On January 23, 2017, President Trump issued a memorandum reinstating the "Mexico City policy," which requires foreign nongovernmental organizations (NGOs) receiving certain types of U.S. assistance to certify that they will not perform or actively promote abortion as a method of family planning, even if such activities are conducted with non-U.S. funds.
The Mexico City policy has remained a controversial issue in U.S. foreign assistance. Since it was first issued by President Reagan in 1984, the policy has been established and rescinded through executive statements and instruments by past and current Presidents. At the time, it represented a shift in U.S. population policy; under the 1973 Helms amendment and other international abortion and family planning-related restrictions, no U.S. funds could be used directly to pay for the performance of an abortion as a method of family planning or for involuntary sterilizations. However, U.S. and foreign recipients of U.S. Agency for International Development (USAID) grants could use their own funds and funds received from other sources to engage, where legal, in abortion-related activities—though they were required to maintain segregated accounts for U.S. money in order to demonstrate compliance with U.S. abortion restrictions. Under Reagan's policy, foreign NGOs were required to certify in writing that they did not, and would not during the time of the funding agreement, perform or actively promote abortion as a method of family planning as a condition for receiving USAID family planning assistance (either as a direct recipient or a sub-recipient through a U.S. NGO that receives USAID funds).
The Mexico City policy as described above was maintained by President George H.W. Bush and rescinded by President Clinton in 1993. President George W. Bush issued a memorandum reinstating the policy in January 2001 and expanded it in March 2003 to include all assistance for voluntary population planning furnished to foreign NGOs by the State Department. President Bush also instituted exceptions for cases of rape, incest, and life of the mother, and for post-abortion care. Several months later, he further announced exceptions for funding provided through the President's Emergency Plan for HIV/AIDS Relief (P.L. 108-25) and intergovernmental organizations (such as the United Nations and its affiliated entities). President Obama revoked President Bush's policy in January 2009.
In January 2017, President Trump reinstated George W. Bush's January 2001 memorandum that reestablished the Mexico City policy. He also directed the Secretary of State to
Over the years, Members have introduced or voted on legislation to permanently establish or reverse the policy; however, none of these proposals have been enacted. In the 115th Congress, several bills aim to codify the reversal of the policy (for example, S. 210 and H.R. 671), while others express support for making the policy permanent (S.Res. 15).
Supporters maintain that the policy prevents U.S. taxpayer dollars from being used to pay for abortion or the promotion of abortion worldwide. They contend that although existing laws ban U.S. funds from being used to perform or promote abortions abroad, money is fungible; organizations receiving U.S. taxpayer funding could use U.S. resources for family planning activities while diverting money raised from other sources to perform abortions or lobby to change abortion laws and regulations. The Mexico City policy, they argue, closes this "loophole."
Opponents contend that the policy deprives women of access to quality health care and information about their health and well-being. They argue that NGOs may cut back or eliminate family planning services because they do not want to risk losing U.S. funding. Some further contend that reduced access to such services may increase the use of abortion as a method of family planning, leading to a rise in maternal deaths as the result of unsafe or illegal abortions. Critics also maintain that the policy imposes a so-called "gag" rule on NGOs that aim to provide women with comprehensive information about their health care options, or change laws and regulations in developing nations to make abortions safe. Such restrictions, critics note, would be unconstitutional if applied to U.S. groups working in the United States. In January 2017, some NGOs stated that they would not receive U.S. funding because of the policy.
Members of the 115th Congress will likely continue to debate and monitor key aspects of the policy.