September 4, 2019

Dear [congressional leadership],

As you debate and consider the FY2020 appropriations bills, the undersigned 136 organizations urge you to include provisions that will promote health care access for millions of people in the U.S. and around the world.

In recent years we have seen policymakers push a radical, unethical, anti-sexual and reproductive rights agenda, including through executive order and rulemaking. The current administration has moved to cut access to critical health care programs in the U.S. and abroad, including all funding to UNFPA’s core and humanitarian work; has dramatically expanded the global gag rule; and has finalized a regulation - referred to as the domestic gag rule - which fundamentally alters the Title X family planning program and effectively restricts access to trusted and highly qualified family planning providers who have long been dedicated stewards of the program, including Planned Parenthood health centers, and opens the door to entities that do not provide comprehensive birth control and reproductive health services. All of these efforts, if left unchecked, will cost communities in the U.S. and around the world access to lifesaving care. The administration’s attacks on sexual and reproductive health and rights must be countered by Congress.

With bipartisan agreements in place on topline budget levels, this fiscal year is an opportunity to not only robustly fund critical domestic and global health programs, but also ensure that these investments are effectively used by protecting and promoting reproductive health access via two provisions that have both bipartisan support and the backing of the majority of voters in this country. The House-passed FY2020 Labor-HHS-Education (Labor-HHS) and State, Foreign Operations, and Related Programs (SFOPs) appropriations bills include essential protections for the Title X family planning program and repeal of the global gag rule. The Senate must also include these critical provisions, which have bipartisan support, in their FY2020 bills, and Congressional leaders must fight for these provisions throughout FY2020 negotiations. We reject any notion that policies protecting Title X and repealing the global gag rule are “poison pills.” Over the last two appropriations cycles, the Senate has protected reproductive health and rights on both domestic and international priorities on a bipartisan basis; it is time to enact those policies into law.
The politicization of reproductive health programs endangers the lives of individuals and erodes their rights. Over the past two and a half years, hundreds of public health experts, provider organizations, and community leaders have spoken out about the danger of these “gag rules,” one of which has already wreaked havoc around the world and the other of which is dismantling Title X, the nation’s only dedicated source of federal funding for reproductive health care.

As the nation’s family planning program, Title X provides access to affordable birth control, STI testing and treatment, HIV testing, cancer screenings, and other critical preventive health services to individuals with low incomes. For nearly fifty years, the program has provided these critical services to those who need them most, including people of color, young people, LGBTQ people, immigrants, and people in rural communities. But the administration is now advancing its ideological agenda through the domestic gag rule which is designed to dismantle the Title X program, limit what information Title X providers can tell their patients, and result in patients losing access to specialized providers of reproductive health care, including Planned Parenthood health centers, which serve 40 percent of all Title X patients, as well as many independent providers. In total, the gag rule is forcing providers that serve nearly half of all Title X patients out of the program. The domestic gag rule poses a significant, immediate threat to health care access and affordability for people who already face serious barriers to care and struggle to afford rising health care costs. Further, the American Medical Association and numerous provider associations have opposed the Title X rule because it violates core ethical standards and undermines the patient-provider relationship. The Title X protective language passed by the House protects access to critical preventive care for the four million people who get care through Title X. Protecting access to birth control is not a partisan issue: the Title X program has had broad, bipartisan support since its inception in the 1970s. Even recent polling suggests there is nothing controversial about this provision to protect Title X — in fact, it maintains the status quo established under the appropriations packages passed in previous years.

Similarly, the global gag rule limits the ability of foreign nongovernmental organizations to use their own funds. The radical and unprecedented expansion of the global gag rule under the current administration has only magnified the negative impact this policy has on the health and lives of communities worldwide, particularly women and girls and LGBTQI people who are often the most marginalized in their countries. Repeal of the global gag rule would ensure that foreign nongovernmental organizations are not prohibited from receiving U.S. assistance based on their provision of counseling, referrals or medical services that are legal in the U.S. and the country in which they operate. Furthermore, it would ensure that foreign nongovernmental organizations are treated fairly and afforded the same ability as U.S. organizations to engage in advocacy and lobbying activities with non-U.S. funding. The global gag rule undercuts access to contraception, HIV/AIDS services, and maternal health care, contributing to more unintended pregnancies and more unsafe abortions. Research and data about previous iterations of the policy, as well as the current expanded global gag rule, point to the policy disrupting a range of health services, silencing public debate, and rolling back progress. By undermining the effectiveness of U.S. global health investments, the global gag rule hinders the ability to meet U.S. global health, development and foreign policy goals. Repeal of the global gag rule has been included in the Senate SFOPs bill every year since FY2001. It has long-standing bipartisan support, alongside funding for UNFPA and international family planning programs, and its inclusion is consistent with previous bills passed by the Senate Appropriations Committee.

Millions of people in the U.S. and worldwide stand to lose access to health care without the inclusion of these critical protections, which have bipartisan support. Furthermore, a majority of people in this country oppose both the Title X and global gag rules. We look to leaders in both chambers to protect access to reproductive health care for people across the country and around the world, and fight for this language until the end.


1. Advocates for Youth
2. African American Ministers In Action
3. AIDS United
4. American Association of University Women (AAUW)
5. American Civil Liberties Union
6. American Humanist Association
7. American Jewish World Service
8. American Medical Student Association
9. American Public Health Association
10. American Society for Reproductive Medicine
11. amfAR, The Foundation for AIDS Research
12. Amnesty International USA
13. Asian & Pacific Islander American Health Forum
14. AVAC
15. Better World Campaign
16. Black Women's Roundtable
17. Catholics for Choice
18. Center for Biological Diversity
19. Center for Health and Gender Equity (CHANGE)
20. Center for Inquiry
21. Center for International Policy
22. Center for Law & Social Policy
23. Center for Reproductive Rights
24. Community Change Action
25. Council for Global Equality
27. End Rape on Campus
28. Endocrine Society
29. Families Belong Together, National Domestic Workers Alliance
30. Feminist Majority
31. Freedom Network USA
32. Funders Concerned About AIDS
33. Girls Inc.
34. Global Fund for Women
35. Global Justice Center
36. Global Woman P.E.A.C.E. Foundation
37. Guttmacher Institute
38. HANA Center
39. Harm Reduction Coalition
40. HEAL Trafficking, Inc.
41. Health GAP
42. Healthy Teen Network
43. Heartland Alliance International
44. Hispanic Federation
45. HIV Medicine Association
46. Human Rights Campaign
47. Human Rights Watch
48. If/When/How: Lawyering for Reproductive Justice
49. In Our Own Voice: National Black Women's Reproductive Justice Agenda
50. Indivisible
51. Infectious Diseases Society of America
52. International Women's Convocation
53. International Women's Health Coalition
54. International Youth Alliance for Family Planning
55. IntraHealth International
56. Ipas
57. Jewish Women International
58. League of Women Voters of the United States
60. MANA, A National Latina Organization
61. Medical Students for Choice
62. Michigan Medicine
63. MomsRising
64. MPact Global Action for Gay Men's Health & Rights
65. MSI United States
66. NAKASEC Virginia
67. NARAL Pro-Choice America
70. National Abortion Federation
71. National Asian Pacific American Women's Forum (NAPAWF)
72. National Association of Nurse Practitioners in Women's Health
73. National Birth Equity Collaborative
74. National Center for Lesbian Rights
75. National Center for Transgender Equality
76. National Council of Jewish Women
77. National Family Planning & Reproductive Health Association
78. National Health Law Program
79. National Hispanic Medical Association
80. National Institute for Reproductive Health (NIRH)
81. National Korean American Service & Education Consortium (NAKASEC)
82. National Latina Institute for Reproductive Health
83. National LGBTQ Task Force Action Fund
84. National Network of Abortion Funds
85. National Organization for Women
86. National Partnership for Women & Families
87. National Women's Health Network
88. National Women's Law Center
89. New Voices for Reproductive Justice
90. NextGen America
91. NMAC
92. North American MenEngage Network
93. North American Society for Pediatric and Adolescent Gynecology
94. O.D. Aid
95. OutRight Action International
96. PAI
97. People For the American Way
98. PFLAG National
99. Physicians for Reproductive Health
100. Pilgrim United Church of Christ, Carlsbad, CA
101. Planned Parenthood Federation of America
102. Population Connection Action Fund
103. Population Institute
104. Positive Women's Network-USA
105. Power to Decide
106. Raising Women's Voices for the Health Care We Need
107. Secular Coalition for America
108. SEIU
109. Sexuality Information and Education Council of the United States (SIECUS)
110. Sierra Club
111. SisterLove, Inc.
112. Society for Adolescent Health and Medicine
113. The AIDS Institute
114. The Center for Sexual Pleasure and Health
115. The Church of Bethesda-by-the Sea
116. The Hunger Project
117. Treatment Action Group (TAG)
118. UltraViolet
119. Union for Reform Judaism
120. United State of Women
121. University at Buffalo Jacobs School of Medicine and Biomedical Sciences
122. URGE: Unite for Reproductive & Gender Equity
123. Utah Health Policy Project
124. VCU Health System
125. Voices for Progress
126. Voto Latino
127. WaterAid America
128. West Virginians for Affordable Health Care
129. White Ribbon Alliance
130. Win Without War
131. Women Employed
132. Women of Reform Judaism
133. Women's Environment and Development Organization (WEDO)
134. Women's Refugee Commission
135. Woodhull Freedom Foundation

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