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Page Number: 13.0

10  AGENCY FOR INT’L DEVELOPMENT v. ALLIANCE FOR 

OPEN SOCIETY INT’L, INC. 
Opinion of the Court 

federal funding to regulate the stations’ speech outside the
Id.,  at  399  (internal  quotation
scope  of  the  program. 
marks omitted). 

Our  decision  in  Rust  v.  Sullivan  elaborated  on  the  ap-
proach reflected in Regan and League of Women Voters.  In 
Rust,  we  considered  Title  X  of  the  Public  Health  Service 
Act,  a  Spending  Clause  program  that  issued  grants  to
nonprofit health-care organizations “to assist in the estab-
lishment  and  operation  of  voluntary  family  planning 
projects [to] offer a broad range of acceptable and effective 
family planning methods and services.”  500 U. S., at 178 
(internal  quotation  marks  omitted).    The  organizations 
received  funds  from  a  variety  of  sources  other  than  the 
Federal  Government  for  a  variety  of  purposes.    The  Act, 
however,  prohibited  the  Title  X  federal  funds  from  being
“used  in  programs  where  abortion  is  a  method  of  family 
planning.”  Ibid.  (internal  quotation  marks  omitted).    To 
enforce  this  provision,  HHS  regulations  barred  Title  X
projects  from  advocating  abortion  as  a  method  of  family 
planning, and required grantees to ensure that their Title
X  projects  were  “ ‘physically  and  financially  separate’ ” 
from  their  other  projects  that  engaged  in  the  prohibited
activities.  Id., at 180–181 (quoting 42 CFR §59.9 (1989)).
A  group  of Title  X  funding  recipients  brought  suit,  claim-
ing the regulations imposed an unconstitutional condition
on their First Amendment rights.  We rejected their claim.
We  explained  that  Congress  can,  without  offending  the
Constitution, selectively fund certain programs to address
an  issue  of  public  concern,  without  funding  alterna-
tive  ways  of  addressing  the  same  problem.  In  Title  X, 
Congress  had  defined  the  federal  program  to  encourage
only particular family planning methods.  The challenged 
regulations  were  simply  “designed  to  ensure  that  the 
limits  of  the  federal  program  are  observed,”  and  “that
public  funds  [are]  spent  for  the  purposes  for  which  they
were authorized.”  Rust, 500 U. S., at 193, 196.