Trump administration seeks to extend Mexico City policy on abortion

The Trump administration is looking to expand a ban on global health aid for foreign organizations that provide or promote abortions.

The proposed change from the State Department would require that foreign groups receiving global health aid through contracts from the U.S. government agree to not provide or promote abortions — even with funding from other sources.

The ban — called a “global gag rule” by opponents, already applies to grants and cooperative agreements between the U.S. government and foreign organizations, but the proposed rule, published Monday in the Federal Register, would apply the policy to contracts, which make up about 40 percent of global health aid, according to the Kaiser Family Foundation.

“This administration is fully aware that the global gag rule is coercive and demonstrably hurts women and families worldwide,” Zara Ahmed, associate director for federal issues for the abortion rights research group Guttmacher Institute, said in a statement.

“By choosing to expand it even further, they are intentionally depriving people of life-saving and essential reproductive health care all over the globe in service of a manipulative ideological agenda.”

The policy has become a game of political football for Democratic and Republican presidents. It was first established by former President Reagan to prohibit foreign organizations from accessing U.S. family planning aid if they provided or promoted abortions. 

U.S. funding for abortion is already illegal under federal law. The policy goes further by withholding U.S. health aid to foreign organizations that provide or promote abortions with funding from other sources.

The policy has been rescinded by Democratic presidents and reinstated by Republicans ever since, including by President Trump in 2017.

But Trump went further, expanding the policy to ban foreign organizations from receiving any type of global health aid, including for HIV and malaria, if they provided or promote abortions.

The State Department issued a report last month concluding that the ban has not affected most grants because the vast majority of foreign organizations agreed to the new requirements.

But access to care had been disrupted or delayed in some countries where some grantees declined to participate under the abortion ban and alternative providers could not be found. Grantees that declined to participate under the new rules included organizations that offered services for HIV, family planning, tuberculosis, maternal and child health and nutrition, according to the report.

“The U.S. government is committed to protecting human life before and after birth,” the report read.

Anti-abortion groups praised the proposed changes Monday as another win for the movement. 

“We thank President Trump and Secretary Pompeo for boldly defending life on the world stage. From day one they have championed innovative policies to protect unborn children and their mothers, as well as taxpayers,” said Marjorie Dannenfelser, president of the Susan B. Anthony List, referring to Secretary of State Mike Pompeo.

The proposed rule announced Monday would mark yet another expansion of the policy, which abortion rights groups and others argue is harmful to global health programs that benefit impoverished nations.

“This is yet another unprecedented expansion of a harmful policy — and amidst a global pandemic,” Planned Parenthood Global tweeted Monday.

Jen Kates, senior vice president and director of global health and HIV policy at the Kaiser Family Foundation, said the rule, if finalized, would force foreign organizations to make some hard decisions. 

“At the very least, it will expand the number of organizations that have to make that decision, and it could lead to some organizations scaling back what they provide,” Kates said. 

“And in some places, if that means that a woman is not able to get access, that could have implications for her health.” 

Updated at 4:43 pm.

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