Press Release


Essential Access Health Petitions U.S. Supreme Court to Review Trump Administration’s Harmful Title X Restrictions

October 1, 2020
Contact: Amy Moy, 415.518.4465

Today, Essential Access Health – the leader of the largest Title X system in the nation – petitioned the United States Supreme Court to review a Court of Appeals decision upholding the Trump administration’s unlawful Title X regulations released in 2019. The high court’s review is warranted following conflicting decisions by the Fourth Circuit and Ninth Circuit, leaving unresolved questions of law about an essential federal health care program.  The American Medical Association, Planned Parenthood Federation of America (PPFA), the National Family Planning & Reproductive Health Association (NFPRHA), the American Civil Liberties Union (ACLU), the Oregon Medical Association and others, joined the petition.

The unethical, harmful regulations restrict medical professionals from providing complete information and appropriate referrals for care to their Title X patients. The administration’s rule also withholds federal funding from providers that offer the full range of family planning services – limiting access to time-sensitive services for low-income patients that live in areas where there are few health care options.

“The Trump Administration’s Title X regulations are another flagrant example of the federal government prioritizing politics over public health. The unlawful regulations deny women complete and unbiased information about their pregnancy options and dictate a lower standard of care for low-income and uninsured patients,” said Julie Rabinovitz, President and CEO of Essential Access Health. “We are committed to halting implementation of the regulations nationwide and ensuring that Title X patients across the country can receive the care they want, when they need it.”

Roughly one in every four Title X providers has withdrawn from the program in response to the rule’s implementation last year, jeopardizing access to time sensitive care for 1.6 million patients nationwide. A recent U.S. Health and Human Services (HHS) estimate services sites decreased by 945 sites and the number of annual patients served in 2019 fell by 21% – despite the Title X rule being in effect for only a few months. In California, it is projected that in 2020, there will be an almost 75% reduction in the number of patients served by Title X in the state – disproportionately impacting rural regions and communities of color. As of August 2020, six states are without any Title X site at all.  

Over the course of its 50-year history, Title X has been a critical component of our public health system – serving more than 4 million patients a year with essential, often life-saving reproductive care. Without Title X, the rates of unintended pregnancy and abortions would have been 31% higher, according to estimates.

Quotes from Litigation Partners:

“The Title X gag rule is designed to take away access to reproductive health care, like birth control and life-saving cancer screenings, by forcing safety net providers like Planned Parenthood out of the program,” said Alexis McGill Johnson, president and CEO of Planned Parenthood Federation of America. “Before this rule was put in place, Planned Parenthood health centers proudly served about 40% of the 4 million patients who got care through the Title X program each year. Since our health centers and others have been forced out, people who have always faced systemic barriers to health care – including those in rural areas, as well as Black, Latino, and Indigenous communities – have suffered the most. Health care should never come down to how much you earn or where you live. We are proud to join with our partners in taking this fight to the highest court.”

“The AMA strongly believes that our nation’s highest court must step in to remove government overreach and interference in the patient-physician relationship. Restricting the information that physicians can provide to their Title X patients blocks honest, informed conversations about all health care options – an unconscionable violation that is essentially a gag rule,” said AMA President Susan R. Bailey, M.D. “As physicians and leaders in medicine, we are fighting against the government’s intrusion in the exam room while protecting open communication between patients and physicians, which is the foundation of high-quality medical care.”

“The Trump administration's Title X rule was a lawless attack on this vital public health program, and must be rejected,” said Ruth Harlow, Senior Staff Attorney at the ACLU. “We call on the Supreme Court to uphold its role as an essential check on unlawful agency actions, hear this vitally important case, and restore the full range of clinical family planning care that millions nationwide have historically relied upon.”

“At stake for our nation is the reproductive health of millions, the majority of whom already face inequities in their lives. Every person deserves high-quality family planning care, and we are committed to restoring Title X’s integrity. We will fight the Trump administration’s unlawful and dangerous Title X rule to the very end,” said Clare Coleman, President & CEO of NFPRHA.


For more information on Essential Access Health v. Azar and other legal challenges at issue in the petition, a timeline of events, and related documents, click here.

Essential Access Health’s lawsuit includes co-plaintiff Dr. Melissa Marshall, a family medicine doctor practicing at a Title X-funded health center in Yolo County, California. Essential Access Health and Dr. Marshall are represented by a team at the law firm Keker, Van Nest & Peters, led by Michelle Ybarra.

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