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Editorial: Thank goodness Biden is lifting a Trump abortion gag rule

A protester wears a banda,na over her mouth during a rally to support women's health programs.
A demonstrator on International Women’s Day in March 2017 rallies in Washington to support women’s health programs and protest the Trump administration’s global gag rule.
(Justin Sullivan / Getty Images)

It’s a relief to see the Biden administration swiftly begin to dismantle the crippling rules and regulations put in place by the Trump administration to prevent healthcare providers not just from offering abortions but from even offering information about the procedure to patients.

On Thursday, Biden is expected to repeal the global gag rule that forces foreign nongovernmental healthcare providers who receive U.S. financial aid to agree not to offer abortions — even when they do so with funds from other sources. These providers are also forbidden, as a condition of receiving aid, from counseling patients on abortion or offering abortion referrals. Biden is also expected to order a review of a similar rule — sometimes called the domestic gag rule — that prevents U.S. healthcare providers who get funds from the Title X Family Planning Program from counseling patients on abortion. Both of the rules have hamstrung healthcare providers in their ability to dispense a wide range of health services to underserved populations.

The global gag rule has been alternately invoked by Republican presidents and withdrawn by Democratic ones ever since it was first imposed by President Reagan at the United Nations International Conference on Population and Development in Mexico City in 1984 (which is why it is also known as the Mexico City policy). For decades, the use of federal dollars to subsidize abortion care in the U.S. has been barred by the Hyde Amendment. Similarly, the Helms Amendment prohibits federal funds granted to foreign healthcare organizations from being used for abortion.

The global gag rule is onerous enough when it prevents family planning organizations in foreign countries from providing abortions or counseling on abortion. But under the Trump administration, the rule was extended to any healthcare organization that also happened to provide reproductive care. That meant organizations providing care in the fields of HIV/AIDS, malaria, maternal and child health — which also may have provided reproductive care to women and girls, abortions, or abortion counseling — were at risk of losing billions of dollars in U.S. aid unless they stopped any and all levels of their abortion care. When organizations agreed to the terms, they couldn’t provide reproductive-age women with information on abortion even if they requested it. When organizations refused to comply and lost much-needed aid, they sometimes had to scale back public health programs. One study in 2019 showed reduced access to contraception, prenatal care, HIV testing and screening for cancers across several African countries, including South Africa, as a result of turning away funds.

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The so-called domestic gag rule, issued in 2019 by the Department of Health and Human Services, requires Title X Family Planning Program recipients to physically segregate their abortion services from any other healthcare services. Previously, they didn’t have to do that. And whether or not the Title X providers offered abortion, they were barred from specifically referring patients to an abortion provider, even if patients requested one. Among the providers who turned away the Title X money rather than adhere to these ridiculous restrictions were all of the Planned Parenthood affiliates (which forced them to look for other funding or cut back on hours and services). According to the Guttmacher Institute, a research organization that advocates for reproductive rights, the domestic gag rule has cut the Title X network’s patient capacity in half.

Neither of these gag rules should be in place. They do nothing but thwart access to a wide range of health services that are needed by people with the least means across the globe. Biden can’t instantly terminate the domestic gag rule because it’s codified in regulations. But he can direct the Department of Health and Human Services to immediately start the process of rescinding the rule and putting new regulations in place.

Biden can rescind the global gag rule with a new presidential memorandum. However, as smart as that would be, his administration should do more. It should work with Congress to pass legislation that will prevent the global gag rule from ever being put in place again. The healthcare organizations that desperately need this funding do not need to be put through a back-and-forth of building up and whittling down their capacity every four to eight years.


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