Expanding Access to Family Planning

Summary#

The Expanding Access to Family Planning Act is a proposed new law. It would create a Title X Clinic Fund, administered through the Office of the Secretary of the Department of Health and Human Services (HHS), and appropriate money for Title X grants, contracts and clinic infrastructure; its stated goal is expanded and sustained investment in these clinics. The bill was introduced in the House and referred to the House Committee on Energy and Commerce; it is not law, and passage is uncertain.

  • For each fiscal year from 2026 through 2035, HHS would receive $512 million for Title X grants and contracts and $50 million for clinic infrastructure, including construction, renovation and equipment.
  • A recipient of this new funding that makes subawards for Title X services could not exclude an entity from the subaward program for reasons other than that the entity cannot provide those services.
  • Clinics receiving this funding would have to provide nondirective pregnancy counseling. Patients with a positive pregnancy test must be offered the opportunity to get information and counseling about prenatal care and delivery; infant care, foster care and adoption; and pregnancy termination.
  • If a patient requests information or counseling, the clinic must provide neutral, factual information and nondirective counseling on each option the patient is interested in, including a referral if requested.

What it means for you#

  • Title X clinics: Clinics receiving this funding would have to meet the subaward and pregnancy-counseling conditions. The bill does not set out how grants would be awarded or how clinics would apply.
  • Patients at funded clinics: You would have to be offered the opportunity to discuss each listed pregnancy option. You could decline information about any option; if you request it, the clinic must provide information and counseling, and a referral if you request one. The bill does not require a clinic to provide every listed service.
  • Entities seeking subawards: A recipient of this funding could not bar you from its subaward program for a reason other than inability to provide Title X services.
  • Taxpayers: The bill would appropriate federal money over ten fiscal years. It does not directly change taxes, patient eligibility or the legal status of pregnancy termination.

Money#

The bill would appropriate $5.62 billion total for fiscal years 2026 through 2035; no separate estimate of other costs is provided.

  • The annual amounts are $512 million for Title X grants and contracts and $50 million for clinic infrastructure.
  • The money would remain available until spent, so it would not have to be spent in the year appropriated.
  • No estimate is given for administering the fund or meeting its conditions.

What is unclear#

  • The bill does not explain how grants, contracts or infrastructure projects would be selected, or how the money would be divided among them.
  • It does not set out application rules, timelines, oversight, reporting or appeals.
  • It does not define when an entity is unable to provide Title X services.
  • The supplied material does not include the current Title X law, so the bill’s interaction with existing requirements could not be verified.
  • It is unclear how clinics would be monitored for compliance with the subaward and counseling conditions.

Case for#

  • The bill appears intended to provide sustained funding for family planning clinics, including money for buildings, renovations and equipment.
  • A possible argument for the funding conditions is that they set basic access and counseling rules for clinics receiving the new money.
  • Requiring neutral, nondirective information about multiple options could help patients make informed choices without directing them toward one option.

Case against#

  • The bill does not explain how the large appropriation would be allocated, what standards would guide decisions or how results would be assessed.
  • The subaward rule limits the reasons funding recipients may exclude an entity, but the bill does not define the key exception—an entity’s inability to provide the services.
  • The new counseling and subaward conditions may require changes in clinic operations, but the bill gives no estimate of the cost or staffing needed.