Title X Clinics Get $562 Million Annually Through 2035 for Services and Building Upgrades

The new Expanding Access to Family Planning Act is setting up a serious, long-term funding plan for clinics that provide family planning services under the federal Title X program. Think of this as the government finally giving its community health infrastructure a solid, decade-long budget.

Starting in fiscal year 2026 and running through 2035, the bill establishes a new pot of money called the Title X Clinic Fund. This fund will dedicate $512 million annually specifically for grants and contracts related to family planning services. On top of that, it sets aside an extra $50 million every year just for improving the physical buildings—meaning new clinics can be built or existing ones can get much-needed renovations. Crucially, the bill specifies that this money doesn't disappear at the end of the fiscal year; it stays available until it’s spent. For clinics that have historically operated on shaky, year-to-year federal budgets, this non-expiring, ten-year commitment is a huge deal for stability.

The Long-Term Budget: What $562M Means on the Ground

This dedicated funding stream is designed to stabilize access to services like birth control, preventative health screenings, and STI testing, especially in areas where healthcare options are limited. For someone working two jobs and relying on a Title X clinic for their annual check-up, this means the clinic is less likely to face sudden cuts or closures. The $50 million for infrastructure is also key. Imagine a rural clinic currently operating out of a cramped, outdated building; this money allows them to upgrade their facilities, potentially adding more exam rooms or better equipment, which translates directly into shorter wait times and better care for the patients they serve.

Rules of Engagement: Subawards and Counseling Mandates

Beyond the money, the bill includes two major regulatory changes. First, it prevents primary recipients of the Title X funding from arbitrarily blocking subawards to qualified partners. This means if a large clinic receives federal money and wants to contract with a smaller, specialized local provider—say, a mobile health unit—to reach underserved populations, they can’t just turn them away unless that local provider literally cannot deliver the required Title X services. This provision aims to ensure the money flows efficiently to the front lines of care.

The second major change involves strict rules for pregnancy counseling. If a patient tests positive for pregnancy at a funded clinic, the clinic must offer information and counseling about three paths: carrying the baby to term (including prenatal care and parenting), adoption/foster care, and terminating the pregnancy. If the patient asks for details on any of those options, the clinic must provide neutral, factual information and counseling, including referrals if requested. The counseling must be “nondirective”—meaning the staff can’t push the patient toward one choice. If the patient says they aren't interested in learning about a specific option, the clinic doesn't have to provide information on that one. This puts the decision firmly in the patient’s hands regarding what information they receive, while ensuring a baseline level of comprehensive information is available.