Family planning and health organizations that serve tens of thousands of people across Pennsylvania could see federal funding delayed or denied by a new Trump administration policy, a new lawsuit alleges.

The suit, which includes the Cumberland County-based Family Health Council of Central Pennsylvania as a plaintiff, takes aim at a step added this year by the U.S. Department of Health and Human Services to applications for Title X grants, which provide local agencies with funds to aid low-income and uninsured patients with family planning and related health services.

That new process is detailed in the Title X 2027 Notice of Funding Opportunity published in April. It states that before applicants are assessed on their merits, a group of presidential appointees will conduct an “alignment review” to determine whether each application matches the agency’s “priorities.” The plan offers no opportunity to appeal the group’s decision.

To the plaintiffs in the suit, that sounded like code for evaluating applicants based on politics.

“The Trump administration’s attempt to condition Title X funding on political allegiance is a grave threat to public health,” Sara Rose, deputy legal director at ACLU of Pennsylvania and attorney on the case, said in a statement. “Grant decisions must be guided by objective standards to ensure that taxpayer money is spent fairly and efficiently without regard to the ideology of its recipients.”

Created during the Nixon administration to help low-income people prevent unwanted pregnancies, Title X funding has long drawn opposition from anti-abortion activists.

The Trump administration has also attempted to shift the focus of the program toward promoting more pregnancies. Officials tried and failed earlier this year to block Title X funding from reaching Planned Parenthood facilities.

The suit is filed in the federal Middle District of Pennsylvania. It names HHS, Secretary Robert F. Kennedy Jr., and other agency staff as defendants.

There are four Title X grantees in the commonwealth, each serving a specific region: The Family Health Council in central Pennsylvania, AccessMatters in Philadelphia, Adagio Health in the west, and Maternal and Family Health Services in the northeast.

Combined, they receive more than $12.6 million in Title X funds annually to serve more than 160,000 patients in Pennsylvania, according to their grant details listed on HHS’ website. (AccessMatters is by far the largest, working with more than 90,000 people.)

These organizations offer everything from fertility care and access to contraception to screenings for cancers and sexually transmitted infections.

Nationwide, the most recent data from HHS shows Title X grantees served nearly 2.8 million people.

Also at issue in the lawsuit is that HHS already has a set of regulations, put in place during President Joe Biden’s administration, that govern Title X applications — and many of them directly conflict with stated Trump administration priorities.

The suit highlights, for instance, that the HHS website currently states that ending “ideologically-laden concepts like health equity” is a priority, while Title X rules simultaneously require grantees to “advance health equity.”

Another alleged conflict stems from the Trump administration’s opposition to diversity, equity, and inclusion initiatives, especially for transgender people. Current Title X regulations mandate that grantees ensure transgender people have access to their programming.

Brigitte Amiri, deputy director at the ACLU’s Reproductive Freedom Project, told Spotlight PA that the Trump administration could overturn the Biden-era regulations by undertaking a public notice and comment rulemaking process.

“But you can’t just do it by a funding announcement,” she said.

The new review step “subverts the integrity” of the Title X grant application process, the lawsuit argues, and enables HHS “to hijack” the Title X program to fund organizations furthering the agency’s “political agenda.”

The lawsuit also notes that Title X funds are prohibited from being used for abortions.

Federal Judge Jennifer Wilson, who was nominated to the bench by Trump in 2019, will hear the case.

Spotlight PA sought a comment on the lawsuit from HHS, but did not receive a response.

The Family Health Council of Central Pennsylvania was selected to join the lawsuit because it has received Title X funding since the establishment of the program in 1970, and it serves a large area, the chief executive of the National Family Planning & Reproductive Health Association told Stateline.

Patricia Fonzi, president and CEO of the Family Health Council, said in a statement that her organization serves more than 31,000 people across a 24-county region.

“We welcome a competitive grant process and believe every applicant should be evaluated on its ability to effectively serve communities, responsibly steward federal resources, and demonstrate the experience and capacity necessary to carry out the Title X statute,” Fonzi said.

“At the end of the day, the success of Title X is measured by whether people can access the care they need in their own communities — and that depends on funding decisions grounded in experience, proven performance, and the ability to deliver comprehensive care where it is needed most.”

The plaintiffs are urging the court to vacate the Trump administration’s new Title X rule and declare it “unlawful.”

Title X funds are issued to agencies on a five-year basis, with annual renewal requirements. The new rule at issue was included in the process for grants under fiscal year 2027, which will begin a new five-year cycle.

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This story was originally published by Spotlight PA and distributed through a partnership with The Associated Press.

• Rhode Island Energy is installing advanced smart meters for all electricity customers.
• The new meters allow for Time-Varying Rates, which can lower costs for customers and the grid.
• While the utility profits from the $188 million meter investment, the system for customer benefits is delayed.
• The utility is currently seeking to increase its profit margin in a new rate case before state regulators.

Rhode Island Energy is currently installing advanced smart meters for all electricity customers. Clean energy and environmental advocates have championed advanced metering for decades because the systems enable incentives for conservation, solar integration and energy storage. The primary vehicle for realizing these benefits is Time-Varying Rates (TVR).

Unlike legacy meters, advanced meters track when electricity is used, not just how much is used. TVR encourages customers to shift heavy usage, like running a clothes dryer or charging an electric vehicle, to off-peak overnight hours when wholesale power is cheap and cleaner. This flattens the grid’s peak demand, brings down wholesale energy costs for everyone and reduces our reliance on polluting “peaker” power plants.

The Rhode Island Public Utility Commission (PUC) is charged with balancing the interests of utility customers with value to utility shareholders. It sets the formulas by which the utility is compensated.

The primary means the utility is compensated is based on a Return on Equity invested (ROE) that is predetermined by the PUC and currently set at 9.275%.  Rhode Island Energy’s capital investments are funded through roughly 51% equity (shareholder capital) and 49% debt. For every $100 million the utility spends on infrastructure, about $51 million is financed via equity, allowing shareholders to collect an annual pre-tax profit of 9.275% on that portion, or roughly $4.73 million. The more the utility spends, the more their shareholders earn.

At a cost of over $188 million for the new meters, Rhode Island Energy shareholders will collect nearly $9 million a year in profit for 20 years from the equity portion of that investment alone, while also saving money on labor by eliminating the need for truck based drive-by meter readers. 

But advanced metering was supposed to benefit ratepayers as well as the utility. Though the meter expenditures were approved by the PUC in 2023 and the meters installations are expected to be completed by the end of this year, it is expected to take until at least 18 months after the meter rollout is completed to implement the billing system infrastructure needed to enable Time-Varying Rates.

The upgrades that deliver more profit to the utility bottom line was fast tracked, while the investment needed to implement the primary benefits to ratepayers is being slow walked. Why weren’t the software upgrades and hardware deployment run in parallel?

Right now, the PUC is weighing a huge general rate case (Docket No. 25-45-GE). Rhode Island Energy has proposed aggressively hiking its profit margin, seeking to raise its ROE from 9.275% to 10.75% and expand its equity share from 51% to 57%.

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