BALTIMORE — Maryland is joining a multistate lawsuit seeking to block new federal requirements for Title X funding that could threaten money for family planning clinics and limit access to reproductive health care, cancer screenings and affordable contraception.

Attorney General Anthony Brown and his Massachusetts counterpart co-led the lawsuit filed Thursday in U.S. District Court for the District of Maryland, alongside attorneys general from 21 other states.

The new requirements, issued by the U.S. Department of Health and Human Services in July, would tie Title X funding to compliance with a range of administration priorities, according to the lawsuit. The states contend the conditions could force health care providers to alter how they counsel patients and provide services or risk losing federal funding.

Title X is the only federal grant program dedicated specifically to family planning and related preventive health services. The program has operated for more than 50 years and supports contraception, cancer screenings, sexually transmitted infection testing and treatment, pregnancy testing and counseling and other preventive care.

Officials with the U.S. Department of Health and Human Services referred all questions to the White House, which could not immediately be reached for comment.

The states argue that the new conditions conflict with federal law and improperly impose political requirements on healthcare providers receiving Title X money. They are asking the court to prevent the federal government from enforcing the requirements and preserve funding under the program’s existing rules.

The July funding notice includes requirements aimed at eliminating diversity, equity and inclusion practices and excludes or stigmatizes transgender people, according to the coalition. It also discourages contraception in favor of natural family planning and requires clinics to counsel patients toward marriage and parenthood rather than provide neutral, patient-centered guidance, the states said. The notice also includes unrelated priorities such as “ending crime and disorder on America’s streets.”

The coalition argues that the conditions could have broad consequences for patients and providers, particularly those serving low-income communities.

The lawsuit contends that Title X rules require providers to offer a broad range of contraceptive methods, provide nondirective counseling and serve patients, including LGBTQ+ people, in an inclusive and nondiscriminatory manner. The states also argue that HHS failed to follow the notice-and-comment process required under the Administrative Procedure Act.

The coalition further contends that the requirements are too vague for providers to determine what compliance would require, violating constitutional limits on conditions the federal government can place on federal funding.

A similar Title X policy caused nearly one-quarter of the program’s grantees nationwide to withdraw, according to the lawsuit. The number of patients served nationally fell by more than 60% over two years, while six states, including New York, lost more than half of their Title X clinics.

New York Attorney General Letitia James led a 2019 lawsuit challenging those restrictions. The Biden administration later rescinded them before the U.S. Supreme Court ruled on the case.

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