Tennessee attorney general sues federal government over abortion rule blocking funding

Tennessee Attorney General Jonathan Skrmetti announces a lawsuit against the Meta Platforms Inc., the parent company of Facebook and Instagram, during a news conference Tuesday, Oct. 24, 2023, in Nashville, Tenn. The complaint alleges that the company knew of the harmful impact of its Instagram platform on young people. (AP Photo/George Walker IV)

NASHVILLE, Tenn. (AP) — Tennessee's top legal chief says the federal government is wrongly withholding millions of dollars in family planning funds after the state refused to comply with federal rules requiring clinics to provide abortion referrals due to its current ban on the procedure.

Attorney General Jonathan Skrmetti filed a complaint in U.S. District Court in Knoxville earlier this week seeking to overturn the U.S. Department of Health and Human Services decision.

“We are suing to stop the federal government from playing politics with the health of Tennessee women,” Skrmetti said in a statement. “Our lawsuit is necessary to ensure that Tennessee can continue its 50-year track record of successfully providing these public health services to its neediest populations.”

An HHS spokesperson said the department does not comment on pending litigation.

Earlier this year, Tennessee was disqualified from receiving millions of federal dollars offered through a family planning program known as Title X. Tennessee has been a recipient of the program since it launched in 1970, recently collecting around $7.1 million annually to help nearly 100 clinics provide birth control and basic health care services mainly to low-income women, many of them from minority communities.

However, the program has also become entangled with the increasingly heated fight over abortion access. In 2021, the Biden administration reversed a ban on abortion referrals by clinics that accept Title X funds. The restriction was initially enacted during the Donald Trump administration in 2019, but the department has swung back and forth on the issue for years.

Under the latest rule, clinics cannot use federal family planning money to pay for abortions, but they must offer information about abortion at the patient's request.

Then, last year, the U.S. Supreme Court overturned Roe v. Wade, allowing many Republican-led states like Tennessee to impose abortion bans. The lawsuit filed on Tuesday alleges that HHS never informed officials how its 2021 rule would apply in states with abortion restrictions.

In March, HHS informed Tennessee health officials that the state was out of Title X compliance because of its policy barring clinics from providing information on pregnancy termination options that weren't legal in the state — effectively prohibiting any discussions on elective abortions. The state defended its policy and refused to back down, causing the federal government to declare in a March 20 letter that continuing Tennessee's Title X money was "not in the best interest of the government.” The state later appealed the decision and that appeal is ongoing.

Meanwhile, in September, HHS announced that Tennessee's Title X funds would largely be directed to Planned Parenthood, the leading provider of abortions in the United States, which would distribute the money to its clinics located in Tennessee.

Ashley Coffield, CEO of Planned Parenthood of Tennessee and North Mississippi, on Wednesday called Title X funding “an important part” of providing Tennesseans affordable sexual and reproductive health care. She added that her organization is "thrilled once again to be a part of delivering these services to the people of Tennessee — particularly in light of the state’s ongoing assault on sexual and reproductive health.”

However, Republican Gov. Bill Lee has called the move “wrong on many levels” and accused the federal government of withholding federal money from families in order to support a “radical political organization.”

Skrmetti's office is asking a federal judge to reinstate Tennessee's Title X money and to rule that HHS can't withhold funds based on a state's abortion ban, arguing that the federal appeals process over the issues has stalled. The state also is seeking “clarity” on whether it needs to use state funds to backfill the federal portion.

Tennessee has increasingly called for rejecting federal funding rather than comply with requirements over LGBTQ+ rights, abortion access and other hot-button issues. Already this year, the Volunteer State has rebuffed federal funding for a program designed to prevent and treat HIV after initially attempting to block Planned Parenthood from participating in the program.

Now, GOP lawmakers are talking about cutting off nearly $1.8 billion in federal education dollars — much of it targeted to serve low-income students, English learners and students with disabilities. Advocates argue that Tennessee has enough revenue to cover the federal funding portion and doing so would give the state more flexibility and not be restricted by regulations on LGBTQ+ rights, race and other issues.