Washington — The Supreme Court on Tuesday rejected a request by Oklahoma officials to restore funding for federal family planning grants to the state Department of Health after it refused to provide patients with a hotline phone number where they could counsel about pregnancy options, including abortion.

The justices denied the state’s emergency relief request, which had asked the Supreme Court to temporarily block the Department of Health from withholding $4.5 million in federal Title X funds from the Oklahoma State Department of Health. Justices Clarence Thomas, Samuel Alito and Neil Gorsuch said they granted Oklahoma’s request.

The dispute is the latest abortion-related case to go before the courts following the country’s Supreme Court’s decision in June 2022. Overturning the Roe v. Wade decision. As more than half of the states After abortions were banned or severely restricted following the ruling, including in Oklahoma, the Biden administration has sought to protect access at the federal level, including through an emergency care law that was signed into law on Center of a dispute before the judges in his last term of office.

The battle for Title X funding

The rule that led to Oklahoma’s Title X funding case was announced in October 2021, months before Roe’s overturn. It requires Title X projects to provide pregnant patients with “non-directive counseling” about family planning options, including abortion, and information about where to obtain services if the patient so desires.

The Oklahoma State Department of Health received a Title X grant in 2022 that was used to fund city and county health departments. After the Supreme Court rolled back the constitutional right to abortion, the department and the Biden administration discussed changing the counseling and referral guidelines for its Title X project because a new Oklahoma law banned abortions, court records show. The measure also made it a crime for a person to advise or induce a pregnant woman to have an abortion.

The two agencies agreed that the state Department of Health could comply with the 2021 rule by ensuring that interested Title X patients are offered the phone number of a national hotline that provides counseling and referral information. Based on that agreement, the Department of Health and Human Services agreed to provide the state agency with $4.5 million from April 2023 to March 2024.

But the Oklahoma Department of Health soon reversed course, saying Title X patients seeking pregnancy counseling would not receive the number, according to a Justice Department filing. As a result, the Biden administration eventually ended the service because the state violated its 2021 rule.

Oklahoma officials sued the federal government over its decision, seeking to temporarily halt the awarding and force the Department of Health to provide additional funding in the future. The state argued that by withholding the Title X funds, the Biden administration violated the Constitution’s spending clause and a federal conscience law known as the Weldon Amendment.

The Department of Health and Human Services prevailed in federal district court and the U.S. Court of Appeals for the 10th Circuit. The appeals court ruled that Congress had left to the federal government the decision on eligibility for Title X grants, which were subject to conditions deemed reasonable by the Department of Health and Human Services.

The divided three-judge panel of the 10th Circuit also found it unlikely that the Biden administration had violated the Weldon Amendment, in part because the state could not prove that the federal government had discriminated against it by refusing to refer pregnant women for abortion.

Oklahoma Supreme Court petition

In their petition to the Supreme Court, Oklahoma officials claimed that the state’s Department of Health was deprived of $4.5 million “solely” for not issuing abortion referrals. They said the Title X funds are critical to Oklahoma’s delivery of family planning services through local health departments and warned that denying Title X services to the state’s rural and urban communities would be “devastating.”

Citing Supreme Court precedent, the state argued that the federal government could not impose an obligation on it to provide abortion services unless it was clearly required by Title X.

“HHS’s order imposes a requirement on Oklahoma on an issue that is expressly reserved for the people in Dobbs,” Oklahoma officials wrote in a document, citing the 2022 Supreme Court decision overturning Roe. They continued, “HHS has intentionally sought to impose the executive branch’s policy preferences on the states, including Oklahoma, and upset the federal-state balance on this important issue.”

However, the Justice Department argued that the case did not affect Oklahoma’s ability to regulate abortion within its borders and questioned how referring patients to a hotline could violate the state’s ban on advising or inducing an abortion.

The Oklahoma State Department of Health could also reject the Title X award, Attorney General Elizabeth Prelogar wrote in a letter.

“The Department of Health and Human Services has determined that counseling and referral are ‘critical to providing high-quality, patient-centered care.’ Without them, patients would be deprived of unbiased information about ‘all pregnancy options,'” she wrote. “This is completely contrary to the fundamental goal of Title X.”

Oklahoma had asked the Supreme Court to announce its decision by August 30, the deadline by which the Biden administration will begin distributing federal funds to other institutions.

A similar battle over Title X funding for Tennessee is also currently playing out in court. This case involves a $7 million grant that the Biden administration refused to pay out after the state refused to give Title X patients access to a national hotline whose operators would give them referral information.

Tennessee, like Oklahoma, banned most abortions in the state after the Supreme Court overturned Roe and announced that it would only offer information and counseling on “all options that are legal in the state.”

A federal district court and the U.S. Court of Appeals for the 6th Circuit declined to stop the Biden administration from cutting off funding.