Hennepin County, Minnesota v. U.S. Department of Health and Human Services

District Court, District of Columbia·Decided August 19, 2026·No. Civil Action No. 2026-2460·Published

Opinion

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

HENNEPIN COUNTY, MINNESOTA et al.,

Plaintiffs,

Case No. 26-cv-2460 (CRC)

v.

UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES et al.,

Defendants.

MEMORANDUM OPINION

Millions of American teenagers have sex. Resulting unplanned pregnancies impose widespread costs on affected individuals and society generally. Alarmed by the country’s rising teenage birth rate, Congress funded grants through the Teen Pregnancy Prevention (“TPP”) Program to support local initiatives proven to reduce teen pregnancy, as well as promising approaches that might also prove effective after further observation and study. Congress intended for these programs to employ a range of strategies, from encouragement of abstinence and delayed sexual activity to education about contraceptives. The effort seems to be working: The teen pregnancy rate has plummeted since Congress began funding the grants in 2010.1

1 Recent surveys from the Centers for Disease Control and Prevention indicate that about one-third of the country’s roughly 17 million high school students have had sex at least once, and one-fifth are currently sexually active. These figures are down from approximately half and one- third of high schoolers, respectively, in 2013. See Jacob Fabina, Erik L. Hernandez & Kevin McElrath, School Enrollment in the United States: 2021, U.S. Census Bureau 2 tbl.1 (June 2023), https://www.census.gov/content/dam/Census/library/publications/2023/acs/acs-55.pdf [https://perma.cc/WFR4-U86J]; Youth Risk Behavior Surveillance Sys., Youth Risk Behavior Survey Data Summary & Trends Report: 2013–2023, CDC (2024), https://www.cdc.gov/yrbs/dstr/index.html [https://perma.cc/UZ2R-6UH2].

Under the current administration, the Department of Health and Human Services (“HHS”) has a different take on teen pregnancy. In its view, the money Congress has appropriated for teen pregnancy prevention should be used only for programs that promote abstinence and “body literacy,” a nebulous concept that appears to elevate fertility and marital procreation over well-tested forms of contraception and pregnancy prevention. The agency also seeks to bar grant recipients from encouraging or “normalizing” teen sexual activity, including through “sexually explicit” content and discussion.

Despite prior judicial rebukes of components of this same policy, HHS has memorialized its new approach through official policy pronouncements, which have in turn been incorporated into recent grant solicitations known as “notices of funding opportunity” (“NOFOs”). HHS has also applied its reimagined teen pregnancy policy by terminating existing grants held by TPP Program providers across the country. Among these providers are the two local governments and one non-profit organization that filed this lawsuit, alongside a second non-profit that supports TPP programming but is not itself a grant recipient. These four Plaintiffs now seek to preliminarily enjoin the policy’s implementation through the issuance of new NOFOs and mass termination of existing grant awards.

HHS is perfectly entitled to formulate its own views about how to stem teen pregnancy—

or even whether it is worth preventing at all—and to pursue policy initiatives consistent with its viewpoint. But it is not at liberty, under the Administrative Procedure Act (“APA”), to impose conditions on grant recipients that Congress did not intend or that are unreasonable or unexplained. The preliminary record suggests that HHS has done just that. Through the TPP, Congress sought to fund a range of evidence-based teen pregnancy prevention strategies, not just abstinence. According to unrebutted record evidence, programs that teach abstinence to the

exclusion of all other approaches are ineffective in delaying sexual initiation and reducing adolescent pregnancy, at least as a general matter.2 The agency’s NOFOs themselves acknowledge a near-absence of evidence on “body literacy” approaches to pregnancy prevention. And an educational initiative that counsels teens on how to avoid pregnancy without discussing the realities of unprotected intercourse and its alternatives would seem to defy social reality, common sense, and scientific evidence alike. Yet HHS seeks to impose these and other unexplained criteria on all TPP grantees moving forward. As such, HHS’s new TPP policy is likely arbitrary and capricious.

Having established the Court’s jurisdiction over this challenge and satisfied the other requirements for preliminary relief, the grant-recipient Plaintiffs are therefore entitled to a preliminary injunction preventing HHS from implementing its new policy, including through its recently-issued NOFOs, while this lawsuit is pending. The Court declines, however, to order the interim reinstatement of existing grants at this early stage, as it is less clear that this Court, as opposed to the Court of Federal Claims, may exercise jurisdiction over those portions of Plaintiffs’ APA claims that seek such relief. To be sure, that “agency guidance discusses” or memorializes “policies related to grants does not transform a challenge to that guidance into a claim ‘founded . . . upon’ contract that only the [Court of Federal Claims] can hear” under a channeling statute known as the Tucker Act. Nat’l Insts. of Health v. Am. Pub. Health Ass’n (“NIH”), 145 S. Ct. 2658, 2661 (2025) (Barrett, J., concurring) (quoting 28 U.S.C. § 1491(a)(1)). But there is a difference between vacating an unlawful agency policy and vacating an unlawfully terminated grant, “if the [Court of Federal Claims] has exclusive jurisdiction” over the latter

2 Whether that holds true for specific age groups, sub-populations, or communities is not evident on this early-stage record.

under the Act. Id. (emphasis added). Present uncertainty over that jurisdictional question counsels against enjoining enforcement of HHS’s grant terminations at this time. I. Background A. The TPP Program Teenage pregnancy is a critical public health issue in the United States, and unplanned adolescent childbearing has lasting and widely-felt health and economic consequences. Compl. ¶ 18. The federal government “has long recognized” the costs of teen pregnancy. Pol’y & Rsrch., LLC v. HHS, 313 F. Supp. 3d 62, 68 (D.D.C. 2018). Yet “its preferred method of addressing this societal concern has changed over time.” Id. at 69. In the late 1990s and early 2000s, Congress focused on “abstinence-only education as the primary tool” for reducing teen pregnancy. Id. (citation omitted). In the mid-2000s, teen birth rates began to tick up after years of decline. Compl. ¶ 20. Legislators were “deeply concerned” by this upward trend, H.R. Rep. No. 111-220, at 176 (2009), and especially “alarmed” given that “America’s teen birth rate” was “already high compared to other developed nations,” S. Rep. No. 111-66, at 160 (2009).3 To address this reemerging problem, Congress created the TPP Program by way of the Consolidated Appropriations Act of 2010. The “short” and “simple” statutory language that created the Program “has remained consistent since [its] inception.” Planned Parenthood of Greater Wash. & N. Idaho v. HHS (“PPGWNI”), 946 F.3d 1100, 1105 (9th Cir. 2020). Congress appropriated funds “for making competitive contracts and grants to public and private entities to fund medically accurate and age appropriate programs that reduce teen pregnancy.”

3 Despite recent improvements, the United States has one of the highest teen birth rates among industrialized countries. Its rate is over twice that of France and Canada and over five times that of Sweden. Alexandria K. Mickler and Jessica Tollestrup, Cong. Rsch. Serv., R45184, Teen Births in the United States: Overview and Recent Trends 11 (2025).

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