President Donald Trump is moving forward with a plan to massively expand a ban on federal dollars going to international groups that perform abortions or provide abortion information.
Senior administration officials said Monday a plan to expand the so-called "Mexico City Policy" had gone into effect. The policy would apply broadly to organizations receiving U.S. global health assistance, compared with past versions of the ban which specifically targeted international family planning groups.
In all, about $8.8 billion in funding could be impacted, far more than the $600,000 covered under the previous version of the ban, which critics call the Global Gag Rule. The expanded policy is being dubbed "Protecting Life in Global Health Assistance." The officials, who requested anonymity and were not authorized to speak on the record, said the ban would apply to groups working on HIV/AIDS, malaria, maternal and child health, reproductive issues and global health.
Officials said the new policy would be applied immediately to new funding issued and then to existing arrangements as they are amended. To receive funding, health organizations must pledge not to provide abortions or abortion information or provide support to any groups that do. There is an exemption in cases of rape, incest or when the woman's life is at risk.
Aid to national and local governments will be exempted, as is humanitarian assistance, migration aid and disaster relief. The Secretary of State could also authorize exemptions on a case-by-case basis.
Officials said there will be a comprehensive review of the impact of the changes over the next six months.
Trump reinstated the policy — a political football instituted by Republican administrations and rescinded by Democratic ones since 1984 — days after he took office, promising to expand the scope. Obama had lifted the ban when he took office in 2009.
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Just how many groups will be impacted in the short term was not clear. Administration officials declined to speculate on how many organizations would not meet the new criteria. Health experts noted that in many areas, groups partner with each other to provide more services, so those relationships could come under scrutiny.
Jen Kates, director of global health and HIV policy at the non-partisan Kaiser Family Foundation, said the policy was a significant expansion compared with past Republican administrations.
"Right now there's a lot of unknowns," she said. "This is a much bigger expansion. And the U.S. role in global health has increased over time. The U.S. footprint right now is quite big in global health."
Suzanne Ehlers, president of Washington-based Population Action International which lobbies in the U.S. and developing countries for women's reproductive health, said in a statement that the change would "cause unspeakable damage to integrated care efforts across all health sectors."
"Despite the Trump administration's ludicrous rebranding of the policy, the Global Gag Rule is unmistakably deadlier than ever," said Ehlers.
Anti-abortion leader Marjorie Dannenfelser, president of the Susan B. Anthony List, welcomed the news, saying in a statement that "with the implementation of Protecting Life in Global Health Assistance, we have officially ceased exporting abortion to foreign nations."
Some critics noted that the president on Sunday released a statement marking Women's Health Week. He said "we recognize the importance of providing women access to the best, evidence-based health information and care, and growing our medical knowledge through basic and applied research support."