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The Honorable Mitch McConnell
Majority Leader, United States Senate
S-230 The Capitol
Washington, D.C. 20510

The Honorable Nancy Pelosi
Speaker, United States House of Representatives
H-232 The Capitol
Washington, D.C. 20515

The Honorable Charles Schumer
Minority Leader, United States Senate
S-221 The Capitol
Washington, D.C. 20510

The Honorable Kevin McCarthy
Minority Leader, United States House of Representatives
H-204 The Capitol
Washington, D.C. 20515

September 4, 2019

Dear Leader McConnell, Leader Schumer, Speaker Pelosi, and Leader McCarthy,

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
  26. CREDO
  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 Center for Research on Women
  53. International Women's Convocation
  54. International Women's Health Coalition
  55. International Youth Alliance for Family Planning
  56. IntraHealth International
  57. Ipas
  58. Jewish Women International
  59. League of Women Voters of the United States
  60. MADRE
  61. MANA, A National Latina Organization
  62. Medical Students for Choice
  63. Michigan Medicine
  64. MomsRising
  65. MPact Global Action for Gay Men's Health & Rights
  66. MSI United States
  67. NAKASEC Virginia
  68. NARAL Pro-Choice America
  69. NASPAG
  70. NASTAD
  71. National Abortion Federation
  72. National Asian Pacific American Women's Forum (NAPAWF)
  73. National Association of Nurse Practitioners in Women's Health
  74. National Birth Equity Collaborative
  75. National Center for Lesbian Rights
  76. National Center for Transgender Equality
  77. National Council of Jewish Women
  78. National Family Planning & Reproductive Health Association
  79. National Health Law Program
  80. National Hispanic Medical Association
  81. National Institute for Reproductive Health (NIRH)
  82. National Korean American Service & Education Consortium (NAKASEC)
  83. National Latina Institute for Reproductive Health
  84. National LGBTQ Task Force Action Fund
  85. National Network of Abortion Funds
  86. National Organization for Women
  87. National Partnership for Women & Families
  88. National Women's Health Network
  89. National Women's Law Center
  90. New Voices for Reproductive Justice
  91. NextGen America
  92. NMAC
  93. North American MenEngage Network
  94. North American Society for Pediatric and Adolescent Gynecology
  95. O.D. Aid
  96. OutRight Action International
  97. PAI
  98. People For the American Way
  99. PFLAG National
  100. Physicians for Reproductive Health
  101. Pilgrim United Church of Christ, Carlsbad, CA
  102. Planned Parenthood Federation of America
  103. Population Connection Action Fund
  104. Population Institute
  105. Positive Women's Network-USA
  106. Power to Decide
  107. Raising Women's Voices for the Health Care We Need
  108. Religious Institute
  109. Secular Coalition for America
  110. SEIU
  111. Sexuality Information and Education Council of the United States (SIECUS)
  112. Sierra Club
  113. SisterLove, Inc.
  114. Society for Adolescent Health and Medicine
  115. The AIDS Institute
  116. The Center for Sexual Pleasure and Health
  117. The Church of Bethesda-by-the Sea
  118. The Hunger Project
  119. Treatment Action Group (TAG)
  120. UltraViolet
  121. Union for Reform Judaism
  122. Unitarian Universalist Women’s Federation (UUWF)
  123. United State of Women
  124. University at Buffalo Jacobs School of Medicine and Biomedical Sciences
  125. URGE: Unite for Reproductive & Gender Equity
  126. Utah Health Policy Project
  127. VCU Health System
  128. Voices for Progress
  129. Voto Latino
  130. WaterAid America
  131. West Virginians for Affordable Health Care
  132. White Ribbon Alliance Global Secretariat
  133. Win Without War
  134. Women Employed
  135. Women of Reform Judaism
  136. Women's Environment and Development Organization (WEDO)
  137. Women's Refugee Commission
  138. Woodhull Freedom Foundation
  139. YWCA USA


​​​​​​​CC: The Honorable Richard Shelby, The Honorable Patrick Leahy, The Honorable Nita Lowey, The Honorable Kay Granger