OAKLAND – California Attorney General Rob Bonta today defended access to critical, federally-funded preventative care and family planning services provided by the Title X program. Attorney General Bonta and New York Attorney General Letitia James are leading a coalition of 23 attorneys general in filing an amicus brief in Ohio v. Becerra in the Sixth Circuit Court of Appeals. The brief asks the court to uphold a district court’s order denying Ohio’s motion to freeze the U.S. Department of Health and Human Services’ (HHS) 2021 final Title X rule while litigation is ongoing. The attorneys general argue that the new Title X rule, which was implemented in November 2021, removed the Trump administration’s harmful restrictions on family planning funding and ensured the distribution of Title X funds to a greater number of family planning and health services providers that deliver care to millions of low-income or uninsured individuals. 

“A strong Title X program helps ensure that individuals and families have access to quality health services and is a vital resource for underserved communities,” said Attorney General Bonta. “Title X clinics are a lifeline for people who access the program, as it is often their only source of medical care. Since the rule was implemented in November 2021, in California, we have seen a significant increase in those seeking medical care through the program. We know this is consistent with national trends. The data is clear: Title X is a necessity, not a luxury. We support HHS' efforts to uplift this critical program.”

The Title X program funds not only family planning counseling and access to various contraceptive methods, but also critical screenings for high blood pressure, anemia, diabetes, sexually transmitted diseases, as well as cervical and breast cancer. The Trump Administration's 2019 rule led to a dramatic loss of Title X providers nationwide. Due to this loss of providers, the number of clients served by the program dropped by 60% from 2018 to 2020. As this federal safety net was pulled from states, low-income, uninsured, and racial and ethnic minorities’ access to Title X family planning services decreased.

In May 2021, Attorney General Bonta co-led a coalition of attorneys general in submitting a comment letter to HHS commending the agency for its work to undo the Trump Administration’s 2019 rule through the promulgation of its new proposed rule. In November 2021, HHS implemented its final ruling allowing Title X clinics to share information with their patients about their reproductive healthcare options; provide patients with referrals for an abortion, when requested; provide pregnant patients referrals for prenatal care; and remove the physical separation of Title X funded services from abortion care.

Since implementation of the final rule in November 2021, Title X providers have increased nationwide as clinics once again take advantage of the provided coverage, and offer more affordable patient services. Prior to the rule’s implementation, California had 242 clinic sites receiving Title X funding. Only a few months after the 2021 rule was implemented, the number of clinic sites grew to 396 — an increase of more than 160. Between 2021 and 2022, the number of patients in California receiving Title X services has more than doubled, from 222,154 to 500,000.

In December 2021, the U.S. District Court for the Southern District of Ohio denied plaintiffs’ motion for a preliminary injunction to pause the application of the 2021 Title X rule. The court rejected the plaintiffs’ legal challenges to the new HHS rule and the plaintiffs’ argument that the 2021 rule would cause irreparable harm. The plaintiffs appealed the decision to the U.S. Court of Appeals for the Sixth Circuit.

In today's amicus brief, the attorneys general assert that granting Ohio’s motion to freeze the 2021 rule would upend the positive impact of its reinstatement. The 2021 Title X rule reestablished protections for quality, preventive healthcare essential to the everyday functions of prospering, healthy communities. Freezing the rule now and reversing the lower court’s decision would harm women, those who live in rural areas, people of color, and members of the LGBTQ community, and would push state health care budgets once again to the brink of exhaustion. 

The California Department of Justice has been fighting to defend access to Title X’s services ever since the Trump Administration introduced its 2019 rule. Attorney General Bonta has continued this fight, and has been a staunch proponent and defender of access to quality reproductive healthcare.

• In November 2021, Attorney General Bonta joined a coalition of 20 state attorneys general in filing an amicus brief urging the Seventh Circuit to halt certain regulations passed in Indiana that restrict access to abortion, arguing that several provisions of the state’s laws place an undue burden on the ability of individuals to exercise their constitutional right to terminate a pregnancy before viability.
• In October 2021, Attorney General Bonta took action against Senate Bill 8 — Texas’ unconstitutional abortion ban — by joining an amicus brief in support of challengers of the law and urging the U.S. Supreme Court to restore an injunction barring enforcement of the law.

Attorney General Bonta and Attorney General Letitia James are joined by the attorneys general of Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Jersey, New Mexico, North Carolina, Oregon, Pennsylvania, Rhode Island, Vermont, Washington, and Wisconsin. 

A copy of the amicus brief can be found here.