Washington— The Supreme Court on Tuesday rejected a request by Oklahoma officials who want to restore federal family planning grant funds to the state health department after it refused to provide the number of a hotline that would provide counseling about pregnancy options, including abortion.
The justices rejected an emergency relief offer from the state, which asked the Supreme Court to temporarily stop the Department of Health and Human Services from withholding $4.5 million in federal Title X funds from the Oklahoma State Department of Health. Justices Clarence Thomas, Samuel Alito and Neil Gorsuch said they would grant Oklahoma’s request.
The dispute is the latest involving abortion to go to the country’s highest court after the June 2022 decision. overturning Roe v. Wade. As more than half the country banning or imposing strict restrictions on abortion after the decision, including in Oklahoma, the Biden administration sought to protect access at the federal level, including through the emergency care law contained in center of dispute before the judge in the most recent season.
The fight over Title X funding
The ruling that led to the case involving Title X funding for Oklahoma was announced in October 2021, months before Roe was overturned. Requires Title X projects to provide “nondirective counseling” to pregnant patients about family planning options, including abortion, as well as information about where services can be obtained if requested by the patient.
The Oklahoma State Department of Health received a Title X grant in 2022, which is used to provide funding for city and county health departments. After the Supreme Court overturned the constitutional right to abortion, the department and the Biden administration discussed changing counseling and referral policies for Title X projects, because of a new Oklahoma law that prohibits abortion, according to court filings. The act also makes it a crime for a person to advise or request an abortion for a pregnant woman.
The two entities reached an agreement in which state health departments can comply with the 2021 rule by ensuring interested Title X patients are offered a national hotline phone number that will provide counseling and referral information. Based on the accommodation, the Department of Health and Human Services agreed to give $4.5 million to the state agency from April 2023 to March 2024.
But the Oklahoma health department soon reversed course and said Title X patients seeking pregnancy counseling would not be given phone numbers, according to a Justice Department filing. As a result, the Biden administration ended up ending the award because it said the country violated the 2021 rules.
Oklahoma officials sued the federal government over the decision and sought to temporarily block the award and force the Department of Health and Human Services to provide additional funding in the future. The state contends that the Biden administration violated the Constitution’s Expenditure Clause and the federal conscience law known as the Weldon Amendment by withholding Title X funds.
The Department of Health and Human Services won before the federal district court and the US Court of Appeals for the 10th Circuit. The appeals court ruled that Congress allowed the federal government to determine eligibility for Title X grants, subject to conditions deemed appropriate by the secretary of health and human services.
A divided three-judge panel of the 10th Circuit also found that the Biden administration violated the Weldon Amendment, in part because the state failed to prove that the federal government discriminated against it by refusing to refer pregnant women for abortions.
Oklahoma Supreme Court Petition
In seeking relief from the Supreme Court, Oklahoma officials claimed that the state health department was stripped of $4.5 million “simply” because it would not provide abortion referrals. He said Title X funding is critical to providing Oklahoma family planning services through local health departments, and warned that cutting Title X services in rural and urban areas of the state would be “devastating.”
Citing Supreme Court precedent, the state argued that the federal government cannot impose an obligation to provide abortion referrals when it is not expressly required by Title X.
“The HHS regulation provides Oklahoma’s requirements on issues it has specifically recognized for those to be addressed in Dobbs,” Oklahoma officials wrote in a filing, referring to the Supreme Court’s 2022 decision that overturned Roe. They continued, “HHS is deliberately trying to impose the policy preferences of the executive branch on the states, including Oklahoma, and upset the Federal-state balance on this important issue.”
But the Justice Department insisted that none of this would affect Oklahoma’s ability to regulate abortions within its borders and questioned how referring patients to the hotline could violate the state’s ban on counseling or obtaining abortions.
The Oklahoma State Department of Health may also reject the Title X award, Attorney General Elizabeth Prelogar wrote in the filing.
“HHS determines that counseling and referrals are ‘critical to the delivery of quality, client-centered care.’ Without them, patients would never get neutral information about ‘all pregnancy options,'” she wrote. “It fits the fundamental purpose of Title X.”
Oklahoma has asked the Supreme Court to issue its decision by August 30, the Biden administration’s deadline for when it will begin distributing federal dollars to other entities.
A similar dispute over Title X funding for Tennessee is also in court. The case involves a $7 million grant denied to the Biden administration after the state refused to provide Title X patients with a national telephone hotline where operators would provide referral information.
Tennessee, like Oklahoma, banned the most abortions in the nation after the Supreme Court overturned Roe, and says it only provides information and counseling for “all legal options” in the state.
A federal district court and the US Court of Appeals for the 6th Circuit declined to block the Biden administration from ending the funding.
