Oklahoma this month filed a lawsuit against the U.S. Department of Health and Human Services (HHS) claiming the Biden administration suspended “millions of dollars” in federal funding over the state’s refusal to provide referrals for abortion in family planning services. 

The state said in the lawsuit that HHS “overreached by unlawfully suspending and terminating millions of dollars of Title X grant funding” to the state. 

That funding “has been terminated solely because Oklahoma will not commit to providing referrals for abortion,” the lawsuit claims. 

Title X is a Nixon-era federal family planning program. It was enacted in 1970 and distributes federal grants to community clinics and health departments in order to provide contraception services and other family planning and health services. Federal law forbids Title X funding from being used to directly procure abortions. 

Oklahoma’s lawsuit says the state has “administered the Title X family planning program in Oklahoma for more than 40 years,” using the grants to “disperse funds through 68 county health departments, who provide critical public health services to rural and urban Oklahoma communities.”

In May of this year, the lawsuit says, HHS pulled Title X funding from the state after having accused it of being “in violation of Title X and out of compliance with the terms and conditions” of the grant, specifically because the state health department “no longer offered pregnant clients the opportunity to be provided information and counseling about abortion/pregnancy termination.”

The state had in 2022 been warned of the requirement to include abortion referrals in its Title X coverage. Oklahoma attempted to “find an agreeable solution with the Health Department that would allow the Health Department to continue receiving Title X funds while complying with Oklahoma law prohibiting abortions,” the lawsuit said. 

The state was “unable to find a solution allowing compliance with the regulation and Oklahoma law,” the suit said. The White House ultimately redistributed the Title X funds, including to an out-of-state provider. 

The lawsuit is similar to one filed last month by Tennessee Attorney General Jonathan Skrmetti, who sued the White House in response to its decision to redirect millions of dollars of Title X funding toward Planned Parenthood in the state.

In both cases, the states have been caught in between back-and-forth policy decisions from the Trump and Biden administrations, with both presidents having issued orders to modify Title X policy relating to abortion. 

In 2019, the Trump administration issued a rule “prohibiting referral for abortion as a method of family planning,” directing that Title X recipients were “not required to choose between participating in the program and violating their own consciences by providing abortion counseling and referral.”

In 2021 the Biden administration reversed that rule. Oklahoma’s lawsuit says the White House now requires that Title X recipients offer pregnant women “the opportunity to be provided information and counseling regarding ... [p]regnancy termination.”

“The federal government’s sole justification for disrupting decades of health services and determining that an out-of-state entity in Missouri was in the best position to provide necessary health services to citizens in the state of Oklahoma is that the Health Department refuses to approve of referrals for abortions,” the suit states.

In a press release on Monday, State Attorney General Gentner Drummond said the Biden administration “is intent on punishing Oklahoma because we do not share its liberal philosophy.” 

“It is patently discriminatory to deny Oklahoma these critical funds, particularly when federal law makes it clear that Title X cannot be used for abortion,” he said. 

“I will continue to fight against federal overreach in all forms,” he added. 

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The suit was filed in U.S. District Court for the Western District Of Oklahoma.