Under the Trump administration, attacks on every front are a constant reality for family planning supporters. Fortunately, there are champions—on Capitol Hill and off—who are always ready to fight back.
Appropriations Process Begins, Proactive Bills Introduced
Early, behind-the-scenes discussions are underway as Congress begins work on the Fiscal Year (FY) 2020 budget. While the Trump administration’s budget blueprint included a 61% cut to international family planning assistance, we do not expect to see that proposal in the final budget. With a strong pro-family planning majority in the House and bipartisan support in the Senate Appropriations Committee, international family planning programs should be protected, and might even see an increase over last year’s funding level.
The past few months have also seen the introduction of a pair of bills intended to rein in the administration’s attacks on reproductive rights. On February 7, the Global Health, Empowerment, and Rights (HER) Act (S.368/H.R.1055) was introduced in the 116th Congress. Sponsored in the Senate by Jeanne Shaheen (D-NH) and in the House by Nita Lowey (D-NY-17), the bill would repeal the Global Gag Rule and prevent a future president from unilaterally reinstating it. It currently has 46 cosponsors in the Senate—including Republicans Susan Collins (ME) and Lisa Murkowski (AK)—and 169 in the House (all Democrats).
The Global Gag Rule is, of course, far from the only way Trump has sought to undermine reproductive rights around the world. First in 2018 and again this year, the State Department eliminated a section on reproductive rights from its annual human rights report. The Reproductive Rights are Human Rights Act (S.707/H.R.1581) was first introduced near the end of the 115th Congress as a response to this elimination. On March 7, the bill was reintroduced in the 116th Congress by Sen. Robert Menendez (D-NJ) and Rep. Katherine Clark (D-MA-5). It currently has 31 cosponsors in the Senate and 134 in the House of Representatives.
Domestic Gag Rule Finalized, Struck Down in Court
On March 4, the Trump administration published the final version of its long-dreaded Domestic Gag Rule, cutting off funds to Title X family planning providers who offer abortion care or referrals, along with a number of other measures undercutting the program. While the new policy was set to go into effect in early May, multiple state attorneys general, along with a number of patient and provider advocacy groups, quickly filed a total of eight lawsuits challenging the rule. The cases are in five different courts across the country, and some have been consolidated for scheduling purposes. There were multiple hearings in April, all focused on requests for preliminary injunctions to block the rule from going into effect until the legal process has concluded. On April 25, a federal court in Washington state granted the injunction, ordering the rule delayed nationwide.
Attorneys for the Department of Justice opposed the move, arguing that a 1991 Supreme Court ruling upheld a previous version of the rule imposed under Ronald Reagan and should cover this new version. Language added in 1995 to the spending bill that funds the Department of Health and Human Services (HHS), however, affirms that although federal family planning funds cannot be used for abortion, pregnancy counseling cannot urge patients toward one choice over another. It would seem that the new rule clearly violates that requirement by disallowing counseling about abortion as an option.
Additionally, the Affordable Care Act contains a provision specifically prohibiting HHS from issuing any regulation that “interferes with communications regarding a full range of treatment options between the patient and the provider” or that “restricts the ability of health care providers to provide full disclosure of all relevant information to patients making health care decisions.”
These facts may prove crucial, although any optimism has to be tempered when considering the ideological balance of the current Supreme Court. However, for now the rule remains suspended, and Title X patients can breathe a sigh of relief.
State Department Announces Further Global Gag Rule Expansion
On his first full day in office, Donald Trump announced a radically-expanded version of the Global Gag Rule. Under previous Republican presidents, the policy, which bars U.S. funding to any foreign nongovernmental organization that uses its own, separate funds to do abortion-related work or advocacy, applied only to family planning funds—around $610 million in FY 2017. Under Trump, it applies to all global health funding—nearly $9 billion.
The new version of the policy has already had devastating effects. Around the developing world, family planning clinics have closed down or cut staff. Many have had to end vital outreach programs or sever the partnerships that allowed them to serve their patients more effectively. Already, there are reports of increases in the number of unintended pregnancies and unsafe abortions in the most heavily impacted areas.
By any rational measure, the policy is a disaster. But on March 26, Secretary of State Mike Pompeo declared that the Trump administration plans to further expand the application of the policy.
The announcement was short on specifics, which we have come to expect from an administration with a bad habit of announcing policies it hasn’t actually written yet. It has led to a great deal of confusion about exactly how the policy has changed. We do know, however, that this administration’s determination to extend the reach of the Global Gag Rule is nothing more than an expression of naked contempt for vulnerable people in the poorest parts of the world. It would be shocking, if that contempt wasn’t already on full display every single day.
“The Trump administration’s expanded Global Gag Rule has diminished the effectiveness of U.S. foreign assistance, silenced medical professionals, and threatened the health of the world’s most vulnerable women at an unprecedented level. We cannot maintain U.S. moral leadership, promote American interests, and build effective relationships abroad by handicapping our most capable international partners and jeopardizing lifesaving programs. With the dire consequences of the administration’s expanded Global Gag Rule already being felt, permanent repeal of this vicious, anti-woman policy is more important now than ever before.”
–Rep. Nita Lowey