Washington • Planned Parenthood has joined forces with eight other local government, health care and advocacy organizations to take the Trump administration to court over the defunding of a national teen pregnancy program.
On Thursday, the groups filed four separate lawsuits in U.S. District Court in the Eastern District of Washington, in Maryland and the District of Columbia, arguing that approximately $220 million in grants was wrongfully terminated. The Obama-era Teen Pregnancy Prevention Program (TPP) was created by Congress to conduct rigorous scientific research into what approaches work to lower teen pregnancy rates and try to provide the best ones to at-risk youths.
It was designed as a five-year program, but grantees reported last summer they had received letters informing them the program would be terminated the following year, at the end of June 2018 — two years ahead of schedule. While the Department of Health and Human Services has not provided details on the decision-making behind the move, it has been seen as part of a broader effort by social conservatives to restrict women's reproductive rights by imposing more barriers to abortion and making access to contraceptives more difficult.
Attorneys from Planned Parenthood, Democracy Forward and Public Citizen accused officials of attempting to illegally dismantle the program based on ideological beliefs rather than science.
Carrie Flaxman, deputy director for public policy litigation for Planned Parenthood Federation of America, said in an interview that the programs have been widely praised as "models for kind of the best practices for teen pregnancy prevention across the country" and should be expanded, not cut back.
"HHS has no authority to terminate the contracts" or the overall program, she said, calling the decision "arbitrary and capricious."
The department said it could not comment on pending litigation.
The lawsuit filed by Planned Parenthood argues that the decision goes against HHS's own regulations regarding the termination of grants, that it goes against Congress's mandate that HHS fund "medically accurate and age appropriate programs that reduce teen pregnancy," and that it "excessively entangles" the government with religion.
"HHS is not at liberty to ignore the clear statutory mandate in favor of programs that are more in line with its ideological objectives. Nor may it make religiously-motivated and coercive spending decisions," the lawsuits state.
The highly unusual decision, made by HHS officials outside the normal budget process, sparked outrage from researchers who said much of the data that had been painstakingly collected for years would become useless if the studies were ended early. State health commissioners expressed concern about the effects on their local communities. The grants, 81 in all, help support sex-education classes and abstinence programs, and they provide social and emotional counseling for pregnant teens and training for teachers as well as funding for research projects.
Official statements from HHS to the media about the program have been vague — mentioning "weak evidence of positive impacts," that the program was "a poor use of ... taxpayer dollars" and the department wanted to make sure the program provides teens the information and skills they need to "avoid the many risks associated with teen sex." However, a number of administration officials have raised politically conservative objections. Valerie Huber, a prominent abstinence advocate who is acting deputy assistant secretary for the Office of Population Affairs, has argued that the program's approach "normalizes teen sex."
In the lawsuits, the grantees charge that HHS is disseminating a "misleading and skewed interpretation" of the program and that the "newfound criticism" is "inconsistent with the agency's own data," noting that evaluations had found that about a third of the experimental interventions led to positive changes in the youth's behavior related to their reproductive health.
The teen pregnancy lawsuits filed on behalf of nine grant recipients represent the latest effort by those who oppose the Trump administration's decisions to seek relief from another branch of the government — the judicial system. Judges have blocked parts of the implementation of versions of the controversial ban restricting the entry of travelers from certain countries. They also have blocked efforts to let employers deny insurance coverage for contraceptives based on religious or moral objections. And in January, a federal judge in Northern California ordered an injunction stopping plans to cut back protections for undocumented "dreamers" who came to the United States as children.
The U.S. teen pregnancy rate has long been a subject of concern for public health officials. While rates have fallen over the past few decades to an all-time low, they still remain stubbornly higher than those of other wealthy countries. An estimated 1.2 million young people were expected to receive health services under the targeted program by its final year in 2020.
Among the organizations that stand to lose money is the Healthy Teen Network, a Baltimore-based agency that provides training and resources about adolescent reproductive health. Patricia Paluzzi, president and chief executive of the organization, said $1 million in grants have been terminated — representing about a third of the group's budget.
One of its biggest projects involves an app that provides reproductive health information to Latina and black Generation Z women. Genevieve Martinez-García, who oversees the project, said the app is part of a research project initially calling for 1,500 participants to be followed for six months. Leaders have had to change those parameters to work with 1,300 volunteers and follow them for six weeks.
"It is a big difference and threatens our ability to long-term efficacy" of the intervention, Martinez-García said.
Meanwhile, Paluzzi said the organization is moving into smaller offices, has frozen open positions and is looking at "major staffing changes" to conserve as much money as possible to keep its programs afloat. Ending the grants, she worries, seems to signal that the Trump administration is turning away from a "focus on evidence and developing things that actually work." For many of those working with teens, the nightmare scenario involves the rise of pregnancy rates and spread of sexually transmitted diseases as a result of projects being cut short.
"It really impacts more than those of us who work in the field," Paluzzi said. "It really impacts the whole country."
In addition to three Planned Parenthood affiliates and the Healthy Teen Network, the plaintiffs include Public Health — Seattle & King County, South Carolina Campaign to Prevent Teen Pregnancy, Sexual Health Initiatives for Teens North Carolina, Project Vida Health Center in Texas and Policy & Research Group in New Orleans, Louisiana.