Contraception is a routine part of life for many Americans and polls show people across political parties agree that it should be legal and accessible.
But the Trump administration is walking back access to birth control for some people — including withholding funding from a Nixon-era program that guarantees access to contraception for low income people.
Title X under threat
It's only been a few generations since birth control was widely accessible in the U.S. Married women were not legally allowed to use contraception in some states, until the 1965 Supreme Court decision Griswald v. Connecticut. Shortly after that, in 1970 – facing poor health outcomes for mothers and babies – Congress created Title X.
Enacted under the Nixon administration, the program guaranteed free contraception for people who needed it. In a special message to Congress in July 1969, Nixon wrote: "It is my view that no American woman should be denied access to family planning assistance, because of her economic condition."
The program has existed ever since. The 2025 budget provided $285.6 million in Title X funds.
Now, a group of 15 public health organizations is suing the Trump administration, arguing that the federal government jeopardized access to services including birth control for more than 800,000 people due to illegal withholding of Title X dollars.
One of the plaintiffs in the lawsuit is Bridgercare in Montana, which distributes funding to 20 reproductive health clinics across the state. Stephanie McDowell, Bridgercare's executive director, recalls receiving a letter from the Department of Health and Human Services on March 31st, notifying her that her organization's funding would be suspended the next day. The letter said Bridgercare had violated the Civil Rights Act and Executive Orders issued by President Trump. Other plaintiffs received similar letters.
" They were citing statements of anti-racism — statements that might be what we would commonly understand as DEI (Diversity, Equity and Inclusion) efforts," says McDowell.
A message on the organization's website underscores that they welcome patients of different identities, including "teens, LGBTQ+ individuals, and survivors of sexual assault."
McDowell says she believes these kinds of statements are what HHS is referring to.
" We meet people where they are, and that oftentimes means letting people know that we're a safe, welcoming space for them, regardless of their income, regardless of their identity," says McDowell.
The Department of Health and Human Services did not respond to a request for comment on this story.
McDowell says her organization has been limping by since their funding was revoked, largely relying on donations. Though services haven't been interrupted for patients, the organization is not in a sustainable position without federal funds, she says.
Other organizations have not been able to shield their patients from the impact of reduced funding.
In Utah, Planned Parenthood representatives said they've had to close two clinics as a result of Title X funds being withheld, as well as implement a fee for some contraception services that were previously free.
"People are living paycheck to paycheck in our communities," says Shireen Ghorbani, who is the interim director of Planned Parenthood Association of Utah. "We are not able to count on the federal government to keep the promise it made to access low cost care and to plan and space their families."
The National Family Planning and Reproductive Health Association, which is representing the organizations that brought the Title X lawsuit against the government, note that some grant recipients have received notice that their Title X funding will be restored.
Permission to limit contraception
It's not only Title X funds that are jeopardizing access to contraception, says Kimi Chernoby, an attorney with the National Women's Law Center. She points to cuts to Medicaid included in the Republican spending bill that was recently signed into law, which jeopardize access to healthcare — including contraception — for millions of women in coming years.
A number of state efforts have also sought to limit birth control. In Indiana, Republican lawmakers removed IUDs and condoms from a program that aimed to increase access to birth control, replacing them with "fertility awareness based methods." After a Right to Contraception bill passed with bipartisan support in Virginia, Republican Governor Youngkin vetoed it.
Chernoby says the Trump administration has created a permission structure for these kinds of efforts. She points to Project 2025, the Heritage Foundation's "blueprint" for the new Republican administration. President Trump has adopted many of its policies.
Project 2025 suggests changing requirements that employer-provided insurance and the Affordable Care Act cover contraception.
The Trump administration also included a provision in the most recent budget law that would withhold Medicaid funds from Planned Parenthood clinics across the country. The change could potentially cripple the organization and prevent it from providing healthcare services including contraception.
That provision is currently blocked in court, though Planned Parenthood officials say they are preparing for an appeal and underscore that 200 clinics across 24 states are at risk of closure.
"They are intent on expanding the population"
Neither the Trump administration nor the Heritage Foundation responded to a request for comment on this story or explained why they seek to reduce access to contraception.
Planned Parenthood's Ghorbani has a theory.
"It is very clear that they are intent on expanding the population," says Ghorbani. She points out that the Trump administration has called on Americans to have more babies, and says limits to reproductive care are a means of achieving that goal. "That can be everything from contraception to access to abortion care," she says.
Ghorbani says even though these cuts have hit low-income patients the hardest, attacks on public health impact the whole ecosystem of healthcare.
"All of this is building a structure that makes it harder and harder for individuals to control their sexual and reproductive lives, to plan their families and have kids when they want to."
Kimi Chernoby, with the National Women's Law Center, draws parallels between the administration's effort to limit contraception with successful efforts to limit abortion.
" We are seeing the anti-abortion folks just repurpose their playbook," says Chernoby, who notes that contraception may be more difficult to limit than abortion given its widespread popularity.
"We see them testing these restrictions on minors and low income communities, but we should regard it very much as a litmus test — and expect that they are going to expand these restrictions to affect all of us."
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