For more than 50 years, one of our most successful anti-poverty & public health programs has been the federal Title X Family Planning Program.
Title X was signed into law in 1970 with support from both political parties. President Nixon said at the time that family planning services should be available to all people who want them but cannot afford them.
The objective of Title X and has remained until this week to help people plan and space pregnancies so they can decide when to start or grow their families.
Title X is the only federal program focused only on family planning. The program provides funding to states, health departments, community health centers, and nonprofit organizations. They use the funding to provide family planning services and reproductive health care to people who otherwise might not be able to afford them.
From a public health point of view, the program has been a big success.
Title X Helped Cut Teen Births
Title X improves health in lots of ways. One of its most important successes has been helping reduce unintended pregnancies and teen births. That matters because early and unintended pregnancies are among the strongest predictors of long-term poverty.
The U.S. teen birth rate dropped 78% from 1991 to 2021. More recently, the birth rate among teens ages 15 to 19 dropped 71% between 2000 and 2022.
That progress happened because of better access to birth control, better family planning services, and more young people getting the tools they need to make informed decisions.
Preventing Teen Births Helps Break the Poverty Cycle
Teen moms are way less likely to finish high school and more likely to live in poverty than young people who delay having children. Their children are more likely to grow up poor, have worse health outcomes and face more barriers in school and later in life.
So preventing teen births isn’t just about preventing pregnancy. It’s about helping interrupt the cycle of poverty from one generation to the next. It helps people space pregnancies in healthier ways and helps young people stay in school, enter the workforce, and build stability before starting a family.
That’s why Title X has always been such an important public health program. It helps people decide when they’re ready to have kids and gives them the tools and resources they need to act on that.
The evidence is clear that helping people plan and space pregnancies improves maternal health, child health, education, work opportunities, and family income.
Basically, Title X is one of the U.S.’ most effective poverty prevention programs.
Title X in Arizona
For many people in Arizona, a Title X clinic is their only regular source of health care. These clinics provide birth control, STI testing and treatment, cancer screenings, pregnancy testing and counseling, and basic infertility services.
Affirm Sexual and Reproductive Health is a 52-year-old Arizona nonprofit that has administered the Title X grant in Arizona for 26 years. Through a statewide network of service sites, Title X serves about 30,000 unique clients in Arizona each year.
Kennedy’s Edict
This week, Kennedy announced that next year’s Title X funding will stop their long-standing focus on family planning and pregnancy prevention.
Instead, he wants Title X to focus on fertility awareness and family formation.
Fertility awareness can help people who are trying to become pregnant. But it doesn’t prevent unintended pregnancy. In other words, it doesn’t work as a family planning strategy.
Title X wasn’t designed by Congress to increase births. It was designed to help people decide when they’re ready to have children and how to space those pregnancies in ways that improve health and economic outcomes for families.
Note: Kennedy’s decision is aligned with the Heritage Foundation’s Project 2025 blueprint, which calls for ending federal family planning policy and making it about fertility awareness & family formation.
The New Grant Rules Change the Mission
Kennedy’s edict was first published as a draft back in April 2026 and was made official this week.
The new guidance downplays birth control while focusing on fertility awareness and natural family planning.
The word “contraception” appears once in the 67-page funding announcement. The document is peppered with the word “fertility”.
2027_Title_X_Services_Notice HHS
Kennedy is even creating a political review before applications are scored on merit. Applications will first be screened for alignment with his values before they’re judged on whether they can actually provide family planning services.
Arizona Services Are Still Open — For Now
For Arizonans right now, nothing has changed (yet). Affirm’s clinics are open and clients are receiving services. Their current Title X grant runs through March 31, 2027 (and hasn’t been canceled yet).
Affirm — High-quality Health Services in AZ
Affirm is preparing a competitive application for the next grant cycle. Applications are due in January, 2027. But if the new federal funding rules stand as written, highly qualified and experienced providers will be excluded from the program before their applications are ever reviewed on merit.
Now the Courts May Decide (again)
As has been the case for this whole administration, the judicial branch is the only backstop we have to prevent the decimation of a host of public health programs — at least until the mid-term elections or until Congress starts doing its job and providing checks and balances.
The National Family Planning & Reproductive Health Association and the Family Health Council of Central Pennsylvania filed as case this week with support from the ACLU and ACLU of Pennsylvania, in federal court in the Middle District of Pennsylvania challenging Kennedy’s new approach.
The lawsuit challenges the funding announcement itself. It argues that Kennedy is trying to reshape Title X (using the Project 2025 model) through the federal grant process in a way that conflicts with the law Congress passed.
The lawsuit also argues that the new funding announcement conflicts with the 2021 Title X rules, which require grantees to provide inclusive, patient-centered care to all clients regardless of gender identity, race, or national origin.
View the Lawsuit: NFPRHA v. Kennedy
In the coming days or weeks, we’ll see whether a federal judge places a preliminary injunction or temporary restraining order on this most recent Kennedy edict.
I think she or he will.
