Funding Restrictions for Family Planning

Laws seeking to restrict funding for family planning generally attempt to limit or terminate state and federal funding to entities—specifically Planned Parenthood—that offer abortion coverage as part of their family planning services. Many laws also seek to disqualify abortion providers from state Medicaid funds.

In 1973, the U.S. Congress passed the Helms Amendment, which prohibits the use of U.S. foreign assistance funds for the performance of abortion “as a method of family planning.” The amendment restricts national governments and NGOs that receive U.S. foreign aid from using such funds to provide abortion services.

Three years later, Congress passed the Hyde Amendment, which prohibits the use of federal funding to pay for abortions, except in cases of rape, incest, or threat to a pregnant person’s life. The Hyde Amendment prevents federal employees, military service members, Native Americans, and Medicaid recipients from accessing the care they need. Additionally, the amendment disproportionately affects low-income pregnant people—which according to its creator, late Congressman Henry Hyde—was the intended goal.

According to Guttmacher, 18 states have abortion-related restrictions on the allocation of public funds, with many of those prohibiting abortion providers or their affiliates from receiving family planning funds; 10 states specifically restrict the allocation of federal Title X family planning funds to exclude certain types of providers; 15 states restrict the allocation of state family planning funds; 3 states restrict organizational participation in their Medicaid “spin-off” programs for family planning services; and one state (Arkansas) prohibits Medicaid from reimbursing Planned Parenthood specifically for services.

Examples of state and federal legislation (Last Updated August 28, 2020)

Laws seeking to restrict Title X funds usually prohibit grants from being awarded to abortion providers, entities that contract or are affiliated with an abortion provider, and entities that counsel or refer for abortion. An example of this type of law at the federal level is the “Title X Abortion Provider Prohibition Act,” which has been introduced in every legislative session since 2007.

In addition to restricting Title X funds from being awarded to abortion providers, some laws take it a step further and prioritize funding away from private reproductive health-focused providers when distributing family planning funds. In 2012, the Susan B. Anthony List (SBA List) and the Alliance Defending Freedom (ADF) teamed up to draft model legislation for Arizona lawmakers that outlined the priority for distribution of public funds for family planning services and specified that the state could not contract with any person or facility that performed non-federally qualified abortions. The law, which also disqualified Planned Parenthood from state Medicaid funds, was challenged in court and the provision targeting Medicaid providers was blocked.

While lawmakers at both the state and federal level have been trying for years to strip funding to abortion providers, efforts surged in 2015 when anti-abortion group, the Center for Medical Progress, released a series of heavily-edited videos alleging that Planned Parenthood was selling fetal tissue remains for profit. While multiple investigations across several different states found no evidence to support the claims, lawmakers began introducing bills to strip funding specifically to Planned Parenthood and any of its affiliates.

At the federal level, lawmakers have introduced bills like the “Defund Planned Parenthood Act,” which would prohibit, for a one-year period, the availability of federal funds for any purpose to Planned Parenthood or any of its affiliates or clinics, unless they certify that the affiliates and clinics will not perform, and will not provide any funds to any other entity that performs, an abortion during that period. Other federal bills would permanently prohibit federal funding to Planned Parenthood and any of its affiliates or clinics.

Since 2015, at least thirteen states (Arizona, Arkansas, Florida, Georgia, Kentucky, Louisiana, Michigan, Nebraska, North Carolina, North Dakota, Oklahoma, Tennessee, and Wisconsin) have passed laws prohibiting, or severely limiting, state funds from being used for abortions or being made available to private reproductive health-focused providers, including Planned Parenthood.

On April 12, 2018, Tennessee Gov. Bill Haslam (R) signed HB 2251/SB 2148, which established the state policy of avoiding the use of state funds to promote or support elective abortions. The law redirects TennCare funds to healthcare facilities that prioritize childbirth and planning services instead of abortion. The law was based on model legislation drafted by Americans United for Life.

On April 4, 2018, Nebraska Gov. Pete Ricketts (R) signed LB 944, an appropriation bill which included a ban on federal funding to health clinics that provide abortion services. The law prohibits Title X funds from being paid or granted to an organization that performs, assists with the performance of, counsels in favor of or refers patients for abortion services.

On May 23, 2018, Louisiana Gov. John Bel Edwards (D) signed HB 891, which prohibits the state’s department of health from entering into a Medicaid provider agreement with any entity that is prohibited from receiving certain public funding for abortion-related reasons. The law  also requires each licensed abortion facility’s location to be physically and financially separate from any facility where publicly funded Medicaid services are provided. HB 891 clarifies a 2016 law, HB 606, which prohibited public funding for entities that perform abortions and which is currently being challenged in court.

On June 7, 2019, Texas Gov. Gregg Abbott (R) signed SB 22, which prohibits a governmental entity from entering into a taxpayer resource transaction with an abortion provider or an affiliate of an abortion provider. The bill essentially prohibits taxpayer dollars at both the state and local level from being used to fund abortion facilities and affiliates.

Laws