However, beginning in 2017, the Trump administration not only reinstated the policy, but it also extended to more than $8 billion in global health assistance.
As pro-abortion groups withdrew from partnership with the U.S. over the pro-life requirements, their funding shortfall was not insignificant. The International Planned Parenthood Federation estimated in 2017 it would lose $100 million annually in funding, while Marie Stopes International estimated an $80 million funding shortfall.
Critics of the policy alleged that the pro-life restrictions were so broad they would hurt important global health initiatives such as AIDS relief. They argued that if NGOs forfeited U.S. foreign aid over the abortion restrictions, and the U.S. could not find suitable replacement partners, then there could be significant gaps in critical health care.
In August, a federal report found that the “vast majority” of U.S. partners in global health assistance accepted the new pro-life policies instituted by the Trump administration. For those which did not accept, either an alternative health provider, foreign governments, or donors stepped in to fill health care gaps.
Smith formerly chaired the House global health subcommittee, and in 2018 he authored a five-year extension of the President’s Emergency Plan for AIDS Relief (PEPFAR). He affirmed the conclusion that there were no significant gaps in health care as a result of the policy.
“So there wasn’t a single dollar cut for any health initiative—not one. It was redirected, but in most cases it was accepted,” Smith said.
“The issue is, abortion is not health care,” he said. “It is a very violent deed, and we don’t want complicity in global abortion.”
The Trump administration also applied funding restrictions to multilateral organizations because of abortion lobbying or alleged involvement in abortions.
In 2019, the Trump administration cut funding for the Organization of American States (OAS) because of its lobbying for abortion. In 2017, it stopped funding the UN’s population fund (UNFPA) because of the fund’s partnership with China on family planning—and alleged complicity in forced abortions and sterilizations under China’s two-child policy.
On Thursday, President Biden issued a sweeping order that repealed the Mexico City Policy and restored funding to UNFPA. He instructed federal agencies to begin reaching out to global health partners, to inform them that the previous restrictions on abortion performance, advocacy, and lobbying are no longer in place.
“Now more money will be flowing to the NGOs that so aggressively promote the destruction of innocent human life,” Smith said.
(Story continues below)
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In addition, on Thursday Biden instructed the Secretary of Health and Human Services—Xavier Becerra has been nominated for the position but not yet confirmed—to review the Trump administration’s “Protect Life Rule.”
That rule applied to the Title X program, set up in 1970 to subsidize family planning and contraception. The Trump administration required Title X grant recipients to not refer for abortions or be co-located with abortion clinics. The original law that created Title X said that funding could not go to “programs where abortion is a method of family planning.”
Planned Parenthood, the nation’s largest abortion provider, withdrew from the Title X program in 2019 rather than comply with the new requirements. It forfeited an estimated $60 million annually in Title X grants by doing so.
Biden said the new prohibition on abortion referrals “puts women's health at risk by making it harder for women to receive complete medical information.”
The idea of the Protect Life Rule was similar to the Mexico City Policy, Smith said: to ensure tax dollars don’t fund clinics where abortions are also being performed.
“We’re supporting the organization and, in this case, it’s under the same roof where babies are being dismembered or chemically poisoned,” he said.