Trump Budget Cuts Push Family Planning Clinics to Lean on States

Family planning clinics are turning to states to temporarily fill gaps left by deep cuts in the Trump administration’s multi-trillion-dollar tax and spending law that are poised to dramatically curtail access to reproductive health care.

The new law’s one-year prohibition on Medicaid reimbursements for family planning services at certain organizations that also offer abortion care immediately became a threat to Planned Parenthood and others. In the short-term, governors and lawmakers in Hawaii, Washington, and other states have made financial commitments to help stabilize the clinics.

While a federal judge earlier this month granted Planned Parenthood’s request for a temporary freeze on the provision, a judgment in favor of the Trump administration would effectively remove one of the largest funding sources for the family planning provider and could result in the closure of nearly a third of its roughly 600 health centers nationwide.

The cuts come as part of a push by Republicans and anti-abortion advocates to crack down on federal funding for abortion care providers. The Trump administration this year also temporarily paused grants issued under Title X of the Public Health Service Act to Planned Parenthood affiliates and health centers offering free to low-cost family planning care.

As states absorb sweeping Medicaid cuts in the federal funding law, family planning providers and policy researchers say it’s inevitable some low-income populations will have limited to no options for affordable contraception, cancer screenings, STI testing, and other care.

“If they’re forced to pay for or delay care, we can see really gaps in access to contraceptive care, which, over time, could lead to higher rates of unplanned and undesired pregnancy, as well as gaps in care for STI screening and treatment services, which are major public health concerns,” said Alina Salganicoff, a senior vice president at KFF and the director of its Women’s Health Policy program.

Planned Parenthood has received funding from Bloomberg Philanthropies, the charitable organization founded by Michael Bloomberg. Bloomberg Law is operated by entities controlled by Michael Bloomberg.

States Stepping In

Most state legislative sessions have wrapped up for the year, but public officials say they’re committed to doing anything they can to support family planning providers.

In Washington state, where Planned Parenthood typically receives at least $11 million in federal Medicaid funding, Gov. Bob Ferguson (D) announced July 9 that he plans to make state funding available if the organization’s challenge to the funding pause is unsuccessful.

Jennifer Allen, CEO of Planned Parenthood Alliance Advocates serving Washington and five states, said in an interview that “this investment will mean that we don’t see clinic closures in Washington.”

The Hawaii legislature in May signed off on $6 million in support to reproductive health-care providers over the next two years. The funding was approved amid a pause on Title X funding, which has since been restored there.

Maine lawmakers stepped in last month to devote $6 million to the state’s family planning providers, including Maine Family Planning, a network of 18 clinics that filed a lawsuit against the Trump administration Wednesday over the Medicaid funding provision.

The Oregon state health agency is working on allocating the $10 million over two years that the state legislature recently approved for Planned Parenthood.

This same support, however, isn’t a guarantee in Republican-led states like Utah, where the state’s Planned Parenthood affiliate recently closed two of its locations after losing roughly $2.8 million in Title X funding.

Securing funding from the Utah legislature is “an impossible ask,” said Katrina Barker, senior director of communications and marketing for the Planned Parenthood Association of Utah.

‘Short-Term Solution’

Anti-abortion groups are lobbying for a longer pause on Medicaid reimbursements to Planned Parenthood, leaving advocates and analysts doubtful states will have enough to prop up the family planning provider beyond a year.

This is “a wonderful short-term solution,” but “the burden of caring for people shouldn’t just fall on the states,” Allen said.

Students for Life of America, which led the “defund Planned Parenthood” campaign in Congress, initially won a 10-year Medicaid reimbursement pause before it was lowered to a year in the final package.

Kristan Hawkins, the group’s president, said she’s hopeful Congress can expand the provision in one of the next budget reconciliation bills.

“Now that we have certainly proven that defunding Planned Parenthood can be done, now we’re going to have to score ongoing efforts,” Hawkins said in an interview.

That push to remove government support for Planned Parenthood will also extend to states, Hawkins said.

Kentucky state Rep. TJ Roberts (R), a Students for Life alum, has said he plans to introduce legislation in the next session to bar Planned Parenthood from receiving any state Medicaid dollars.

In the face of further cuts, long-term support to family planning providers is a “heavy lift” for states, which “do not have the ability to run a deficit,” and face more cuts in the federal funding law, Salganicoff said.

The federal package cuts nearly $1 trillion from Medicaid through work requirements that states will have to develop and implement. The law is also expected to result in decreased payments to hospitals or nursing facilities in at least 29 states, according to a KFF analysis.

The future of the Title X program also remains uncertain, with Trump’s 2026 budget package proposing to eliminate funding for family planning services.

Republicans and anti-abortion groups have proposed that the country’s approximately 1,400 federally qualified health centers take on the low-income patients who would otherwise go to Planned Parenthood.

But a May analysis by the Guttmacher Institute found that health centers offering contraceptive care would have to increase their capacity to provide these services by 56%.

Shifting patients’ options for family planning providers also “increases wait time” and “limits the access and availability of services,” said Michelle Trupiano, executive director of the Missouri Family Health Council Inc., the sole Title X grantee in that state.

“We need all the providers working together to truly meet the needs of everybody who deserves access to health care,” Trupiano said.