Tennessee’s Title X funding has been on a rollercoaster for years, and the drama is continuing into President Donald Trump’s second term.
That money helps health clinics offer reproductive care to low-income patients. That includes STI screenings, contraception and counseling on family planning. Over the past decade, it has been used as a weapon in the political battle over abortion.
The Trump administration recently canceled all Title X grants going to Planned Parenthood. That included the chapter in Tennessee, which announced to patients last week that prices will change because of the loss.
And the Tennessee Department of Health had some funding reinstated. But concerns about funding cuts, shakeups and layoffs at federal health agencies have left state officials wondering whether Title X will even exist in a few years.
“We know that we’re going to get some partial funds this year, some next year,” said Commissioner of Health Ralph Alvarado. “Beyond that, we’re not sure that the program is going to continue. So we’re still a little bit up in the air, and we’ll wait to see how everything kind of comes out in the wash … In the meantime, we’re going to continue to rely on our state funds.”
The General Assembly has been authorizing a state funding stream for reproductive health services for a few years, since Tennessee got caught up in the chaotic back-and-forth on Title X policy.
The inconsistency started in 2019, under Trump.
During Trump’s first term, the administration instituted the “domestic gag rule.” That was the nickname for an anti-abortion overhaul within the program. It banned referrals from Title X-funded clinics to abortion providers. It created requirements for clinics’ buildings, saying abortion services couldn’t be offered in the same physical space as Title X-funded care. About half of the country’s Title X providers lost their grant during that time, according to the Guttmacher Institute, and many shuttered.
Then, the Biden administration rescinded that policy and replaced it with a new one. It required all Title X providers to include abortion options in family planning counseling. Tennessee and Oklahoma refused to comply, and the administration yanked the states’ Title X funding.
The state sued that administration, but the Tennessee Lookout reported the court sided against Tennessee.
“Tennessee was free to voluntarily relinquish the grants for any reason, especially if it determined that the requirements would violate state laws,” the court wrote. “Instead Tennessee decided to accept the grant, subject to the (rule’s) counseling and referral requirements.”
In September 2023, the state’s Planned Parenthood chapter worked with a few other providers to secure its own Title X grant. That is the grant the Trump administration has suspended.
The administration has canceled all Title X funding for seven states, including California, Maine and Mississippi, according to KFF Health News. The nonprofit news outlet estimates more than 800 clinics across the country have lost funding.
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