Category archives: State roundup

State Round-Up: Defunding the Abortion Industry

by Chantel Hoyt

June 9, 2021

Editor’s note: This is part of an ongoing series about key provisions that states have advanced in 2021.

States have been working for years to protect taxpayers from having to subsidize the abortion industry, and the momentum continues this year.

As I’ve written elsewhere,

Ever since Roe v. Wade, Congress and most states have taken bipartisan efforts to stop taxpayer funds from going to pay for abortions and, later, to flow to the abortion industry. These efforts greatly intensified in 2015 when the release of several undercover videos by the Center for Medical Progress showed Planned Parenthood officials laughing and joking about the transfer and sale of fetal tissue. These videos shocked the American people and shined a light on an unsavory profit center for the abortion industry, the gruesome harvesting of body parts of the aborted unborn (sometimes even, apparently, before fetal death).

Most Americans support defunding Planned Parenthood. An annual Knights of Columbus/Marist poll shows a majority of Americans oppose the use of taxpayer dollars to pay for abortion; in January it found that 60 percent of Americans, including 35 percent of Democrats, oppose public funding of abortions. A 2016 Harvard poll and a 2018 PRRI poll found that over half (58 percent and 51 percent, respectively) of Americans believe that Medicaid should not pay for abortions. Not surprisingly, 33 states have introduced legislation to restrict government funding of the abortion industry in recent years.  These bills largely address the three main streams of abortion funding – Medicaid (a joint federal-state health coverage program), Title X (a federal family planning grant program) and state appropriations.

Abortion funding restrictions have shifted from merely banning direct funding of abortion procedures to also cutting off abortion businesses. This distinction is important because even if taxpayer funds are not used for performing an abortion, they still support abortion centers by helping them offset their other costs. This frees up their budget to pay for abortions and other abortion-related expenses. After watching the undercover videos, federal and state policymakers realized it is time to defund abortion businesses.

Since 2015, states have consistently introduced bills that have attempted to defund both abortions and abortion centers. At least 131 bills have been introduced in 33 states in the past 6 years. Of these, 26 bills sought to defund Planned Parenthood in Medicaid, 43 bills in Title X, and 90 bills in state appropriations (About twelve of these 131 bills were specific in only prohibiting the funding of abortion procedures.  Thirteen of these bills sought to simply expand or strengthen existing defund laws. 22 of the 131 bills were temporary budget bills, in which states inserted a ‘rider’ restricting abortion funding into their yearly appropriations bill going into effect for the upcoming fiscal year.) 29 of the total 131 bills have been enacted in 19 different states. 

In addition to addressing the three streams of funding mentioned above, some states have gotten creative. For example, Iowa’s HF 422 (2015), rather than prohibiting funds from going to entities that supply abortions, sought to prohibit abortions from being done by entities that receive public funds (this bill was not enacted). A few states have sought to limit health insurance coverage of abortions.  Kentucky’s HB 484 (2020), for example, prohibited abortions from being covered under state-sponsored health insurance programs (this bill was enacted). In 2017, Wisconsin introduced a bill (SB 154) that would have prohibited publicly-funded universities from utilizing state funds to perform, assist, or train others to perform abortions.

Texas currently has the strongest defunding laws in place, as the state successfully defunded abortion businesses in Title X and state appropriations. First, Governor Greg Abbott issued a letter defunding Planned Parenthood from the state Medicaid program in 2015. While this action was enjoined, Texas was subsequently granted a Medicaid waiver allowing the state to redirect federal funds away from abortion businesses. This was the first (and so far, only) waiver of its kind to be granted.  Six other states – Arizona, Louisiana, Arkansas, Mississippi, Florida, and Indiana – have similarly enacted very strong legislation defunding the abortion industry, as they have attempted to defund abortion businesses in Medicaid and successfully defunded abortion businesses in Title X and state appropriations. However, none received a federal waiver for Medicaid; this is typically a multi-year process, which seems unlikely under the current administration, so pro-life state policymakers should begin thinking now about the waiver requests they’ll want the next time we get a pro-life administration.

In a like manner, a plethora of states have attempted to permanently defund abortion businesses in one or two streams of funding. While a state attempting to defund abortion businesses in a particular area doesn’t carry as much weight as a successful defund, it is still notable and shows the public’s support for defunding the abortion industry in that state. The following 15 states fall into this category:

  • Alabama, Utah, South Carolina – Attempted to defund abortion businesses in Medicaid
  • Kansas, Tennessee – Attempted to defund abortion businesses in Medicaid; deprioritized abortion businesses in Title X (i.e. when distributing federal grants, the state prefers non-abortion health care providers ahead of any entities that supply abortions)
  • Missouri, Idaho – Attempted to defund abortion businesses in Medicaid; defunded abortion businesses in state appropriations
  • Wisconsin, Kentucky, Ohio – Defunded abortion businesses in state appropriations; defunded or deprioritized abortion businesses in Title X
  • Michigan, Oklahoma – Defunded or deprioritized abortion businesses in Title X
  • Nebraska, Iowa, North Carolina – Defunded abortion businesses in state appropriations

Though lacking the strength of abortion industry funding bans, other states have taken action to defund abortion procedures. The 13 states that have done this are:

  • Colorado, Wyoming, South Dakota – Defunded procedures in Medicaid and state appropriations
  • Nevada, North Dakota, Georgia, Virginia, West Virginia, Delaware, Rhode Island – Defunded procedures in Medicaid
  • Pennsylvania – Defunded procedures in Medicaid; attempted to defund procedures in state appropriations
  • Minnesota – Attempted to defund procedures in Medicaid and state appropriations
  • Montana – Attempted to defund procedures in Medicaid

Lastly, several states have been successful in temporarily defunding abortions and/or the abortion industry. These states have passed yearly appropriations bills that include a pro-life ‘rider’ specifying that certain funds shall not be used for abortions and/or abortion businesses for the duration of the upcoming fiscal year. The following six states have done this:

  • Iowa – Temporarily defunded procedures in Medicaid and abortion businesses in state appropriations and Title X (2019-2020); temporarily defunded procedures in Medicaid (2015-2016)
  • Nebraska – Temporarily defunded abortion businesses in Title X (2018-2019)
  • New Hampshire – Temporarily defunds abortion businesses in state appropriations (since at least 2019)
  • Missouri – Temporarily defunds abortion businesses in state appropriations (since at least 2018)
  • Pennsylvania – Temporarily defunded abortion businesses in state appropriations (2018-2019)
  • Michigan – Temporarily defunded abortion businesses in state appropriations (2017-2018)

As I wrote,

It is clear the majority of states want to prevent taxpayer funds from going to the abortion industry. These efforts have become normative since the release of the undercover Planned Parenthood videos in 2015. This effort has not slowed, with 19 bills being introduced this year in 14 different states; four having been enacted to date.

States believe that taxpayers should not fund the abortion industry, and states will continue passing laws that reflect the principle that abortion is not health care. After all, no other type of health care has as its main purpose and goal extinguishing an already-existing human life. As a recent FRC publication proves, abortion is not the type of health care for which health care professionals should advocate. Because of these and other reasons, abortion is far from deserving of taxpayer funds and states are sure to continue passing laws that recognize this fact.

A Growing Number of States Are Protecting Minors from Transgenderism

by Chantel Hoyt

May 19, 2021

Editor’s note: This is the first in an ongoing series about key issues that states have advanced in 2021.

The cultural phenomenon of transgenderism is growing at an astonishing rate. The number of gender reassignment clinics in the United States has increased from one in 2007 to 50 today. In her book, Irreversible Damage, Abigail Shrier reports that most Western countries have seen a 1,000-5,000 percent increase in teenage females seeking treatment from gender clinics and psychologists—many of whom recommend that these girls socially and physically transition through hormones and sometimes surgery. This is aimed at treating what is known as gender dysphoria, defined by the American Psychological Association as “psychological distress that results from incongruence between one’s sex assigned at birth and one’s gender identity.”

One’s sex is never “assigned at birth”; it is always objective and observable by the time of birth. Propagating an ideology of fluid sexuality undermines a scientific understanding of human anatomy and damages children’s lives. The staggering growth of transgender ideology increasingly pressures children to undergo life-altering procedures with puberty-blocking drugs, cross-sex hormones, and irreversible surgeries. These unscientific, destructive gender transition procedures should not be allowed to interrupt the development of children and irreversibly alter their bodies.

States have been taking bold steps to protect vulnerable minors from being harmed by the unscientific idea that people can be “born in the wrong body.” To date, a total of 20 states have introduced gender transition bans in 2021. On April 6, Arkansas became the first state in the nation to ban the use of puberty blockers, cross-sex hormones, and gender reassignment surgeries for the purpose of gender transition on individuals under 18 when the legislature enacted House Bill 1570, the Save Adolescents from Experimentation (SAFE) Act, over the governor’s veto.

The Arkansas SAFE Act can be considered the “gold standard” for gender transition procedure bans. Arkansas HB 1570 has four key provisions:

  1. It protects minors from puberty blockers, cross-sex hormones, and gender transition surgeries (with a professional penalty).
  2. It bans the use of public funds and/or insurance coverage mandates for such procedures on minors.
  3. It includes an exception for the treatment of minors with a diagnosis of a physiological intersex disorder.
  4. It provides legal remedies for minors who have been permanently disfigured and/or sterilized by such procedures.

In addition to Arkansas, four states introduced fairly strong bills this year: Kentucky (HB 336), Mississippi (SB 2171), Iowa (HF 193), and North Carolina (S 514). Each of these bills contains a prohibition and professional penalty (Iowa’s bill includes a civil penalty as well), an exception for minors with a physiological intersex disorder, and legal remedies for minors harmed by such procedures. However, they do not prohibit medical insurance from covering such procedures for minors or put any restrictions on public funds being used for such purposes.

Two other states, Georgia (HB 401) and Indiana (HB 1505, SB 224), also introduced bills with all but the insurance/public funding ban. Yet, these bills impose criminal as opposed to professional penalties, which may make them more difficult to pass. Tennessee’s bills (SB 657 and HB 578), which also contain criminal penalties, are diluted because they allow minors who have entered puberty to be subjected to such procedures, provided they have parental consent and the written consent of two doctors and a psychiatrist. Family Research Council does not support allowing for medical experimentation on minors before they are old enough to make adult decisions.

Twelve states this year have introduced protections for minors that contain criminal penalties but lack legal remedies and/or exceptions for children with physiological intersex disorders (in addition to lacking provisions addressing insurance and public funds). They are:

  • Alabama (SB 10, HB 1, no private right of action)
  • Arizona (SB 1511, lacks key definitions, no private right of action)
  • Florida (HB 935, no private right of action)
  • Kansas (SB 214, HB 2210, no private right of action)
  • Louisiana (HB 575, no private right of action)
  • Missouri (SB 442, lacks key definitions, no exception for intersex disorders, no private right of action)
  • Montana (HB 113, lacks key definitions, no exception for intersex disorders)
  • Oklahoma (SB 583, SB 676, no private right of action, no exception for intersex disorders)
  • South Carolina (HB 4047, no private right of action)
  • Texas (HB 2693, HB 1399, SB 1311, lacks key definitions, no private right of action)
  • Utah (HB 92, no private right of action)
  • West Virginia (HB 2171, no private right of action)

Bills like these have been the most common for gender transition bans since 2017. They would need to add a prohibition on insurance coverage and/or public funding, an exception for minors with intersex disorders, and stronger legal remedies, in addition to trading their criminal penalties for professional penalties.

Two states, Missouri and Montana, introduced very weak bills in 2021. Missouri HB 33 includes a prohibition and professional penalty but no other provisions. Montana HB 427, despite including each key provision besides one addressing insurance and public funds, only prohibits gender reassignment surgery, not the use of cross-sex hormones or puberty blockers. Since the latter is what is most often used on minors, this makes the bill much weaker.

Eight additional states introduced bills from 2017 to 2020. The strongest of these was Minnesota HF 4694, which included each of the key provisions, including a ban on insurance coverage. However, it imposed a civil penalty instead of a professional penalty, had slightly weaker definitions, and lacked findings, among other drawbacks. The next strongest of these bills was Ohio HB 513, which lacked an insurance coverage/public funding ban and imposed criminal penalties. Four of these states—Illinois (HB 3515, 2019), Idaho (H 465, 2019), South Carolina (4716, 2020), and South Dakota (HB 1057, 2020)—lacked most key provisions. Additionally, Idaho’s bill contained criminal penalties and South Dakota’s bill contained a civil penalty, as opposed to a professional penalty. New Hampshire’s bill (HB 1532, 2018) was especially weak, prohibiting gender reassignment surgery for minors but containing no other provisions.

Over the past four years, one thing has been made clear—states want to protect their minors from life-altering procedures such as puberty-blocking drugs, cross-sex hormones, and irreversible surgeries. They have come to grips with the reality that “gender transition” is an experiment. No intervention can change a person’s genetic composition, and the best studies have demonstrated no reduction in the number of completed suicides among those who have transitioned. We have also seen states proposing stronger, more successful bills each year. Arkansas’ SAFE Act made it the first state to pass potent protections for minors. Arkansas HB 1570 is a watermark and standard that states are sure to follow, making a safer United States for future generations.

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