In April, the Trump administration collected more than $65 million in Title X from clinics across the country, and some of that funding is still frozen, making it complex for clinics to offer free or low-cost contraception and other family planning services. Some states are seeking a refund of the funds, but Idaho officials decided against it because of a conflict with state law. (Getty Images)
The Idaho Department of Health and Human Services has quietly denied all of its $1.5 million in annual federal Title X funding, leaving patients across the state without free and low-cost contraception and reproductive health services under a key family planning program.
Although thousands of Idahoans have received Title X health care for more than 50 years, the state has made no public announcements since the decision went into effect in April, leading to the closure of 28 of 43 — about 65% — Title X-funded family planning clinics in public health districts across the state, according to the Idaho Department of Health and Human Services.
After the Title X money was rejected outright, the Department of Health and Human Services said there were no plans for the state to make up the difference by increasing its family planning budget.
In one district, Eastern Idaho Public Health, spokeswoman Brenna Christofferson said contraceptive services are no longer available at all, with only current Title X patients being informed. Testing and treatment for sexually transmitted infections and screening for breast and cervical cancer continue to be provided through various funding sources.
Many clinics have closed in eastern Idaho, including more populated cities like Twin Falls and Idaho Falls and rural areas like Salmon, Rexburg and Rigby. Title X services also ended at clinics such as Terry Reilly Health Services in one of the most populated areas of Nampa and Caldwell in southwestern Idaho.
The decision to withdraw the funds came at the same time as the Trump administration he jerked more than $65 million in Title X funding from Planned Parenthood clinics and some independent reproductive health clinics across the country, most of which is still frozen, including for the last remaining Planned Parenthood facility in Meridian, Idaho. Spokeswoman Nicole Erwin said Planned Parenthood continues to raise funds to facilitate offset costs and keep family planning services affordable on a sliding scale.
While Idaho’s move came at the same time as national attention focused on the frozen funds, it was a separate decision, according to Health and Human Services.
“The discontinuation of Title X funding… was not related to Title X policy changes made earlier this year by the federal administration,” said AJ McWhorter, a spokesman for the Department of Health and Human Services. “The department made the decision to decline funding to comply with applicable Idaho laws regarding parental rights and pregnancy options counseling.”
Nationally, seven of the 16 grantees received funding back, while others waited nearly seven months for resolution, said Clare Coleman, president and CEO of the National Association for Family Planning and Reproductive Health.
“For Idaho, going defunded not only disadvantages and endangers young people, but puts everyone in the state at risk,” she said. “It hurts women, it hurts men and it hurts young people.”
Coleman Organization defendant to the U.S. Department of Health and Human Services for frozen funds, and the case is still pending. A coalition of 20 states led by Democrats sued federal government agencies in July to halt activities related to several social safety net programs, including Title X. This matter is placed on hold until the government is closed.
In 2023, US Health and Human Services reported Title X provided care to nearly 3 million people nationwide, a 7% escalate from the previous year. Under program guidelines, people whose family income is at or below 100% of the federal poverty level can receive services for free, while those making up to 250% of the federal poverty level pay a reduced rate on a sliding scale.
The program, established by Congress and signed into law by former Republican President Richard Nixon in 1970, is intended to prioritize low-income or uninsured people, including people who earn too much to qualify for Medicaid, who otherwise might not have access to family planning and reproductive health services. Abortion services cannot be covered by Title X dollars.
Pregnancy options and parental consent
Federal statute leading the administration Title X funds include a youth services section that states that grantees may not require parental or guardian consent before or after a minor applies for or receives family planning services. Another section recommended that grantees enable pregnant patients to obtain information and advice regarding prenatal care and childbirth, infant care, foster care, adoption, and termination of pregnancy. Idaho has a near-total ban on abortion, with a few exceptions.
The Idaho Legislature passed Senate Bill 1329 in 2024, requiring parental consent to “provide health care services” to a child, except for life-saving care. The Idaho Capital Sun reported the law also created difficulties for the state’s suicide hotline because some minors need parental consent to receive certain services.
Coleman said the teen and pregnancy options requirements have long been part of Title X guidelines and do not conflict with state law because federal law should prevail under the U.S. Constitution.
Idaho is one of at least two states that currently has no Title X funding, Coleman said, after Utah lost all of its Title X money when the Trump administration stopped funding Planned Parenthood clinics, which were the only places offering these low- or no-cost services. Planned Parenthood of Utah closed two of its centers — in Logan and St. George – following the decision to freeze funding. Logan is less than an hour from Idaho’s eastern border.
Following the Trump administration’s actions in April, some states were temporarily left without Title X providers, but some states, including Missouri and Mississippi, had funding restored at a later date. The federal health agency also restored funding in May to two states with abortion bans, Tennessee and Oklahoma, whose grants were canceled under Democratic President Joe Biden over his refusal to include abortion as an option during pregnancy counseling.
In letter from HHS to Tennessee officials notifying the award, the Acting Director of Grants Management wrote: “Tennessee is one of only two states that lost funding due to failure to comply with the 2021 Title X regulations requiring abortion counseling and referral. The Department declines to enforce this provision against the State and you may reference this letter in that regard.”
McWhorter said a total of 7,528 Title X clients were served in Idaho in 2024. The remaining 15 family planning clinics are supported by other funds, and additional sites providing services may be added as funds become available. These clinics are located in two of the state’s seven public health districts, which totaled approximately 1,400 people in 2024.
Closures pose another challenge in already a complex landscape sexual and reproductive health care in idaho. A recent study found that 94 of 268 practicing OB/GYNs left Idaho between August 2022 and December 2024, and getting care is becoming more complex, according to residentswho say waiting times are longer and some treatments are not available locally.
Coleman said that under the Biden administration, when an entity lost Title X dollars due to noncompliance or other reasons, efforts were made to reallocate the funds to another willing participant. Without these actions, the funds would revert to the U.S. Treasury and the next opportunity for another Idaho entity to apply for Title X funding would come in overdue 2026.
Preventing unplanned pregnancies
Amy Klingler, a clinician in rural eastern Idaho, told States Newsroom she was devastated by the closure of the Eastern Idaho Public Health family planning clinic. She had worked there in addition to other clinical work since 2006 and found there weren’t many other options for family planning care in that area of the state.
“Idaho residents don’t trust doctors, but they trust their doctor,” Klingler said. “So when we see rural health care being eroded and doctors leaving Idaho or not coming to Idaho, I think that’s really going to have an impact on the health of people in our communities.”
Additional cuts to Planned Parenthood through Medicaidalong with across-the-board cuts to the Medicaid program that could force the closure of more rural hospitals and clinics, will force people to delay care until they become sicker and require more costly medical care, Klingler said.
She said the consent to treatment bill has good intentions, and in an ideal world, every child would feel comfortable talking to family members about contraception. However, she said she believes there are teenage women who don’t employ birth control because they don’t want to talk to their parents about it.
And with Idaho’s abortion ban, unplanned pregnancies must either be carried to term or the person must travel to another state where abortion is legal. In Idaho, it is also a crime to transport a minor to another state for an abortion without parental consent.
“Providing free birth control is really effective if you’re trying to prevent unplanned pregnancies,” Klingler said.
Klingler said that on her last day at the family planning clinic in June, everyone cried together.
“We often ended the day saying, ‘We did a really good job today,’” she said. “And not being able to do that good job is kind of heartbreaking.”
This story was originally produced by News from the USwhich is part of States Newsroom, a nonprofit news network that includes Pennsylvania Capital-Star, and is supported by grants and a coalition of donors as a 501c(3) public charity.
