This week, Oklahoma asked the Supreme Court to review a federal appeals court ruling that upheld the Biden-Harris administration’s suspension of federal family planning funds in response to the state’s near-total ban on abortions, a position the federal government has taken in similar cases involving Tennessee.

Oklahoma contends that last year alone, it lost $4.5 million in Title X funding, which supports family planning services such as contraception and pregnancy testing, after the Department of Health and Human Services under President Joe Biden suspended a grant the state has received for “more than 40 years,” according to Oklahoma Attorney General Gentner Drummond, a Republican.

“Oklahomans have depended upon these services for decades,” Drummond said, emphasizing that the suspension of the funds jeopardizes access to essential healthcare services such as cancer screenings and pregnancy prevention. The funding was withheld after the state refused to comply with one of the grant’s amended requirements to provide counseling to pregnant women on all options, including abortion.

Drummond initially challenged the loss of these funds through a lawsuit, followed by a motion for an injunction against HHS. He argued that a requirement under Title X to provide counseling on all pregnancy options violated federal law, especially in light of the state’s ban on most abortions following the reversal of Roe v. Wade two years ago.

Supreme Court rejected initial petition last month

In September, the Supreme Court refused to reinstate federal funding for Oklahoma’s family planning services under Title X, though Republican-appointed Justices Clarence Thomas, Samuel Alito, and Neil Gorsuch said they would have granted Oklahoma’s petition to hear oral arguments on the merits of the case.

Oklahoma contends that the abortion referral requirements go against the state’s policies following the 2022 Dobbs v. Jackson Women’s Health Organization decision, which gave states the power to set restrictions on abortions. The state is also citing the Weldon Amendment, which prohibits federal funds from going to agencies that discriminate against healthcare entities refusing to make abortion referrals.

The Sooner State has missed out on a total of $10 million in Title X funding due the dispute with HHS.

Only a few Title X sites remain operational in the state, with the Biden administration choosing to divert funds to the neighboring Missouri Family Health Council, which partners with Planned Parenthood clinics in Oklahoma.

Drummond’s petition asserts that the appeals court’s decision conflicts with rulings from other circuits, urging the Supreme Court to resolve the dispute.

Tennessee fighting back in similar HHS dispute

Other states with restrictions on abortion are fighting back against the Biden-Harris administration’s withholding of family planning funds, including Tennessee, which is facing a similar $7 million setback to its funding thanks to the federal government’s policy.

The Alliance Defending Freedom, which worked alongside Mississippi to defend its gestational law in 2022 that resulted in the overturning of Roe, filed an amicus brief on Wednesday in a lawsuit pending at the U.S. Court of Appeals for the 6th Circuit surrounding Tennessee’s effort to receive Title X funding for family planning services.

“The Biden-Harris administration’s Title X rule forces doctors to refer for abortions to receive federal funding and ignores the reality that referring for an abortion is antithetical to the healing profession,” ADF senior counsel Chris Schandevel said after filing the brief.

A three-judge panel on the 6th Circuit ruled in August, “There is no indication that the non-directive options for counseling and the neutral information required by the rule are not ‘allowable under state law,’” noting the abortion ban does not address counseling.

ADF is requesting that the full 6th Circuit review this decision in addition to Oklahoma’s separate push for Supreme Court intervention.