This decision upholds the stance of the Biden Department of Health and Human Services to withhold millions of dollars from Oklahoma. 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.

Title X, a program established in 1970, funds public and private healthcare providers for family planning services. In 2021, HHS introduced a rule requiring providers to offer nondirective counseling on prenatal care, adoption, and abortion, including details on where these services can be accessed.

Following the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization in 2022, which eliminated the right to abortion, HHS permitted Title X providers to comply with the rule by sharing a third-party hotline number for abortion referrals.

Oklahoma initially agreed but later reversed its position, resulting in the loss of approximately $4.5 million in federal funds. The Oklahoma State Department of Health distributes federal funding to public health services and county health departments throughout the state.

“HHS’s regulation foists upon Oklahoma a requirement concerning an issue that has been recognized as specifically reserved to the people to address in Dobbs,” according to Oklahoma’s petition, referring to the 2022 Supreme Court ruling leaving authority over abortion access to the states. The state also argued that depriving county health departments of Title X services “would be devastating.”

The Sooner State contended that the federal government violated the spending clause of the Constitution and an amendment protecting providers from discrimination for refusing to provide abortion referrals based on religious or moral grounds.

However, the 10th U.S. Circuit Court of Appeals dismissed these claims, and the Supreme Court has now refused to grant an emergency injunction.

A related case in Tennessee involving a $7 million grant was similarly denied by the 6th U.S. Circuit Court of Appeals.

Oklahoma asked the Supreme Court to act by Aug. 30, the date to which the federal government agreed to wait before distributing to other entities the grants that would have gone to the state.