The Moment is Right for Permanent Repeal of the Global Gag Rule

It’s become a near standard expectation that Congress is far too polarized to get much done these days. And it’s certainly too divided to make big progress on an issue as politically thorny as reproductive rights. We see debate after debate and headline after headline, yet the arduous legislative process feels like it has less and less to show for it. Yet surprisingly, Congress has the best opportunity it’s ever had to shock us all with a big win this year for global health and women’s rights.

The Mexico City Policy, commonly called the Global Gag Rule, prevents any non-governmental organization recipient of American foreign aid from referring patients for an abortion or advocating for abortion services in healthcare. It has come and gone since its creation in the 1980s, but like many things the Trump administration undertook, they made the policy far worse, by supersizing it to an effective ban on anyone at any federally-funded organization even mentioning the topic of abortion to patients—even if that component of work wasn’t taxpayer funded.

The outcome was a clear negative impact on global health, with many organizations that provide services unrelated to abortion feeling forced to withdraw from American funding, all while a global pandemic raged. Paradoxically, the rule even worked against its stated goal of decreasing abortion, with abortions increasing in sub-Saharan Africa by 40% during the times it was in place from 1995 to 2014. And under Trump’s extreme version, one third of organizations working to combat HIV under the President's Emergency Plan For AIDS Relief (PEPFAR) program (started by George W. Bush) cut prevention and treatment programs. It also affected organizations with seemingly no connection to the issue of abortion. Water Aid was brought under the expanded restrictions, even though its mission is to promote safe water storage, sanitation, and handwashing with soap.

All in all, the rule is bad policy. Fortunately, with the inauguration of President Biden in 2020, the Trump administration’s supersized Global Gag Rule was repealed. And now, Congress has a narrow but clear opportunity to ensure it never comes back.

Senator Shaheen (D-NH) and Representative Lee (D-CA) have authored and introduced the bipartisan Global Health Empowerment and Rights (HER) Act, important and concise legislation that would ensure that American foreign aid is never again leveraged to enforce arbitrary censorship thousands of miles away in programs the US doesn’t even fund. Critically, both Senators Collins (R-ME) and Murkowski (R-AK) have co-sponsored the Senate version of the bill. And so far, the language of the Global HER Act has been included in the Foreign Operations Appropriations bill for 2022, meaning that by keeping this important measure in must-pass appropriations legislation, we could score a big win for global health.

Voters across the country want to see that Congress can act decisively on the issues they hold dear, and recent polling shows that 7 in 10 Americans agree the Global Gag Rule should end forever. Americans know that health decisions are best made between a patient and their doctor, without onerous strings attached from an ocean away.

Policymakers were right to include the Global Gag Rule repeal in the appropriations process for 2022. It’s time to finish the job. Now we have to fight to ensure they stay in all the way to the finish line of President Biden’s desk. The timing and the path forward are ripe for a true victory.