or religious grounds, not clinical evidence.”
But Trump’s HHS is already redirecting $1.5 million in Title X dollars from contraception to this fringe movement, funding an infertility training center to advance “root cause treatments” and referrals to “root cause specialists,” opening the valve for Title X funds to flow to UPC industry actors who promote RRM.
Trump already did a dry run on directly funding UPCs under Title X in 2019, not only banning Title X clinics from discussing abortion but enabling diversion of $1.7 million to Obria, a UPC network “led by God” and committed to never dispensing contraception.
When Trump was reelected, antiabortion leaders called for reinstatement of those Title X changes and reopening the door to UPCs. The new funding guidelines do just that. As of FY2027, non-clinical and faith-based organizations (read: UPCs)—in blue, purple and red states alike—will be eligible to apply.
While UPCs pose as women’s health clinics in need of public support, they are in fact part of a multi-billion-dollar industry tied to the extremist groups that overturned Roe and are now going after contraception and IVF. Not only will expansion of Title X eligibility divert our tax dollars to this right-wing agenda, it will further bankroll an industry already awash in private funding, with a track record of fraud, overbilling and illegal use of taxpayer dollars in at least 14 states, and a gaping discrepancy between its revenue and the value of its services.
Moreover—and critically—because this industry is unregulated, its “clinics” are subject to none of the health, safety, licensing or privacy standards that govern medical offices. Shockingly, in state legislatures across the country this session, UPCs have actually fought reasonable, baseline proposals that they protect patient privacy, be licensed if offering medical services, and establish credentialing standards for staff performing invasive transvaginal ultrasounds.
Expanding Title X eligibility to these unregulated pregnancy clinics marks a serious departure from the standard of care established by leading medical authorities such as ACOG and the American Medical Association. It will lower essential, long-standing patient safety safeguards and dilute oversight of desperately-needed reproductive health services, putting patients at risk and further decimating the landscape for reproductive healthcare nationwide.
Our federal government is already subsidizing UPCs with little transparency or accountability. A 2024 analysis found 650 UPCs received over $400 million in federal funds between 2017 and 2023, but many “do not follow national, evidence-based standards and guidelines.” And in a March 2026 response to a directive from U.S. representatives to account for federal dollars going to UPCs, Trump’s Government Accounting Office was able to identify only $34 million allocated to 16 UPCs “due to major data gaps.”
Expanding Title X eligibility to UPCs without closing these yawning medical and fiscal accountability gaps means even more taxpayer dollars will go to an industry that does not meet even baseline standards for patient privacy, medical oversight, and safety, and is plagued by financial waste the government cannot currently track nor evaluate.
But Trump’s Title X changes aren’t about protecting women’s health or responsibly shepherding taxpayer dollars.
Using Title X to “defund” Planned Parenthood, the nation’s leading provider of reproductive health services has long been an antiabortion movement project. In 1997, antiabortion strategist Michael Schwartz wrote, “After they are barred from getting Title X funds, that can be expanded to … all federal funds from any source.” And CPC industry leaders have long lobbied to “replace” Planned Parenthood.
In March 2025, Trump picked up the mantle, freezing $65.8 million in Title X funding that forced closure of over 30 Planned Parenthood health centers.
A White House spokesperson has noted that current Title X grants to Planned Parenthood will be the last.
Title X changes are, in fact, a lever in the bigger political project for which Trump’s budget is a blueprint: a Christian nationalist, pronatalist agenda to impose traditional marriage and gender roles on American women while eviscerating the federal government’s role in providing the healthcare and supports mothers and children need.
Budget director (and Project 2025 author) Russell Vought introduces Trump’s budget heralding a 44 percent increase in defense and 10 percent cut to all non-defense spending. He names Medicaid and the SNAP food program as examples of “profligate” spending and “futile” programs to be reined in. Agency budgets that follow eliminate whole healthcare, housing, food security, workforce, childcare and other safety net programs that are lifelines for women, teens, and mothers.
The HHS budget and Title X guidelines echo the federal budget’s priorities—and its grievances. HHS’ “Make America Healthy Again” reorganization replaces reproductive health funding with pronatalist programming, eliminating teen pregnancy prevention, for example, while funding embryo adoption for “family-building.”
Title X will now require grantees to end DEI policies and practices, protect parental rights in the religious upbringing of children, enforce the Hyde Amendment prohibiting use of funds for abortion, and ensure funds do not benefit “illegal aliens.”
As columnist Jessica Grose wrote, they want to “provide as little government support to families as possible, but they also want women to stay home to raise their families.”
Trump’s federal budget and changes to Title X are meant to impose this impossible reality on American women.
