Major Federal and State Funding Cuts Facing Planned Parenthood

Planned Parenthood clinics have provided sexual and reproductive health services across the country since 1916 and currently serve over 2 million patients a year through close to 600 clinics across the United States. In many communities Planned Parenthood is the only clinic offering reproductive health care, including contraception, sexually transmitted infection testing and treatment, abortion services, pregnancy testing, cancer screenings like Pap smears and breast exams, and other preventive services. One third of Planned Parenthood’s revenue comes from state and federal government funding, including Medicaid, to provide health care services. According to Planned Parenthood’s 2022-2023 Annual Report, abortion services make up 4% of all the health services they provide, and federal funds rarely go toward abortion care (only in cases of rape, incest and life-threatening situations). The vast majority of the state and federal funding goes to reimburse reproductive and preventive services. “Defunding” Planned Parenthood has long been a priority of Republican leadership at both state and federal levels and was highlighted as a priority in Project 2025. There are currently multiple efforts at the federal and state level to limit funding to Planned Parenthood.

According to newly released KFF Health Tracking Poll data, one in three women (32%) say they have gone to a Planned Parenthood clinic for care, as well as one in ten men (11%) (Figure 1). Nearly half of Black women have gone to a Planned Parenthood clinic. Over four in ten individuals with Medicaid say they have received services at Planned Parenthood and one third of those with private insurance. One in five Republican women and four in ten Democratic women have received care at a Planned Parenthood clinic.

There are currently three major efforts underway to cut funding to Planned Parenthood that could result in major reductions in services and staff, and ultimately, could result in clinic closures.

1. Medicaid

There have been efforts by anti-abortion groups and policymakers to exclude Planned Parenthood clinics from participating in the Medicaid program for many years because of their involvement in the provision of abortion services, even though federal funds cannot be used to pay for abortion services outside of cases of rape, incest, and life endangerment. KFF analysis shows that in 2021, one in 10 women on Medicaid who obtained family planning services got their care at Planned Parenthood. The share ranges from three in ten women with Medicaid in California (29%), to no women in in North Dakota and Wyoming where Planned Parenthood does not have a presence. Among the Medicaid patients who used Planned Parenthood for their family planning care, 85% obtained contraceptive services and about half got STI and/or gynecological care (Figure 2).

Republicans in Congress are currently considering a reconciliation financing bill that would ban federal Medicaid payments to Planned Parenthood and other Medicaid essential community providers across the country for services they provide to Medicaid beneficiaries. The Congressional Budget Office estimates that this will increase federal Medicaid spending by $300 million over ten years. In 2017, when Republicans were in the majority, they made a similar attempt to exclude Planned Parenthood from Medicaid via the reconciliation bill to repeal and replace the Affordable Care Act. While that bill did not pass, it would have cut off all federal payments to Planned Parenthood, including Medicaid reimbursement for contraceptive, STI, and preventive care for one year. The network of safety net providers, including health centers, health departments, and outpatient hospital sites likely would not have had the capacity to fully absorb the loss of Planned Parenthood in many communities in 2017, nor would they today. Prior research in Texas found that removing Planned Parenthood from the Texas family planning waiver program resulted in reduced contraceptive continuation and an increase in Medicaid covered births.

Several states have also attempted to exclude Planned Parenthood from their state Medicaid programs. Texas eventually terminated Planned Parenthood from its full-scope Medicaid program in 2021, and other states (South Carolina, Idaho, Tennessee) also have pending Section 1115 waiver applications at Centers for Medicare & Medicaid Services that would allow them to do the same. The Supreme Court is currently considering a case about South Carolina’s efforts to exclude Planned Parenthood from participating in their state’s Medicaid program and whether Medicaid beneficiaries can sue if they cannot freely choose their provider so long as they are willing and qualified to provide care, which is one of the federal provisions of the Medicaid law. The Supreme Court will likely rule on this in June and if the court rules in favor of South Carolina, states will have greater latitude to exclude Planned Parenthood from their Medicaid program.

2. Title X

The Trump Administration is currently withholding Title X funds from all nine of the Planned Parenthood grantees in the Title X program, which amounts to $20.6 million to provide services to low-income and uninsured people, saying the grantees are not aligned with the president’s opposition to Diversity, Equity, and Inclusion. In addition, other grantees that include Planned Parenthood clinics in their networks have received notices that that their funding is being withheld. Altogether, 144 Planned Parenthood clinics in 20 states are affected by the Title X decision to withhold funding (Figure 3).

Figure 3

While Title X makes up a smaller share of funding that supports services at Planned Parenthood clinics compared to Medicaid, these funds enable clinics to provide free and low-cost contraceptive methods, STI testing and treatment, pregnancy tests, cancer screenings like Pap smears and breast exams, and other preventive services. Already, two Planned Parenthood clinics in Utah and four Planned Parenthood clinics in Michigan have announced they will close due to Title X funds being withheld.

President Trump’s budget proposes terminating the $286 million appropriation for the Title X program. Furthermore, Project 2025 calls for reinstating the Title X regulations from the first Trump Administration that prohibited clinics from participating in the program if they had co-located abortion services or provided abortion referrals. This blocked 410 Planned Parenthood clinics from participating in Title X funding until the Biden Administration reversed the Trump Administration regulations.

3. Teen Pregnancy Prevention

Six Planned Parenthood affiliates receive funds from the Federal Teen Pregnancy Prevention (TPP) program to implement programs and develop, test, and evaluate innovative approaches to prevent teen pregnancy across the United States. These grantees, funded in 2023, have received $5.6 million annually to reach populations with the greatest unmet need with the goal of improving the optimal health of adolescents and reducing teen pregnancies and sexually transmitted infections.

On March 31, 2025, the TPP grantees were notified that the continuation applications due on April 15, 2025, would require them to demonstrate alignment with current Presidential Executive Orders, many of which are in direct conflict with the content in the evidence-based programs the grantees are funded to implement. This includes Executive Orders that ban the promotion of racial equity and gender inclusivity, current tenets of the TPP program (and also the care provided by family planning clinics). The funding opportunity the grantees applied under was called “Advancing Equity in Adolescent Health through Evidence-Based Teen Pregnancy Prevention Programs and Services” and applicants had to demonstrate as part of their grant application the extent to which they were committed to advancing health equity. Five of the six Planned Parenthood TPP grantees have filed a lawsuit against the Trump administration asking the Court to set aside the new alignment requirements and order HHS to allow grantees to continue receiving funding under the initial grant agreement. President Trump’s budget also proposes eliminating the Teen Pregnancy Prevention program along with Title X.