Title X program shifts focus away from birth control under Trump administration

After a delayed application window, Title X grants were awarded for the year; HHS guidance for the 2027 cycle emphasizes fertility-awareness or "natural family planning" methods and states Title X funds cannot be used to promote or offer abortions.

Federal Title X grants were awarded for the year after a shortened and delayed application window that had raised concerns among clinics. The Title X program provides federal funding for reproductive health services to low-income and uninsured patients and serves about 2.8 million people. HHS's Office of Population Affairs issued guidance for the 2027 funding cycle that emphasizes fertility-awareness or "natural family planning" and states Title X funds should not be used to promote or offer abortions. Key facts: - Grants for the current year were distributed after the application period opened unusually late and lasted about a week, and many grantees received awards at or near their 2025 allocations, according to the National Family Planning and Reproductive Health Association. - The 2027 guidance encourages integration of noninvasive, evidence-based practices that promote health literacy, fertility awareness, and what it calls "fertility-awareness-based methods." - The guidance states Title X funds cannot be used to promote or offer abortions and cites alignment with President Trump's Executive Order on Enforcing the Hyde Amendment, according to HHS. - HHS said it intends to make up to $257 million available for Title X in 2027 pending the final federal budget, down from about $286 million in recent years. - The next round of Title X applications is due in January, and clinics and advocacy groups are reviewing the new guidance. Summary: HHS officials issued new guidance that shifts emphasis toward fertility-awareness methods and restricts abortion-related uses of Title X funds. Grants for the current year were awarded after the delayed application process, and HHS has indicated a proposed funding level for 2027. The next formal application cycle is scheduled for January as clinics continue to assess the guidance and its implications.