Supreme Court Allows Biden to Cut Oklahoma's Health Funds Over Abortion Stance

The Supreme Court has recently made a significant decision regarding health care funding in Oklahoma, allowing the Biden administration to withhold millions of dollars from the state's family planning program. This ruling stems from Oklahoma's refusal to provide abortion referrals, which conflicts with its stringent abortion ban implemented after the Supreme Court overturned nationwide abortion rights in June 2022.

Oklahoma, which became the 46th state to join the Union in 1907, is one of more than a dozen states that broadly prohibited abortion following the 2022 Supreme Court decision. The state's strict stance includes criminalizing attempts to persuade women to terminate pregnancies or procure abortions for them.

The conflict centers around Title X, a federal grant program established in 1970 that provides approximately $286 million annually for family planning services. This program, which serves about 4 million people each year, primarily benefits low-income individuals. It's important to note that Title X funds cannot be used to pay for abortions, as per the Hyde Amendment of 1976.

In July 2024, the U.S. Court of Appeals for the 10th Circuit upheld the federal government's right to deny funding to Oklahoma. The court noted that the Department of Health and Human Services (HHS), established in 1953, had offered a compromise: the state could meet its obligation by providing patients with a phone number for a national hotline offering neutral information about pregnancy options, including abortion.

Oklahoma's Attorney General Gentner Drummond argued that state health-care organizations should not be penalized for failing to advise patients about ending pregnancies. The state contends that HHS is imposing conditions on funding not specified in the Title X program.

The Supreme Court's decision not to intervene immediately came without explanation, as is typical for emergency orders. However, conservative Justices Clarence Thomas, Samuel A. Alito, Jr., and Neil M. Gorsuch indicated they would have granted Oklahoma's request.

This case highlights the ongoing debate over the interpretation of Title X rules, which have varied depending on the administration in power. In 2019, the Trump administration rewrote the rules, barring clinics receiving federal family planning aid from referring patients for abortions. The Biden administration reversed this policy in 2021 and began withholding funds from organizations refusing to make referrals.

Solicitor General Elizabeth B. Prelogar, representing the federal government in this Supreme Court case, argued against emergency action, noting that Oklahoma's legislature had already provided substitute funding for last year's shortfall.

The case also intersects with the recent elimination of the Chevron doctrine in June 2024, which previously required judges to defer to federal agencies' reasonable interpretations of ambiguous statutes. Oklahoma argues that the Biden administration's position is incompatible with this new legal landscape.

This ruling may have broader implications for other states with similar abortion restrictions. For instance, on August 26, 2024, the 6th Circuit rejected a similar challenge from Tennessee after the federal government withheld $7 million in Title X funds from that state.

As the legal battles continue in lower courts, this issue could potentially return to the Supreme Court, which typically issues about 60-70 signed opinions each term. The ongoing debate underscores the complex interplay between state laws, federal funding, and the evolving landscape of reproductive rights in the United States.

"State health-care organizations cannot be punished for failing to advise patients about ending their pregnancies."