They Didn't Just Cut TPP. They Replaced It.

Yesterday I wrote about what it felt like when PATCH lost $130,000 in federal funding overnight. If you haven't read that post yet, I'd encourage you to start there: "It Happened. What We Warned About Is Here."

When most people hear that a federal program lost its funding, they picture an empty line item. A gap. Something that used to exist and now doesn't.

That is not quite what happened to the Teen Pregnancy Prevention program. I spent the past several days digging through the federal government's own documentation, and what I found is more troubling than a simple funding cut. The program wasn't eliminated. It was replaced, with a new version that looks similar on the surface but is fundamentally different underneath.

I think Wisconsin's donors, advocates, and elected officials deserve to see exactly what changed.

What TPP used to be

For more than a decade, the federal Teen Pregnancy Prevention program operated with an annual budget of approximately $101 million. It funded 73 organizations across the country under a five-year grant structure, organized around a deliberate continuum: incubate new ideas, accelerate the most promising ones, evaluate them rigorously, and only then implement proven approaches at scale.

This was not a haphazard program. It had eight straight years of published performance data, tracking reach, dosage, fidelity, quality, partnerships, and dissemination. It reached deeply into communities with the greatest need, including 11,515 youth in juvenile justice settings, 8,203 youth in foster care and out-of-home care, and 1,561 youth experiencing homelessness, just within three specialized settings tracked between 2015 and 2023.

This is the program that funded PATCH here in Wisconsin. It is the program that funded similar work in Milwaukee, in Oneida County, in Bayfield County, and in a dozen other Wisconsin communities. It is the program responsible for a 72 percent decline in teen birth rates since 2007.

What replaced it

On June 26, 2026, the federal government terminated the bulk of this program nationwide, including Wisconsin's award. A few days later, I found the replacement sitting quietly on the same federal website.

It is called "Replicating Effective Teen Pregnancy Prevention Programs." It offers up to $63.4 million, a one-time solicitation, not a stated annual budget, for an estimated 52 awards. Grants last up to two years, with an optional third year, down from the five-year horizon organizations like PATCH had built their work around.

The language has changed too. The old program talked about reducing teen pregnancy and STIs through rigorously evaluated, evidence-based approaches. The new solicitation talks about "body literacy," "informed consent," and helping teens "clarify reproductive life goals." These are not phrases from the public health literature I have spent my career working in. They are phrases drawn from a different ideological tradition, one focused on abstinence and natural fertility awareness rather than comprehensive, evidence-based education.

There is no published commitment to reaching homeless youth, foster youth, or justice-involved youth in this new solicitation. There is no evidence base yet, because the model is new. There is no eight-year track record, because it does not have one.

Why PATCH won't be applying

I want to be direct about something: PATCH will not be competing for this new $63.4 million pool, and it is worth explaining why.

The new funding is explicitly governed by the priorities of the Office of the Assistant Secretary for Health, the same office overseeing this transition. Those priorities state plainly that the administration considers health equity an "ideologically-laden concept" and commits to "ending diversity, equity, and inclusion (DEI) policies and practices" across all OASH-funded programs. They go further, warning against funding anything that could be characterized as "discriminatory equity ideology."

PATCH's entire model is built on equity. We exist because health care systems have historically failed to listen to young people, particularly young people from communities that face the greatest barriers to quality care. Our work centers youth voice specifically because some voices have been left out of decisions about their own health for too long. That is not an ideological add-on to our program. It is the program.

Applying for funding that requires us to disavow that framework, or to redesign our work around "informed consent" and "body literacy" language rather than equity and youth leadership, would mean becoming a different organization. We are not willing to do that, and we do not believe we should have to.

This is, I think, the clearest illustration of what I mean when I say TPP was not simply cut. It was rebuilt around a value system that organizations like ours cannot, in good conscience, compete within. The price of admission to the new program is abandoning the principles that made the old one work.

Why this distinction matters

I want to be precise about what I am and am not saying. I am not simply saying funding was cut, although it was, and PATCH lost $130,000 of it overnight. I am saying something more specific: the federal government dismantled a mature, evidence-based public health infrastructure and replaced it with an unproven, ideologically driven model, under the same program name, in the same week.

That distinction matters because it tells you this was not a budget decision. A budget decision reduces funding. This was a substitution. Roughly $63 million in, roughly $68 million out. The dollar figures are even similar. What changed was not the amount of money. What changed was who gets it and what they're required to say, and believe, to get it.

What I'm asking of you

If you have read this far, you understand something most people do not yet know about what happened to programs like PATCH. I am asking you to do three things with that knowledge.

Share this post. Most people, including many people who care deeply about teen health, do not know that TPP wasn't simply defunded. They think it disappeared. The fact that it was replaced with something built on a different premise entirely, one that organizations like ours cannot in good conscience apply for, is a story that needs to travel further than our blog.

Support PATCH directly. We are still here, still committed to this work, and still need community support to bridge the funding gap created by this transition. You can donate at patchprogram.org/donate.

Talk to your elected officials. Whether you reach out to your member of Congress, your state legislators, or write a letter to the editor, decision-makers need to hear that their constituents understand the difference between cutting a program and quietly rebuilding it around a different set of values.

We did not choose this fight. But understanding exactly what we are up against is the first step in winning it.