Mexico City policy
The Mexico City policy is a United States government policy that blocks U.S. federal funding for non-governmental organizations that provide abortion counselling or referrals, advocate to decriminalize abortion or expand abortion services. From 1973 on, the United States Agency for International Development (USAID) has followed the Mexico City Policy for 17 of the past 32 years. The Mexico City Policy is a U.S. government policy that – when in effect – has required foreign non-governmental organizations (NGOs) to certify that they will not “perform or actively promote abortion as a method of family planning” with non-U.S. funds as a condition for receiving U.S. global family planning assistance and, as of Jan. 23, 2017, any other U.S. global health assistance, including U.S. global HIV (under PEPFAR) and maternal and child health (MCH) assistance.
The policy is a political flashpoint in the abortion debate, with Republican administrations adopting it and Democratic administrations rescinding it. The policy was enacted by Republican President Ronald Reagan in 1984, rescinded by Democratic President Bill Clinton in January 1993, re-instituted in January 2001 as Republican President George W. Bush took office, rescinded on January 23, 2009, as Democratic President Barack Obama took office and reinstated on January 23, 2017, as Republican President Donald Trump assumed the office.
Scope of the policy
The policy requires non-governmental organizations to "agree as a condition of their receipt of [U.S.] federal funds" that they would "neither perform nor actively promote abortion as a method of family planning in other nations". The policy has exceptions for abortions done in response to rape, incest, or life-threatening conditions.
The policy has significant impacts internationally. All NGO's, Non Government Agencies, internationally, regionally and locally in other counties that receive United States aid cannot "directly or indirectly" offer abortion as a course of family planning. This includes but is not restricted to, "providing advice and information about or offering refuel for abortion, even if it is legal in said country", "promote changes in a country's laws or policies related to abortion as a method of family planning", or "conducting public information campaigns about abortion as a method of family planning". The policy doesn't prohibit international NGO's from providing advice, a referral, or performing an abortion if the pregnancy causes a severe risk to the life of the mother or was a result of incest or rape. It is also possible for these international NGO's to answer questions about an abortion if the woman makes it clear she has decided to have a safe, legal abortion. This only applies if the country the woman is living in has abortion rights laws and the information is given "passively" instead of providing the information as "medically appropriate". 
History of the policy
Named for Mexico City, the venue of the United Nations International Conference on Population where it was announced, the policy was instituted by U.S. President Ronald Reagan in 1984. The final language of the 1984 policy was negotiated by the deputy chairman of the U.S. delegation, Alan Keyes, then an Assistant Secretary of State.
After the establishment of the Mexico City policy, organizations were required to meet its specified conditions in order to be eligible for federal funding from the United States, and as a result, several international abortion agencies no longer received a portion of their funds from this source. The International Planned Parenthood Federation (IPPF) did not alter its operation and lost more than 20% of its total funding. Other family planning organizations, such as the Family Guidance Association of Ethiopia and the Planned Parenthood Association of Zambia, likewise did not make the changes required by the Mexico City policy and had their funding cut. NGOs in Romania and Colombia adapted to the new U.S. guidelines and continued to qualify for federal funding.
In 1987 and 1988, the policy was challenged by two U.S. Appeals court rulings in DKT Memorial Fund Ltd. vs. USAID, involving Phil Harvey and two foreign NGOs, and Planned Parenthood Federation of America, Inc. v. USAID. Ultimately, the two court rulings contributed to the policy being used only against foreign NGOs, while not invoked against U.S. NGOs.
President Bill Clinton rescinded the Mexico City policy on January 22, 1993. He referred to the policy as being "excessively broad" and stated that it had "undermined efforts to promote safe and efficacious family planning programs in foreign nations". On January 22, 2001, President George W. Bush reinstated the policy by executive order, stating, "It is my conviction that taxpayer funds should not be used to pay for abortions or advocate or actively promote abortion, either here or abroad. It is therefore my belief that the Mexico City Policy should be restored". In September 2007, Barbara Boxer, a Senator from California, created an amendment designed to lift the funding conditions put in place by the Mexico City policy. It passed by a vote of 53–41. President Bush promised to veto any legislation which would eliminate the Mexico City policy. The policy was rescinded again by President Barack Obama on January 23, 2009, and further reinstated on January 23, 2017 by President Donald Trump. Trump not only reinstated the policy but expanded it, making it cover all global health organizations that receive U.S. government funding, rather than only family planning organizations that do, as was previously the case. This includes offices such as, USAID, the Department of State, Global Aids Coordinator, Center of Disease Control and Prevention, National Institute of Health, and Department of Defense. 
The nature of the policy has implications for organizations in certain countries such as South Africa. Even if these organizations support the policy itself, it is illegal for them not to inform a woman seeking an abortion of her rights, and/or refer her to a facility where she may have an abortion. The President's Emergency Plan For AIDS Relief (PEPFAR) was excluded from the Mexico City policy under the George W. Bush administration, but has not been excluded since the Mexico City policy was reinstated on Jan 23, 2017. 
In May 2017, Rex Tillerson announced an expansion of the policy:
- Originally a ban covering roughly $600 million in family planning money, the Trump policy now applies to all international health care aid doled out by the U.S. government — nearly $9 billion.
Debate over the policy
The policy originally enacted from 1984 to 1993 spoke to abortion only, not family planning in general. However, in 2001, the policy was re-implemented and expanded to cover all voluntary family planning activities, and critics began to refer to it as the "global gag rule." These critics argue that the policy not only reduces the overall funding provided to particular NGOs, it closes off their access to USAID-supplied condoms and other forms of contraception. This, they argue, negatively impacts the ability of these NGOs to distribute birth control, leading to a downturn in contraceptive use and from there to an increase in the rates of unintended pregnancies and abortion. A study of nations in sub-Saharan Africa suggests that unintended pregnancies increased and abortions approximately doubled while the policy was in effect. Critics also argue that the ban promotes restrictions on free speech as well as restrictions on accurate medical information. The European Parliamentary Forum on Population and Development presented a petition to the United States Congress signed by 233 members condemning the policy. The forum has stated that the policy "undermines internationally agreed consensus and goals".
Supporters of the policy have argued, using the example of the Philippines, that the ban prevents overseas health organizations from using U.S. government funds to contravene the contraception and abortion laws of the countries in which they operate. Supporters also argue that the policy prevents the health agencies from promoting abortion at the expense of other birth control methods.
President Obama in his rescinding of the policy on January 23, 2009, had chosen not to act the previous day, the 36th anniversary of the Roe v. Wade decision and the day of the large March for Life in Washington. Both of Obama's predecessors had taken action on respective January 22nds at the beginnings of their first terms. The Vatican condemned Obama's repeal of the policy almost immediately.
The Sandbæk Report of the European Union, which calls for the funding of the United Nations Population Fund (UNFPA), was seen by some Catholic commentators as a contrast to the Mexico City policy. The European commissioner Poul Nielson said that the European Union wished to "fill the decency gap" left by the Mexico City policy.
The UNFPA states that it does not "provide support for abortion services". Pro-life individuals and organizations have accused the UNFPA of supporting forced abortions by the Chinese government. The Bush administration withheld funding from the agency due to concerns about its alleged involvement. A 2002 U.S. State Department investigation found "no evidence" that UNFPA knowingly took part in forced abortions. The organization has stated that it "has never, and will never, be involved in coercion in China or any part of the world".
In 2010, the Harper government in Canada announced a maternal health development aid plan for the upcoming G8 summit which did not include financial support for abortion or contraception, drawing comparisons to the Mexico City policy.
References in popular culture
An episode of the television series Boston Legal, "Squid Pro Quo", which originally aired on May 9, 2006, featured a case involving USAID's withdrawal of funding to an overseas non-profit organization.
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