President-elect Trump is expected to reinstate a controversial policy soon after taking office that would bar foreign nongovernmental organizations that perform, counsel on or provide information on abortions abroad from receiving U.S. funding.
The Mexico City Policy, referred to as the global gag rule by its opponents, was first introduced during the second Reagan administration and has been rescinded by every Democratic president and reinstated by every Republican president since then. Trump previously restored the policy four days into his first term before President Biden rescinded it again a week into his own.
Proponents of the policy claim that it prevents U.S. taxpayer funds from being spent on abortions. But opponents stress that there is legislation in place — like the Helms Amendment — that already protects taxpayer funds from being used on abortions abroad.
Instead, they argue, the global gag rule imposes restrictions that diminish the effectiveness of global health programs.
“It’s like putting a brand-new red sock into a white load of laundry, it taints everything that’s around it,” said Rachel Clement, senior director of U.S. government strategy at the Population Action International, a nongovernmental organization that works to increase global access to family planning and reproductive care.
Even though the U.S. does not fund abortions overseas, nongovernmental organizations that perform, provide counseling on or information on abortions are still eligible to receive funding from the U.S. if they use separate funds to pay for abortion-related work.
The Mexico City Policy has typically been reinvoked by presidential memoranda, which is what Trump did during his first term. It also, historically, required foreign NGOs to certify that they would not perform or promote abortions as a method of family planning through any funding source to receive U.S. government global family planning funding, according to health policy nonprofit KFF.
Congress also has the ability to institute the policy through legislation but has only done so once before.
Trump will likely reinstate the policy just as quickly after he is sworn into office again on Jan. 20 — if not more so — as he did in his first term.
“We do anticipate that it will be a Week 1 policy, if not a Day 1 policy,” said Caitlin Horrigan, senior director of global advocacy at Planned Parenthood Federation of America.
When Trump reinstated the policy in 2017, he renamed it “Protecting Life in Global Health Assistance” and amended it to include the majority of the country’s bilateral global health assistance, according to KFF.
One of the global assistance programs included under that expansion was the President’s Emergency Plan for AIDS Relief (PEPFAR), which has helped combat HIV and AIDS across Africa for more than 20 years.
The program has now come under scrutiny after U.S. officials recently told members of Congress that a review of PEPFAR-funded service providers in Mozambique found some nurses have been performing abortions since 2021.
Health assistance programs that are found to violate the policy can have their funding terminated.
Trump’s expansion of the policy also included nutrition, maternal and child health programs, as well as tuberculosis and malaria prevention programs, and extended restrictions to roughly $8.8 billion in U.S. global health assistance, according to Human Rights Watch.
Reproductive health advocates expect Trump to further expand the policy, pointing to his past actions on the global gag rule and Project 2025 as evidence of what is to come.
Project 2025, a conservative policy blueprint spearheaded by the Heritage Foundation, recommends the Mexico City Policy be expanded to include almost all U.S. foreign assistance.
This would include humanitarian aid, which would greatly boost the amount of foreign aid dollars impacted by the policy, according to Rebecca Brown, vice president of global advocacy at the Center for Reproductive Rights.
The United States has given about $54 billion in humanitarian assistance since 2021, according to the Department of State.
It could also be expanded to include organizations that receive U.S. foreign assistance but are U.S.-based, Brown added, hindering their ability to work.
Trump sought to distance himself from Project 2025 on the campaign trail, stating that he had “nothing to do” with the lengthy policy proposal. But a number of its authors served in his first administration, and he has since selected some to be a part of his incoming one.
“We don’t know for sure what he will do, but we are preparing,” Horrigan said.
