The Trump Administration yanked more than $65 million in Title X funding from clinics nationwide in April, and some of that funding is still frozen, leaving clinics struggling to offer free or low-cost contraception and other family planning services. Some states are suing to get the funding back, but Idaho officials chose to forego it due to a conflict with state law. (Getty Images)

The Idaho Department of Health and Welfare quietly declined the entirety of its annual $1.5 million federal Title X funding, leaving patients statewide without free and low-cost contraception and reproductive health care services from a key family planning program. 

Though thousands of Idahoans relied on the health care provided through Title X for over 50 years, the state made no public announcements as the decision took effect in April, leading to the closure of 28 out of 43 — about 65% — Title X-funded family planning clinics in public health districts throughout the state, according to the Idaho Department of Health and Welfare. 

After turning down the Title X money entirely, Health and Welfare said there are no plans for the state to make up the difference by increasing the family planning budget. 

In one district, Eastern Idaho Public Health, spokesperson Brenna Christofferson said contraception services are no longer available at all, which has only been communicated to existing Title X patients. Sexually transmitted infection testing and treatment, and breast and cervical cancer screenings are still provided using different funding sources.

Many of the clinics closed in eastern Idaho, including more populated cities such as Twin Falls and Idaho Falls, and more rural areas such as Salmon, Rexburg and Rigby. Title X services also ended at clinics like Terry Reilly Health Services in one of southwestern Idaho’s most populous areas of Nampa and Caldwell. 

The decision to forego the funds came at the same time the Trump administration yanked more than $65 million in Title X funding from Planned Parenthood clinics and some independent reproductive health clinics across the country, much of which is still frozen, including for Idaho’s last remaining Planned Parenthood in Meridian. Spokesperson Nicole Erwin said Planned Parenthood continues to fundraise to help offset costs and keep family planning services affordable on a sliding scale.

Although Idaho’s move came at the same time national attention was focused on the frozen funds, it was a separate decision, according to Health and Welfare.

“The discontinuation of Title X funding … was not related to the federal administration’s Title X policy changes earlier this year,” said AJ McWhorter, spokesperson for the Health and Welfare Department. “The department made the decision to decline the funding to remain compliant with current Idaho laws concerning parental rights and counseling on pregnancy options.”

Nationally, seven out of 16 grantees have had their funding restored, while others have been waiting nearly seven months for resolution, said Clare Coleman, president and CEO of the National Family Planning and Reproductive Health Association.

“For Idaho to walk away from the money doesn’t just disadvantage and imperil young people, it imperils all the people in the state,” she said. “It hurts women, it hurts men, and it hurts young people.”

Coleman’s organization sued the U.S. Department of Health and Human Services over the frozen funds, and the case is still pending. A coalition of 20 Democratic-led states sued federal government agencies in July to halt its actions related to several social safety net programs, including Title X. That case is paused while the government is shut down.

In 2023, U.S. Health and Human Services reported Title X provided care to nearly 3 million people nationwide, a 7% increase from the prior year. Under the program guidelines, people with family income levels at or below 100% of the federal poverty level can receive services free of charge, while those making up to 250% of the federal poverty level pay a discounted rate on a sliding scale.  

The program, established by Congress and signed by former Republican President Richard Nixon in 1970, is intended to prioritize low-income or uninsured people, including those who make too much to qualify for Medicaid, who may not otherwise have access to family planning and reproductive health services. Abortion services cannot be covered by Title X dollars.

Pregnancy options and parental consent 

The federal statute guiding the administration of Title X funds includes a section on adolescent services that says grantees cannot require the consent of parents or guardians before or after the minor has requested or received family planning services. Another section directs grantees to allow pregnant patients the opportunity to receive information and counseling regarding prenatal care and delivery, infant care, foster care, adoption and pregnancy termination. Idaho has a near-total abortion ban with few exceptions.

Idaho’s Legislature passed Senate Bill 1329 in 2024, requiring parental consent for “the furnishing of health care services” to a child, with the exception of lifesaving care. Idaho Capital Sun reported the law has also created difficulties for the state’s suicide hotline, because some minors need permission from a parent to receive certain services.

Coleman said the adolescent and pregnancy options requirements have long been part of Title X guidance, and it has not conflicted with state law because federal law should take precedence 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 withheld funding from Planned Parenthood clinics, which were the only places offering those low-cost or free services. Planned Parenthood of Utah closed two of its centers — in Logan and St. George — in the wake of the decision to freeze funding. Logan is less than an hour away from eastern Idaho’s border.

Some states were temporarily left without Title X providers after the Trump administration’s actions in April, but the funding was restored at later dates for certain states, including Missouri and Mississippi. The federal health agency also restored funds in May for two states with abortion bans, Tennessee and Oklahoma, whose grants were revoked under Democratic President Joe Biden’s administration because of their refusal to include abortion among the options during pregnancy counseling. 

In a letter from HHS to Tennessee state officials providing notice of the award, the acting chief grants management officer wrote, “Tennessee is one of only two states to have lost funding for failure to comply with the Title X 2021 regulations requiring counseling and referral for abortion. The department is declining to enforce this provision against the state, and you may rely on this letter to that effect.” 

A total of 7,528 Title X clients were served across Idaho in 2024, McWhorter said. The 15 remaining family planning clinics are supported by other funds, and additional service sites may be added as funding becomes available. Those clinics are in two out of the state’s seven public health districts, which served about 1,400 people combined in 2024. 

The closures add another challenge in an already difficult landscape for 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 care is becoming harder to obtain, according to residents, who say wait times are longer and certain treatment is unavailable locally. 

Coleman said under Biden’s administration, when an entity lost Title X dollars for noncompliance or other reasons, there was an effort to reallocate the funding to another willing participant. Without that action, it would revert back to the U.S. Treasury, and the next opportunity for another Idaho entity to apply for Title X funding will be late 2026. 

Preventing unplanned pregnancies 

Amy Klingler, a clinician in rural eastern Idaho, told States Newsroom she was devastated by the closure of Eastern Idaho Public Health’s family planning clinic. She worked there in addition to another clinical job since 2006 and said there aren’t many other options for family planning care in that area of the state.

“Idahoans 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 is really going to impact the health of people in our communities.”

The additional cuts to Planned Parenthood through Medicaid, along with overall Medicaid cuts that may force the closure of more rural hospitals and clinics, will force people to delay care until they are sicker and require more expensive medical care, Klingler said.

The minor consent for treatment bill had good intentions, she said, and in an ideal world, every child would feel comfortable talking to their family members about birth control. But she said she is confident there are young women who don’t get birth control because they don’t want to have that conversation with their parents. 

And with Idaho’s abortion ban, unplanned pregnancies either have to be carried to term or the person must go to another state where abortion is legal. It’s also a felony in Idaho for someone to take a minor to another state for an abortion without parental permission.

“Providing free birth control is really powerful if you’re trying to prevent unplanned pregnancies,” Klingler said.

On her last day at the family planning clinic in June, Klingler said the staffers cried together.

“We often ended the day by saying, ‘We did some really good work today,’” she said. “And to not be able to do that good work kind of hurts the heart.”

A demonstrator stands outside the Wisconsin State Capitol in Madison, Wisc., in 2022 to commemorate missing and murdered Indigenous women and girls. Researchers have launched a new survey to determine the prevalence of brain injuries in Native survivors of sexual assault and domestic violence. (Photo by Stacy Revere/Getty Images)

Abigail Echo-Hawk, director of the Urban Indian Health Institute, recalled a Native mother in her 30s who started having memory loss and other dementia-like symptoms.

The woman had suffered multiple blows to her head and falls at the hands of her husband over the years. He had wanted to disable her, to make it more difficult for her to keep her children if she tried to leave him, Echo-Hawk said.

Many Native women have traumatic brain injury symptoms as a direct result of abuse, Echo-Hawk said. Tribal health advocates and groups serving survivors have long been aware of the problem, she said, but there has been little national research documenting the extent of it.

“It’s a very difficult thing to see,” said Echo-Hawk, of the Pawnee Nation of Oklahoma. “This is a pressing concern.”

The Urban Indian Health Institute, an Indigenous health research group, this month launched a first-of-its-kind national survey of American Indian, Alaska Native and Native Hawaiian women to determine the prevalence of brain injuries in Native survivors of sexual assault and domestic violence. The goal is to illuminate the extent of the problem, guide clinicians, raise public awareness and direct resources.

A 2015 study in Arizona found a higher incidence of traumatic brain injuries in Native women in that state, but the new survey is the first national, Indigenous-led study of its kind, according to the institute.

It comes as domestic violence groups across the nation are struggling with federal funding delays caused by the government shutdown. As the impasse continues, the Trump administration has furloughed grant workers at the Office on Violence Against Women, which is part of the U.S. Department of Justice.

Traumatic brain injuries can cause memory loss, confusion and long-term behavioral changes and raise the risk of dementia. Some abusers intentionally inflict traumatic brain injuries on their victims because it doesn’t leave visible bruises, according to the Brain Injury Association of America.

The link between domestic violence and traumatic brain injuries has been documented in women generally, and the effects of such injuries have been studied in former football players and veterans. But research on Native communities is lacking. Even when victims show up in ERs, their cases can go underreported.

In a previous survey of survivors, some Native women reported broken teeth, evidence of blows to the head, Echo-Hawk said. But pushing and strangulation also can cause traumatic brain injuries.

Violence is a public health crisis among American Indian, Alaska Native and Native Hawaiian women, who are overrepresented in intimate partner violence statistics. Fifty-five percent report experiencing intimate partner violence, and a disproportionate number of Native women and girls are murdered or go missing.

In a 2020 survey by the federal Centers for Disease Control and Prevention, nearly 44% of American Indian and Alaska Native women reported being raped in their lifetime.

“People are losing their children because of memory loss and dementia,” Echo-Hawk said. “When people are experiencing intimate partner violence, they end up in ERs. Their children suffer. The whole community suffers as a direct result. And the same with the crisis of missing and murdered Indigenous women and girls.”

Doctors and other hospital staff should receive more training on brain injuries and should know which communities are most likely to experience violence, said Nikki Cristobal, policy and research specialist for Pouhana ʻO Nā Wāhine, a nonprofit domestic violence resource center for Native Hawaiians.

Cristobal said one survivor told her clinicians hadn’t performed a brain scan or traumatic brain injury assessment on her, despite her ongoing psychological and cognitive symptoms. “It never occurred to anybody,” she said.

“We have to talk more about it,” said Cristobal, who worked with Echo-Hawk on developing the survey and is the principal investigator for the Missing and Murdered Native Hawaiian Women, Girls and Mahu state task force.

Native communities, including Native Hawaiians, have endured long-term, intergenerational traumas during colonization and forced assimilation that can’t be ignored when targeting the disproportionate rates of violence, Cristobal said.

“It’s the undercurrent,” Cristobal said. “It’s the precursor.”

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

An emergency room nurse tends to a patient at Houston Methodist The Woodlands Hospital in Texas. States, counties and nonprofits are striving to continue their work to close racial health disparity gaps but are struggling amid a loss of federal dollars. (Photo by Brandon Bell/Getty Images)

Racial health disparities may widen as states, universities and nonprofits grapple with federal funding cuts to programs that were aimed at filling gaps in care, public health experts say.

As part of its federal restructuring and crackdown on diversity, equity and inclusion (DEI) programs, the Trump administration has been shuttering federal offices and rescinding grants dedicated to addressing worse health care access and outcomes for racial minorities.

The shake-up has caused some state agencies and nonprofits to pause programs and some groups and universities to apply for foundation grants instead.

Hundreds of grants have been terminated for state, local and territorial health departments as well as nonprofits and universities, many of which addressed health equity across rural, low-income and communities of color.

The nation’s racial health disparities were laid bare during the COVID-19 pandemic, when the virus killed Black, Hispanic and Indigenous people at higher rates than white people. The police murder of George Floyd in May 2020 also fueled a racial reckoning across the nation, prompting efforts by states, universities, health systems and the federal government to address racial health disparities.

Those approaches ranged from targeted vaccine campaigns and efforts to enroll more people of color in clinical trials to corrections of diagnostic tests that relied on inaccurate information about race and biology.

Communities of color have long had less access to health care, increased exposure to environmental pollutants and higher rates of certain chronic illnesses and cancer deaths. They also have more diabetes-related amputations because of a lack of access to care. And specific genetic diseases, such as sickle cell disease, disproportionately affect Black people.

“COVID revealed the impact of health disparities to individual health — as well as how not addressing these disparities undermines the health system for everyone,” said Dr. Georges Benjamin, executive director of the American Public Health Association.

Now, many of the programs trying to address health disparities are being rolled back.

As a result, health policy experts, clinicians and researchers fear those disparities will widen as states, universities and nonprofits grapple with lost federal dollars while the administration continues to limit federal funding for DEI programs. In July, the U.S. Department of Justice released guidance saying such initiatives should not receive federal funding, alleging they are “discriminatory.”

Entities that receive federal funds “must ensure that their programs and activities comply with federal law and do not discriminate on the basis of race, color, national origin, sex, religion, or other protected characteristics—no matter the program’s labels, objectives, or intentions,” the news release said.

Several state and local health officials were reluctant to speak with Stateline on the record about how the federal administration’s DEI crackdown has left them in a bind, fearing retaliation or targeting by the federal government. The White House did not respond to Stateline’s request for comment.

“My concern about what the administration is doing is that they are, in effect, making these disparities worse,” Benjamin said. “Everybody’s health is not the same. … It’s important to know that the disparities are really profound.”

Benjamin added that the cumulative effect of disparities means more late-stage disease — costing both patients and health systems more.

“There’s a trope or misunderstanding out there that DEI is a ‘woke’-related agenda. DEI is not a ‘woke’ agenda. DEI is an American agenda, because it’s really one that is the same thing as ‘rising tides lift all boats,’” said Brandon Wilson, senior director of Health Innovation and Public Health at Community Catalyst, a health equity advocacy organization. “When you cut [resources] off, you’re actually disproportionately impacting those who are already impacted.”

‘Increasing need’

The administration canceled billions of dollars in grants from the National Institutes of Health (NIH), the Centers for Disease Control and Prevention, the Environmental Protection Agency and the Department of Health and Human Services.

Many of the grants helped recipients create solutions tailored to their communities’ needs and strengths.

At least three dozen state, local and territorial health departments have had pandemic-era grants that addressed health equity terminated. While originally focused on COVID-19, agencies have since used that grant money for other public health efforts: testing and contact tracing for a wide range of diseases, better data reporting, and community partnerships that address social and environmental effects on health.

The money was part of a $2.2 billion national health equity initiative that aimed to address vulnerabilities and protect those communities ahead of the next outbreak.

The Department of Health and Human Services told media such cancellations were due to the pandemic emergency ending in 2023.

At NIH, the administration terminated more than 5,400 NIH research grants, although about 2,800 were reinstated. Canceled grants included research toward illnesses like HIV and AIDS, which disproportionately affect Black and Hispanic people as well as gay and transgender people.

The Trump administration has also gutted federal offices dedicated to fighting disparities, including the Offices of Minority Health under the Centers for Medicare & Medicaid Services and the Department of Health and Human Services.

At the state level, the Arkansas Department of Health recently shut down its own minority health-focused office. Ashley Whitlow, a spokesperson for the department, said in a statement that it “relies on federal grant funding to support a variety of public health programs.”

“The recent reduction in program staff reflects the Arkansas Department of Health’s ongoing efforts to operate more efficiently with the resources available. Despite these changes, ADH remains fully committed to serving communities across the state,” the statement said.

Meanwhile, Maryland’s Department of Health said its minority health office is funded through state general funds and not directly impacted by the federal cuts.

The nation has seen a spike in congenital syphilis cases, which disproportionately occur among Black and Indigenous families.

“Regardless of whether you’re at the highest risk, any outbreak that’s not controlled can spread widely and broadly, and you can see that that’s what’s happening with measles,” said Dr. Julie Morita, former executive vice president of the Robert Wood Johnson Foundation and former health commissioner Chicago Department of Public Health.

But states likely can’t replace all the lost federal dollars.

“You’ve got declining capacity, and increasing need — which is a formula for problems,” said Richard Frank, director of the Brookings Institution Center on Health Policy.

“It’s impossible to make all that up with state and local dollars,” he continued. “You’re going to see programs that serve real people getting pulled back.”

Frank and Wilson also expressed concern about the Medicaid changes included in the broad tax and spending law President Donald Trump signed in July. The law is projected to cut federal Medicaid spending by an estimated $911 billion over the next decade, largely because new work requirements will push people off the rolls. Data shows the majority of Medicaid enrollees already work, and experts say many will be kicked off the rolls due to difficulties in states’ reporting processes. Black and Hispanic people are disproportionately represented on the Medicaid rolls.

OB-GYN Dr. Versha Pleasant, a clinical assistant professor at the University of Michigan, directs the Cancer Genetics and Breast Health Clinic at Von Voigtlander Women’s Hospital. She treats patients at high risk for breast and ovarian cancers. Black women have an almost 40% higher risk of death from breast cancer than white women.

“That, to me, is unacceptable,” she said, adding that such disparities speak to the need for ongoing programs to “provide everyone with a fair chance at leading a long and healthy life.”

“If we don’t make a special effort to save the most vulnerable lives … where does that leave us?” she continued. “The changes that we’re seeing are only going to magnify preexisting challenges.”

Data and dollars

Dr. Sarah Rudman, acting public health officer at the Santa Clara County Public Health Department in California, and others have told Stateline that federal officials are informing health agencies that race and ethnicity data are no longer required to be reported.

“We are being asked to change the way we collect our own data here and report it,” Rudman said, adding that her county is going to continue collecting data to “understand who is here, who’s experiencing what health outcome and what they need.”

Many families, in the shadow of the county’s Silicon Valley, still struggle with poverty — more than 27,000 children suffer food insecurity, United Way Bay Area says.

“It is sometimes surprising and striking to people to understand how much poverty and other types of vulnerability are hidden among the more visible wealth of Silicon Valley, and that’s where we’ve dedicated our resources,” Rudman said.

“It’s hard to even imagine what my colleagues in smaller areas of California or in other parts of the country are experiencing,” she added about lower-income counties. “We are feeling extremely strained and already in our second round of layoffs, knowing that many more are likely. So I think that the hits are going to be that much more significant in areas who have less resources than we do.”

Federal officials also canceled the county’s $5.7 million grant to address COVID-19-related disparities, used to shore up vulnerable communities ahead of the next disease outbreak, natural disaster or heat wave, Rudman said. The money helped the county conduct basic laboratory testing and vaccine outreach for a wide range of diseases, not just COVID-19.

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

Health and Human Services Secretary Robert F. Kennedy Jr., joined by President Donald Trump, delivers an announcement on “significant medical and scientific findings for America’s children” in the Roosevelt Room of the White House on Sept. 22, 2025 in Washington, D.C. Federal health officials suggested a link between the use of acetaminophen during pregnancy as a risk for autism, although many health agencies have noted inconclusive results in the research. (Photo by Andrew Harnik/Getty Images)

WASHINGTON — A majority of Americans disapprove of Health and Human Services Secretary Robert F. Kennedy Jr.’s job performance and the federal government’s evolving vaccine policy, according to a poll released Thursday by the nonpartisan health organization KFF.

In addition, the vast majority of those surveyed have heard the unproven claims made by President Donald Trump, Kennedy and others in late September that taking acetaminophen, also known as Tylenol, during pregnancy could be one possible environmental factor in a child later being diagnosed with autism.

A total of 77% of the people KFF polled said they knew of the statements, though whether people believe the claims, which have yet to be established by the medical community, varied.

Only 4% of those surveyed said it is “definitely true” that taking Tylenol during pregnancy increases the risk of the child developing autism, and 35% said the claim is “definitely false.” Thirty percent said it is “probably true” and 30% said it is “probably false.”

Combined, 65% said it’s either probably or definitely false to say that taking acetaminophen during pregnancy increases the chance of a child developing autism, a complex disorder that experts believe is the result of both genetic and environmental factors.

When broken down by political party, 86% of Democrats, 67% of independents and 43% of Republicans said the claims were either probably or definitely false.

The survey shows 59% somewhat or strongly disapprove of how Kennedy is handling his new role at the top of the country’s public health infrastructure.

The level of support changes considerably depending on political party affiliation, with 86% of Democrats, 64% of independents and 26% of Republicans disapproving.

A slightly higher number, 62%, either somewhat or strongly disapprove of the United States’ vaccine policy.A similar trend emerged when those polled were broken up by political parties. Eighty-eight percent of Democrats, 67% of independents and 31% of Republicans somewhat or strongly disapproved of vaccine policy.

The survey shows a declining share of Americans have faith in the Centers for Disease Control and Prevention to provide trusted information about vaccines, compared with previous KFF polls in September 2023 and earlier this year.

A total of 63% of respondents two years ago trusted the CDC on vaccines, but that has declined to 50%.

Democrats’ faith in the CDC’s vaccine recommendations has dropped from 88% two years ago to 64%, independents have gone from 61% to 47% and Republicans have remained relatively steady, only going from 40% to 39%.

Across political parties, a person’s own doctor as well as the American Academy of Pediatrics and the American Medical Association remain broadly trusted for vaccine information.Eighty-three percent said they trust their doctor or health care provider, 69% believed information from the American Academy of Pediatrics and 64% had faith in the AMA.

The poll of 1,334 adults took place from Sept. 23 to Sept. 29 and had a margin of error of plus or minus 3 percentage points for the full survey. Questions broken down by a person’s political ideology had a margin of error of plus or minus 6 percentage points.

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