Trump's latest gift to evangelicals: Cutting women's health even more


It's an unnecessary and cruel move.

On Monday, the Trump administration proposed expanding its anti-abortion foreign policy again, further restricting foreign organizations' abilities to provide comprehensive reproductive health care. 

It's an unnecessary and cruel move given that there are already laws in place that bar the use of American taxpayer money for abortion in any country, even if the procedure is legal there. 

Since he took office, Trump has already significantly expanded the policy, known as the global gag rule. He signed an order reinstating and expanding the rule in 2017 as one of his first acts. Under the rule, foreign non-governmental organizations are now barred from performing or "actively promoting" abortion if they want to receive any U.S. global health funds. 

Cutting off this funding stream doesn't just affect organizations that focus on reproductive health and family planning. It now also applies to HIV-related funding, maternal health, malaria, and nutrition programs. 

The proposed expansion would mean the rule would apply not just to organizations that receive grants but would be expanded to cover any organization that receives money through contracts. 

According to the Kaiser Family Foundation, which tracks reproductive health policies, that's about 40% of the global health funding the United States supplies. Even groups that provide or promote abortions with non-U.S. funding would be barred from receiving U.S. global health aid. 

The Trump administration insists there has been only a minimal gap in care provided because a relatively small amount of NGOs declined U.S. global aid in order to keep providing necessary abortion care and referrals. 

That's not true. Organizations that declined funding reported that they've been able to serve significantly fewer people. In Kenya, one group estimates it now serves 15,000 fewer people than it was able to with U.S. aid. 

The additional harms from the current version of the global gag rule are already apparent. Because the rule denies people basic reproductive health care, there has been a large increase — 40% — in the number of people seeking abortions in affected countries. A review of over 40 studies found that the implementation of the existing global gag review was "consistently associated with poor impacts on health systems' function and outcomes." 

Moreover, the rule sweeps too broadly. As Slate reported last year, many NGOs are uncertain as to what the rule actually covers and "have grown wary of providing any family planning services at all for fear of losing their funding."

The expansion of the rule will lead to an expansion of the harms. Jen Kates, the senior vice president and director of global health and HIV policy for the Kaiser Family Foundation, said the rule would "expand the number of organizations" that have to make choices about whether to accept U.S. aid and decrease the services they provide. 

Kates also said that "it could lead to some organizations scaling back what they provide" and that in some locations, "if that means that a woman is not able to get access, that could have implications for her health." 

In the end, an expansion of the rule will not meet its stated goal of decreasing abortions. Instead, research has already borne out that it increases the number, and dangerous illegal  providers may be the ones to perform those abortions. 

However, the expansion of the rule will likely play well with Trump's evangelical base. Evangelical Christians are helping drive the administration's foreign policy decisions, even pushing the United States to threaten a veto of a United Nations resolution that condemned rape. The administration felt the reproductive health language in the resolution condoned abortion and sexual activity. 

While an expanded global gag rule may help Trump shore up his evangelical base for the 2020 election, it does so at the expense of women around the world.

Published with permission of The American Independent Foundation.