$100M for Teen Pregnancy Prevention Sits Unspent

Congress appropriated $101 million for the federal Teen Pregnancy Prevention (TPP) Program, and President Trump signed it into law in February. Yet with less than a week left in the 2026 fiscal year, the Department of Health and Human Services has spent just about $500,000 of it, according to NPR. The standoff has become a test of how far an agency can go in declining to spend money Congress has directed it to spend.

The gap came into focus Friday, when 92 House and Senate Democrats signed a letter to HHS demanding the money be released. “Withholding these funds deprives teens across the U.S. of vital resources and threatens to unwind decades of progress made in reducing teen pregnancy,” the letter reads.

How the money stopped moving

The TPP Program was created in 2010 to fund medically accurate, age-appropriate programs that reduce teen pregnancy, selected through rigorous academic evaluation. Grantees have ranged from public health departments and universities to Planned Parenthood affiliates and faith-based groups.

That grant pipeline narrowed abruptly in late June, when HHS canceled all but about a dozen of the program’s grants — 53 of 67, totaling roughly $66 million — most of them in the third year of a five-year cycle, per NPR. Termination letters cited “Misalignment with agency priority, specifically normalizing sexual activity for minors.”

The terminations hit organizations across the political spectrum and served high-need populations, from Native American youth to foster and unhoused youth. At Healthy Futures of Texas, a nearly $2 million annual grant funded 11 programs before it was canceled effective immediately. “I’m frustrated that these are lives that were being changed — there’s generational impact and social and economic mobility for our communities,” president and CEO Ginger Mullaney told NPR.

A new plan, and a legal reckoning

Soon after canceling the grants, HHS issued a new Notice of Funding Opportunity emphasizing abstinence and “body literacy” over evidence-based instruction. The new terms align with an approach called restorative reproductive medicine, which discourages contraception and instead emphasizes fertility-awareness methods, according to CT Mirror/Stateline. Applicants must pass an “alignment review” with agency priorities conducted by political appointees, and the funding notice awards more points to first-time applicants — a change critics say could open the door to anti-abortion crisis pregnancy centers.

The overhaul did not survive court scrutiny intact. On Aug. 19, U.S. District Judge Christopher Cooper ruled the new policy “likely arbitrary and capricious” and blocked its implementation, noting that the funding notice cited research papers that do not exist, according to the Georgetown Litigation Tracker. “The TPP Program now mandates an abstinence-only approach to pregnancy prevention, promotes the nebulous concept of ‘body literacy,’ and prohibits the ‘normalization’ of sexual activity among minors,” Cooper wrote.

The ruling blocked the new requirements but did not immediately reinstate the terminated grants. On Sept. 21, the court granted plaintiffs’ motion to suspend the Sept. 30 spending deadline — meaning the money is not legally required to be disbursed by the end of the fiscal year, Public Citizen notes. HHS could still reinstate the grants on its own, or the court could compel it.

The separation-of-powers question

At the center of the dispute is a question the courts have wrestled with for decades: whether an agency may decline to spend funds Congress has appropriated, and pursue a different policy instead. Rep. Judy Chu (D-Calif.), who led the letter to HHS, framed it as a straightforward legal obligation.

“HHS is obligated to spend this money as directed by Congress,” Chu told NPR. “This is a bipartisan program created by Congress with the clear intent of supporting evidence-based education models that help reduce teen pregnancy, sexually transmitted diseases, and other health risks for young people.”

HHS did not respond to NPR’s request for comment. The agency’s FY2027 budget request called for eliminating the program entirely, and the administration has argued the program funds organizations that promote what it considers radical ideology.

What is at stake

The stakes reach beyond the balance in a single program’s account. The U.S. teen birth rate fell about 72% over the period the TPP Program has existed and hit a record low in 2025, according to NPR. Experts attribute the decline to a mix of more comprehensive sex education, better contraception access, and broader behavioral trends — not to any single program. Still, grantees say the abrupt cancellation broke trust with the families they serve.

“You work hard to recruit these families to come with their teens to do your programming, and then you’re canceling them,” Kristin Fairholm, executive director of EyesOpenIowa, told NPR. “I worry for our young people. I think we’re doing them a huge disservice.”

In Bozeman, Mont., Bridgercare executive director Stephanie McDowell framed the value of the work simply: “So we teach facts; families teach values. And those are truly complementary, not competing roles.”

What to watch

Three things will shape what happens next. First, Cooper is expected to decide soon whether to reinstate the terminated grants — a ruling that could restore roughly $66 million in funding. Second, the appropriations deadline has been suspended, but the underlying obligation to spend the $101 million remains in dispute, and either HHS or the court will have to resolve it. Third, the broader fight over the program’s future continues in the FY2027 budget process, where the administration has again proposed eliminating it.

For now, about $100 million sits in an account Congress filled and the administration has not emptied. Whether that money reaches the communities it was meant for may depend less on policy than on a judge in Washington.