An Unhealthy Obsession — The Cruelty Behind Cuts to Family Planning Programs Proposed by the Trump Administration and House Republicans 

An Unhealthy Obsession — The Cruelty Behind Cuts to Family Planning Programs Proposed by the Trump Administration and House Republicans 

As fiscal year 2026 (FY 2026) spending deliberations haltingly begin, the Trump administration and House Republicans have made one of their priorities clear: terminate funding for international family planning and reproductive health (FP/RH) programs. This campaign goes beyond the usual handwringing about abortion and has mushroomed into animosity toward providing contraceptive services overseas. Their unhealthy obsession with controlling other people’s reproductive health decisions is blatantly apparent, as evidenced in both the president’s budget request for the coming fiscal year, a rescission proposal that would claw back previously appropriated foreign assistance funds, and the lead-up to the House committee markup of the State Department and foreign operations appropriations bill in July. 

The upcoming budget battle is just the latest in a series of attacks on the rights, health, and bodily autonomy of millions. Congress has the opportunity to align itself with its constituents’ beliefs in legally protected sexual and reproductive health and rights (SRHR) and protect global FP/RH. But will they? 

Escalating Attacks on Family Planning Funding, Both Rhetorical and Real 

Since inauguration, the Trump administration and its allies in Congress have continued their anti-contraception rhetoric and dramatically escalated claims that family planning services are not “life-saving” to asserting that FP/RH services are “antithetical to American interest and worsen the lives of women and children,” all in the span of a mere four months.  

Here is the timeline of that radical evolution: 

The dismantling of foreign assistance 

As previously detailed in the March edition of the Washington Memo, disinformation about sexual and reproductive health was central in attempted justifications by Donald Trump and Elon Musk to dismantle foreign assistance, fire thousands of experts, and terminate more than 80% of U.S. foreign aid programs. You may remember the debunked lie told by both that the U.S. Agency for International Development (USAID) was preparing to send $50 million worth of condoms to Gaza—and, under later embellishments, $100 million worth of condoms to Hamas? 

Though easily debunked, they—and other claims—were oft repeated or misconstrued during the reign of terror launched against USAID and foreign aid by Elon Musk and his Department of Government Efficiency (DOGE) apparatchiks, along with State Department political commissars, which dismantled over 60 years of U.S. government investments in sustainable development, global health, and humanitarian assistance in short order. 

Waiver for life-saving humanitarian assistance 

Eight days after an executive order was issued on Inauguration Day requiring a pause and review of U.S. foreign assistance programs, Secretary of State Rubio signed an emergency humanitarian waiver to allow lifesaving humanitarian assistance to continue during the 90-day period of review. The catch? FP/RH was explicitly excluded, branded as “non-life saving,” alongside abortion, DEI, transgender health, and gender programs. As defined in Rubio’s memo, the waiver was available for the provision of “core life-saving medicine, medical services, food, shelter, and subsistence assistance, as well as supplies and reasonable administrative costs as necessary to deliver such assistance.” 

Lumping FP/RH in with politicized issues that target and demonize vulnerable minority populations and rev up Trump’s MAGA base is part of a longer-term strategy to use transphobia, racism, and misogyny as wedges in electoral politics to divide the American public. The maneuver was portended over the last two years by the House Republican majority’s inclusion in their version of the appropriations bill of statutory provisions seeking to export America’s “culture wars,” including bans on gender-affirming care and “drag queen workshops, performances, or documentaries.” It also sought to prohibit the use of funding to implement Biden executive orders on diversity, equity, inclusion, and accessibility initiatives aimed at increasing diversity in the diplomatic and development workforce or to advance “critical race theory.”  

“Skinny” Budget Release 

On May 2nd, the White House released its long-overdue “skinny” budget request for FY 2026, proposing a massive $6.2 billion in cuts to global health and foreign assistance programs.  If enacted, it would represent a roughly 60% reduction from the current appropriated level of funding. The magnitude of the cut to global health presaged the eventual zeroing out of all funding for FP/RH programs on May 30, when the more detailed budget request document was sent to Capitol Hill. 

The documents accompanying the budget reveal a near-obsessive focus on family planning among Trump political appointees.  A table in the 46-page document outlining significant discretionary funding changes bizarrely labels the $6.2 billion global health cut as “Global Health Programs/Family Planning,” even though eliminating all FP/RH would represent less than 10% of the total proposed reduction of global health programs. The justification is weirdly fixated on SRHR issues and perpetuating culture war rhetoric, stating in its entirety:  

“The United States is the largest global contributor to programs that provide so-called family planning services through liberal NGOs and have funded abortions. This stands in direct conflict with the President’s action reinstating the ‘Mexico City Policy.’ The Budget protects life and prevents a pro-abortion agenda from being promoted abroad with taxpayer dollars. The Budget focuses on life-saving assistance and preventing infectious diseases from reaching the United States. The U.S. President’s Emergency Plan for AIDS Relief [PEPFAR] funding is preserved for any current beneficiaries.”  

In a fact sheet titled  “Cuts to Woke Programs,” family planning is featured prominently among the “woke” elements of the foreign assistance program. The preamble states: “President Trump is committed to eliminating radical gender and racial ideologies that poison the minds of Americans. The President’s FY 2026 Budget upholds the Constitution by eliminating funding for cultural Marxism. When all else fails, dust off Joe McCarthy’s “Red Scare” playbook. 

The fact sheet includes family planning among the list of “radical, leftist priorities” along with climate change, DEI, and LGBTQI+ activities to which foreign aid has been funneled in the past and is proposed for elimination, specifically for “things such as . . . ‘family planning’ abortion services [sic] in places such as Afghanistan, Syria, and Africa.” Please note the scare quotes around family planning and the spurious allegation that taxpayer funds have been used to provide abortion services in any USAID-recipient country anywhere. 

Budget appendix and State Department Congressional Budget Justification 

On May 30th, the Trump administration issued a technical budget supplement that included an appendix, typically used to recommend lengthy and exact statutory changes.  This version went much further. In the absence of an enacted FY 2025 spending package and the existence of a continuing resolution extending the FY 2024 funding levels and policy restrictions through the current fiscal year, the administration has chosen to essentially rewrite the statutory language governing State Department operations and foreign assistance programs in the manner that they would if left to their own devices, excluding some old boilerplate and adding some new provisions. 

Interestingly, the proposed changes include codifying the Global Gag Rule (GGR) without expanding it beyond the January 24 presidential memorandum. And in an unprecedented twist: the proposed text explicitly incorporates the Hyde Amendment’s limited abortion exceptions—rape, incest, and life endangerment—and applies them to foreign NGOs using non-U.S. funds, which would allow a foreign NGO to remain eligible to receive U.S. global health assistance if it uses non-U.S. government funds to promote or perform abortion “in cases of rape or incest or when the life of the mother would be endangered if the fetus were carried to term.” 

Notable is the absence of any mention of family planning in the Global Health Programs (GHP) account. The global health sectors explicitly described as providing “life-saving assistance” and thereby receiving funding include global health security efforts, tuberculosis, malaria, polio, and HIV assistance through PEPFAR, with a “focus on maintaining treatment, testing, prevention of mother-to-child transmission, and critical oversight for those already on assistance.” Prevention efforts, including contraceptives, are quietly removed from the budget.  

The State Department’s Congressional Budget Justification (CBJ), issued shortly after the release of the appendix, confirms what we already suspected, explicitly stating: 

The Request eliminates funding for programs that do not make Americans safer, such as family planning and reproductive health, neglected tropical diseases, and non-emergency nutrition. [emphasis added] 

Proposing to zero out all international FRH funding is not unprecedented for Donald Trump. He attempted the same in 2017, in his first budget request, before Congress reversed that, zeroing out later in the FY 2018 appropriations process. Given Republican lawmakers’ subservience to Trump and their unwillingness to assert their constitutional prerogatives in insisting that the executive branch spend appropriated funds for the purposes Congress intended and approved, a similarly favorable outcome is by no means preordained. 

For purposes of comparison, the following table contains the final budget request of Trump’s first term for FY 2021 and Biden’s FY 2025 request, the amounts that Congress appropriated for those fiscal years, and Trump’s most recent budget request for FY2026. 

A remarkable exchange between Congresswoman Grace Meng (D-NY) and Secretary Rubio during a May 21 House appropriations subcommittee hearing on the State Department’s FY 2026 budget request was instructive and put a fine point on the dilemma facing Democratic appropriators: It confirmed that the Trump administration has no intention of respecting congressional directives—a constitutional conundrum yet to be resolved by Congress and the courts. 

Meng: I wanted to follow up in the same vein with international family planning and reproductive health programs…You are statutorily required to spend $575 million [on] bilateral international family planning awards as Congress provided in 2024. What is the plan? 

Rubio:  As I said on those programs with regard to that, there is no plan to spend that money. We are not going to be in that business globally. I mean, we don’t, we’re not going to do it. 

Meng:  So it doesn’t matter that Congress passed the law? 

 Rubio: Well, the money – that’s not – the money that’s been appropriated is for that purpose, but the money has been spent. Those programs, the way that money was being spent, and the specific uses, we’re not going to continue to do it in that same way. 

 The State Department later issued a partial response to an April 24th letter signed by nearly 90 Members of Congress asking about terminated FP/RH projects. Lawmakers, including Representative Lois Frankel (D-FL), the Ranking Member of the National Security, Department of State, and Related Programs committee, and Representative Grace Meng (D-NY), who serves on the powerful House Appropriations Committee, have committed to following up until they get a complete response. 

 Rescissions Package 

Following several months of threats, on May 28, the White House finally proposed rescinding $9.4 billion in previously appropriated FY 2025 funds for foreign assistance and public broadcasting. Of the total, $8.3 billion would be clawed back from bilateral and multilateral foreign aid under a process outlined in the Impoundment Control Act of 1974. Presidential use of the rescissions process to get congressional approval to not spend funds it appropriated was common until 2000, but the process fell into disuse until 2018 when Trump unsuccessfully proposed rescinding funding increases in an omnibus spending bill that passed narrowly in the House but lost by a whisker in the Senate.  Let’s hope history repeats itself. 

The current proposal would rescind $500 million of the $4 billion appropriated in FY 2025 for global health programs administered by USAID, ramping up the Trump administration’s anti-FP/RH rhetoric to new heights, and culminating in calls for the “eliminat[ion]” of “programs that are antithetical to American interests and worsen the lives of women and children, like ‘family planning’ and ‘reproductive health,’ LGBTQI+ activities, and ‘equity’ programs.”

Until today, in the absence of any additional breakdown of the proposed $500 million rescission being provided to Congress, it was impossible to know how much of the $575 million appropriated for bilateral FP/RH programs in the FY 2025 continuing resolution is being targeted. In response to questions from Sen. Brian Schatz (D-HI), Russell Vought, the director of the White House’s Office of Management and Budget (OMB), during his appearance today before the Senate Appropriations Committee, confirmed that the entire $500 million cut to global health programs being proposed for rescission is from the FY 2025 bilateral FP/RH appropriation.

Schatz: What about family planning? Are you cutting that?

Vought: Yes.

Schatz: How much?

Vought:$500 million.

[. . .]

Vought: There are two accounts for global health [being proposed for rescission]. $500 million for family planning and $400 million for PEPFAR.

 A separate proposal would rescind $437 million, the entire amount appropriated in FY 2025 for International Organizations and Programs (IOP) account that funds U.S. contributions to United Nations agencies, including the UN Population Fund (UNFPA) and, surprisingly, the UN Children’s Fund (UNICEF), which historically has enjoyed broad, bipartisan support in Congress and a sacrosanct U.S. contribution each year. UNICEF was subjected to a dressing down by the U.S delegate for alleged apostasy from the new U.S. policy orthodoxy during its June executive board meeting.  

On June 12, the House narrowly passed the Rescissions Act of 2025 (H.R. 4) on a 214 to 212 vote, with all Democrats present voting against and all but four Republicans supporting. During the House floor debate, Republicans once again trotted out their cherry-picked “woke” programs, including SRHR-related projects, and those related to LGBTQI+, climate change, and DEI, deeming them undeserving of taxpayer dollars and examples of “waste, fraud, and abuse.” Rep. Nancy Mace (R-SC), Capitol Hill’s self-appointed bathroom monitor, echoed the outrage over $3 million for “circumcision, vasectomies, and condoms in Zambia.” Not particularly radical in either amount or purpose. One suspects that the mention of circumcision triggered the most uninformed outrage despite its role in significantly reducing the risk of heterosexual HIV transmission and acquisition in men and as a key HIV prevention strategy in many countries. 

 Meanwhile, the antipathy of Trump political appointees toward contraception and family planning has grown to such heights that State Department officials are contemplating destroying $9.7 million in contraceptive commodities sitting in a warehouse in Belgium rather than transferring them to experienced international organizations and recipient governments to distribute, all at an additional cost of roughly $167,000. An additional $9 million worth of contraceptives and HIV-prevention drugs are reported to be sitting stuck in warehouses in recipient countries. Informed observers suggest that the value of contraceptive supplies already paid for by the U.S. government, but currently in limbo and at risk of expiration and destruction, may be closer to $40 million when the estimate includes supplies purchased but remaining at the manufacturer and not yet shipped, as well as those in transit. So much for being concerned about waste. 

 The rescissions package now heads to the Senate, where it faces an uncertain fate. Sen Susan Collins (R-ME), Chair of the Appropriations Committee, voiced concerns about the proposal’s rumored cuts to PEPFAR programs and “the women’s global health initiative,” suggesting it might weaken the chances of Senate passage. Since the House-passed bill contains cuts to both HIV/AIDS and FP/RH programs, Sen. Collins presumably remains concerned and will not support it. Other Republican senators, such as Sen. Lisa Murkowski (R-AK), have opposed the $1.1 billion in cuts to public broadcasting. It is also time for other senior Republican appropriators to begin to reassert their constitutional prerogatives and defend the federal spending allocations that they fought hard to obtain for their states and constituents during last year’s appropriations process, completed just three months ago. With so little detail in the rescission proposal itself, passage would afford the Trump administration unbounded flexibility in allocating the cuts, which ought to trouble Republican appropriators who think that they can protect their priorities. 

Suppose the Senate does not approve the rescissions proposal by a simple majority vote by midnight on July 18. In that case, the Trump administration is legally obligated to spend the appropriated funds for the purposes for which Congress originally designated them. Whether OMB’s Russell Vought, who has openly challenged the Article I power of Congress to direct federal spending and the constitutionality of the Impoundment Control Act, will comply remains an open question.  

What’s Next on FY 2026 Appropriations 

The House committee markup of the State Department and foreign operations appropriations bill, originally scheduled for this week, has been postponed and not rescheduled.  FP/RH advocates fully anticipate that the “Chairman’s mark” produced by the Republican majority will significantly cut—if not zero out—bilateral FP/RH funding, prohibit funding for UNFPA from any account, and legislatively codify the expanded Trump GGR. Democratic champions will undoubtedly offer pro-SRHR amendments during the markup to strip out bad provisions in the Chairman’s mark, which are unfortunately destined to fail on straight party-line votes.  

While the House has already marked up two bills in full committee, the Senate has not even scheduled markups on any of its 12 subcommittee bills. In fact, there is no agreement between Senate committee Chair Collins and Vice Chair Patty Murray (D-W), the ranking Democrat, on the top-line discretionary spending level. Chair Collins has indicated recently that the FY 2026 appropriations process is on hold until the Senate completes action on the massive Trump reconciliation bill. The Senate Republican leadership had set a goal of passing the reconciliation bill by the Fourth of July recess, but dissent in the Republican ranks may make meeting that timetable difficult.  

Stay tuned.