They’re calling it a funding cliff for sexual health in America. Pap smears and HIV tests will be cancelled. IUD appointments will have to be rebooked; condoms and birth control pills that used to be free will now come with a price tag. Maternal health outcomes will worsen, and STDs will spread. Some nurses, doctors, and other health clinic staff will be laid off, and clinic hours will be slashed. The long-term impacts for public health could be horrific.

On 31 March, millions of Americans may lose access to birth control and STD screening services provided by the Title X program, a $286m annual public health investment that provides sexual and reproductive care for Americans, mostly women, who are low-income or lack health insurance. More than 2 3 million people used the program in 2023; now, they are likely to be denied care – being forced to pay out-of-pocket for services that used to be free, or to make the decision to go without.

It’s not that there’s no more money for the program; Congress has appropriated the funds. It’s not that clinics are not competent to provide the care; Title X has been in place for almost 60 years. Instead, the funding may run out at the end of March – endangering the health and safety of millions – because the Trump Department of Health and Human Services is refusing to conduct the basic administrative tasks needed for it to function.

Every year, the hundreds of non-profit clinics and local health departments that receive Title X funding provide a........

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