With the clock ticking toward a March 31 funding cliff, a bloc of U.S. senators is turning up the heat on the Biden administration over stalled family planning money.
On March 11, 2026, a group of senators led by Mazie Hirono, Patty Murray and Angus King sent a letter to Health and Human Services Secretary Robert F. Kennedy Jr. urging the department to immediately release Title X family planning funds and grant a one‑year continuation to current grantees. The lawmakers warned that existing awards are set to lapse on March 31, 2026, and said that if HHS does not act by April 1, millions of people could lose access to contraception, cancer screenings and other preventive care. Clinics and advocates say the delay has already created serious uncertainty for sites that primarily serve low‑income and uninsured patients.
According to a press release from Sen. Mazie K. Hirono's office (Hirono's office), the letter, which was signed by 36 senators, asks HHS to issue a one‑year, full‑funding extension for all current Title X grantees and notes that the department has not released its usual continuation guidance this year. The release says HHS typically posts non‑compete continuation grant guidance in late December, giving grantees roughly 90 days to prepare applications and budgets. Senators argue that breaking that pattern could trigger layoffs and closures at thousands of clinics nationwide if HHS does not move quickly.
Title X's reach
Title X is the only federal grant program devoted solely to family planning and preventive care, and it operates at a significant scale. The HHS Office of Population Affairs reports that Title X grantees served nearly 2.8 million unique clients in 2023 across about 3,853 service sites. Those sites provide contraception, cervical‑cancer screenings, pregnancy testing and counseling, and sexually transmitted infection testing and treatment. For many low‑income and uninsured patients, those clinics function as their primary source of health care. Full program details are available in the agency's 2023 Family Planning Annual Report (HHS Office of Population Affairs).
Last year's freeze and legal fight
HHS's decision to pause some Title X grants in 2025 set off alarms among providers and state attorneys general. KFF reported that on March 31, 2025, the department notified 16 grantees that year‑four funding would be temporarily withheld, affecting roughly 879 clinics and putting as many as about 834,000 people at risk of losing access to care. Providers pushed back in court, and the National Family Planning & Reproductive Health Association and allied groups challenged the withholdings. Advocates say the pause forced some sites to reduce services or shut down temporarily. The litigation and eventual restoration of funding are documented by civil liberties lawyers and news outlets that reported the withheld funds were later restored (KFF, ACLU of DC, AP).
What the senators wrote
“In short, these services not only make our communities healthier, but also improve educational and economic attainment for women and their families,” the lawmakers wrote, arguing that a lapse in funding would risk layoffs of essential health‑care staff and closures at thousands of Title X clinics. The letter, led by Hirono, Murray and King, urges HHS to protect uninterrupted access by immediately issuing a one‑year full‑funding extension for all current grantees (Hirono's office).
What's at stake now
With less than three weeks left before the March 31 funding expiration, senators and health‑care groups say clinics need clarity to plan staffing, supply contracts and patient appointments. Advocates point to Title X's role in preventing unintended pregnancies, catching cervical cancer early and diagnosing sexually transmitted infections, services that can be costly and slow to rebuild if they are interrupted. Local reporting on the March 11 letter and the looming deadline has emphasized the particular strain on clinics that serve rural and low‑income communities (Maui Now).
Legal observers note that last year's challenges showed how quickly withholding congressionally appropriated grants can trigger lawsuits and political backlash, and that the voluntary dismissal of the National Family Planning & Reproductive Health Association's suit came only after HHS restored the withheld money (ACLU of DC). If HHS were to hold back additional awards this year, providers warn that new litigation and urgent state‑level actions could follow.
For now, lawmakers have put HHS on notice: release the continuation awards or issue a one‑year extension, or risk what senators describe as a potentially catastrophic interruption in access to birth control and preventive care. Clinics and patients are watching to see whether the department acts before the end of March.
