A rule revived by the Trump administration gutting funding for organizations that perform or promote abortions abroad could cost the International Planned Parenthood Federation (IPPF) around $100 million in funding, according to analysis by the New York Times. It’s the latest indication that White House efforts to hinder reproductive justice work are hitting the well-known non-profit health organization.
According to a State Department report on Tuesday, four organizations working internationally (along with dozens of their regional partners) have rejected rules reintroduced by the Trump administration requiring health care funding recipients to eschew any connection to abortion. The White House argues that number is relatively small — of the 733 organizations with funding up for renewal, the government says 729 accepted the new stipulations laid out by President Trump.
But those that opted out will be hit hard. While the organizations that declined to go along with Trump’s mandate remained unnamed in the State Department report, both Marie Stopes International (based in London) and IPPF have publicly said they will decline. According to the Times, Marie Stopes works in 37 countries and will lose out on $80 million, while IPPF, active in over 170 countries with 29 impacted by the ban, will likely see a $100 million loss.
The United States serves as the world’s biggest source of health funding, providing around $8.8 billion in global assistance annually. Officials said that money declined by the four organizations would go to others providing similar services, but were unable to speak to the long-term impact the funding stipulations might have globally.
“It is too early to analyze systematically what effect, if any, this will have on programming,” the report reads. “When a partner declines to agree to the policy and the department or agency reprograms funds to other organizations, the amount of funding directed to respective recipient countries will remain the same.”
The report was intended to measure the impact of a policy Trump revived shortly after taking office. The Mexico City policy, also known as the “global gag rule,” is a Reagan-era policy that bars international funding for any organization that offers abortion counseling or referrals, advocates for decriminalizing abortion, or offers abortion services. It has been revived and rescinded on a partisan basis: Republican administrations have typically favored it while Democratic administrations have not.
Reviving the policy has far-reaching implications. Currently, no U.S. federal funding can be used to fund abortions under the Hyde amendment. Another piece of legislation, the Helms amendment, prohibits international groups from using U.S. funding for abortions. The global gag rule goes a step further, preventing organizations from using separate funds in countries without restrictions like those in the United States.
Unlike past Republican presidents, Trump has expanded the rule to include all U.S. global health assistance, as opposed to reproductive health efforts alone. Typically, the global gag rule impacts around $600 million in funding. But Trump’s decision to bring the policy back on his first working day in office impacted nearly $9 billion in international aid. The Kaiser Family Foundation has estimated some 1,275 foreign non-governmental organizations could be impacted by the policy.
A number of studies have shown that international funding for abortion is crucial. Around 42 million people worldwide elect to have abortions annually and nearly 70,000 die as a result of abortions performed without appropriate safety measures. The global gag rule exacerbates those statistics: in many countries, pregnant people are twice as likely to have an unsafe abortion when global funds are restricted.
Historically, the policy has backfired: When the gag rule was last revived under President George W. Bush, abortion rates actually increased in Sub-Saharan Africa. The policy’s revival has also shuttered clinics across developing areas around the world, leading to restricted access to HIV/AIDS prevention and treatment, along with trauma counseling for survivors of rape. One Kenyan health clinic described the global gag rule as “a death sentence” for those seeking care.
Those statistics have done little to slow legislators who take issue with safe and legal abortion services — especially those provided or funded by Planned Parenthood’s U.S. branch, PPFA. The organization has long been a favorite target of conservatives and the Trump administration, who have sought to defund all of its health care efforts, including HIV tests, STD screenings, pelvic exams, and general health services. While he has waffled on his stance towards the organization, Trump has repeatedly worked to gut Planned Parenthood since taking office, inserting provisions in his Affordable Care Act repeal bill last March, which would have stripped the non-profit of funding, in order to appease ultra-conservative Freedom Caucus members.
Arguably no policy under Trump has targeted the organization more than the global gag rule. At the time of the policy’s revival in 2017, Planed Parenthood joined a coalition from a wide range of sectors in criticizing the decision.
“When in place, the negative impacts of the global gag rule have been broad and severe: health services have been dismantled in a number of communities; clinics that provided a range of reproductive, maternal, and child health care, including HIV testing and counseling, were forced to close; outreach efforts to hard to reach populations were eliminated; and access to contraceptives was severely limited, resulting in more unintended pregnancies and more unsafe abortions,” the coalition wrote in a letter.
IPPF has not formally responded to the State Department’s report. Spokespersons for the organization did not immediately return a request for comment.