Slash and Burn — Trump Budget Request Zeroes-Out International Family Planning

Today, the Trump administration sent to Capitol Hill a budget request for FY 2018 that zeroes-out all funding for international family planning and reproductive health programs, proposing to eliminate a critical health program that was just appropriated $607.5 million by Congress in the recently-enacted FY 2017 omnibus spending package. This hostile attack on family planning by the Trump administration was widely anticipated, but disturbing nonetheless—and Congress will not abide.

Elimination of all international FP/RH funding in a President’s budget request for foreign assistance is unprecedented—one might even say it’s “unpresidented.” Since the inception of the USAID population assistance program in 1965, the only similar historical episode was an aborted proposal by the Office of Management and Budget to eliminate all funding for international FP/RH programs for FY 1983, not a full year into President Reagan’s first-term in December 1981. The gambit by executive branch anti-contraception activists was quickly beaten back by career officials at the State Department and USAID. But never before has such a radical proposal to slash the budget completely advanced to the final budget proposal sent to Congress.

As far as can be determined, international family planning programs have never been mentioned in a main budget narrative document, highlighting the importance that the Trump-Pence administration must attach to delivering on the demands of its small, but vocal anti-choice, anti-contraception political constituency. In the section of the “Major Savings and Reforms” document (p. 70) showcasing a more than $2 billion reduction in State Department and USAID global health programs, the administration touts that “the Budget achieves further savings by eliminating funding in the Global Health Programs account for international family planning programs, a reduction of $523 million below the 2017 [Continuing Resolution] level.”

The State Department’s Congressional Budget Justification (CBJ) trumpets the elimination of the international FP/RH funding request in its discussion of “key program eliminations” (p. 238):

“The FY 2018 Budget eliminates funding for Family Planning.  The U.S. is by far the largest overall global health donor.  While the United States will continue significant funding for global health programs, even while refocusing foreign assistance, other stakeholders must do more to contribute their fair share to global health initiatives.”

Although only the $523 million for FP/RH programs funded under the Global Health Programs (GHP) account is specifically mentioned, it is logical to assume that the entire $607.5 million in bilateral and multilateral funding appropriated for the reminder of the current fiscal year is proposed for elimination. The GHP allocation for FP/RH programs represents the majority of bilateral funding each year, but an additional $51 million is allocated in the current budget from the Economic Support Fund (ESF) for FP/RH activities in a small number of strategically important countries.

Any ESF supporting FP/RH activities is not typically identified at all or this early in the release of budget details, but it is safe to assume that there are no ESF monies designated for FP/RH purposes. As further evidence that there is likely to be no allocation for FP/RH within ESF, the CBJ states that all of development assistance is being consolidated into ESF, and economic and development assistance is being refocused “where it can do the most to immediately and directly strengthen U.S. national and homeland security, support key strategic partners and allies, help defeat ISIS and other transnational terrorist groups, and open markets and foster economic opportunities for U.S. businesses.”

With regard to the U.S. contribution to the UN Population Fund (UNFPA), all funding for voluntary contributions to UN agencies through the International Organizations and Programs (IO&P) account is eliminated, so no funding is even potentially available for UNFPA within the budget request. This is irrespective of the recent Kemp-Kasten determination by the Trump administration that led to the complete withholding of the $32.5 million contribution to UNFPA, appropriated within the IO&P account in the FY 2017 omnibus.

For purposes of comparison, the following table contains the final budget requests of Presidents George W. Bush and Obama and final congressional appropriations for those fiscal years and today’s Trump budget:

Abandoning investments in international family planning would be felt by women and girls who are left without recourse to find alternative means to protect themselves against unplanned pregnancies—many of which will now result in unsafe abortions. Eliminating U.S. assistance for international family planning and reproductive health programs would result in 3.3 million more abortions; 15,000 more maternal deaths, 8 million more unintended pregnancies, and 26 million fewer women and couples receiving services.

The budget follows the Trump administration’s announcement last week of a devastating Global Gag Rule (GGR) expansion by fifteen orders of magnitude, which would for the first time also impact funding for HIV/AIDS, maternal and child health, malaria, global health security and other global health programs and follows the public release of the standard provisions. At the time, officials declared that “the United States remains deeply committed to supporting health programs around the world. This change will have no impact on the total amount of U.S. Government funding for health programs around the world.”

Today’s budget request patently contradicts these assertions. By zeroing out international family planning and slashing other global health programs, the Trump administration demonstrates its flagrant disregard for human lives. It was not enough to cut off providers of comprehensive services with Trump’s expanded Global Gag Rule—this budget would ensure that millions more will be left without access to care, imperiling global health systems.

While as dismaying and disheartening as today’s announcement zeroing-out international FP/RH programs may be, Congress will not go along with this egregious proposal—and a host of similar devastating proposed cuts targeting other important priorities and programs across the broad sweep of the federal government. The extreme delay in the submission by the Trump administration of its FY 2018 budget request sets back the timetable of the congressional budget and appropriations process by months. Given the disarray among congressional Republicans and the continuing partisan divide, the likelihood that Congress will end up resorting to a continuing resolution (CR) to fund the federal government in FY 2018 is increasingly becoming a foregone conclusion. A year-long CR with FY 2017 FP/RH funding levels and no legislative codification of the expanded Trump GGR or a prohibition on a UNFPA contribution is looking pretty good today.