PRI Review for September 25, 2017: IPPF Abortions Hit One Million Mark; India’s Two-Child Policy Advances; Last Chance to Repeal Obamacare

International Planned Parenthood Federation Performs Over One Million Abortions in 2016, Report Shows

One of the world’s most extensive and prolific abortion networks has passed a tragic milestone. In 2016, the International Planned Parenthood Federation (IPPF), for the first time reported in its history, aborted more than one million unborn baby boys and girls in a single year.

The final death toll for 2016: 1,094,679 children lost through surgical or chemical abortion[1]—roughly the equivalent of the population of Austin, Texas.

IPPF also performed an additional 3.6 million abortion-related activities including abortion counseling, consultation, and diagnostic procedures. The figures were recently released in IPPF’s Annual Performance Report 2016.

IPPF, a London-based international pro-abortion organization, maintains a vast network of affiliates (Member Associations) across the globe that actively perform and/or advocate for abortion, “comprehensive sex education,” abortifacient methods of contraception, and other “sexual and reproductive rights.” IPPF maintains 142 Member Associations worldwide and is currently active in 171 countries. Planned Parenthood Federation of America is IPPF’s Member Association in the United States.

Founded in 1952 by the International Committee on Planned Parenthood (ICPP), an international alliance of pro-birth control organizations founded and largely financed by Margaret Sanger, IPPF has long promoted abortion and contraception.

Annually, IPPF pours millions of dollars into its Member Associations and other like-minded organizations which operate on the country-level to provide abortion and/or contraceptive services and to lobby for ever more lenient abortion laws. In 2016, IPPF awarded $68 million in grants to its Member Associations and other organizations, according to IPPF’s Financial Statements 2016.

The Population Research Institute’s new 2017 edition map “International Planned Parenthood Federation (IPPF) Funding for Organizations Worldwide” shows how much IPPF has invested in organizations around the world since 2008.

IPPF claims that its network has contributed to over 950 legislative or policy changes worldwide since 2005.[2] Legislative and policy changes supported by IPPF have covered a wide range of issues including weakening or eliminating laws in defense of life, imposing explicit “comprehensive sex education” curriculum in schools, attacking parental notification and minimum-age consent laws, and ensuring public funding for abortifacient methods of contraception.

In 2016, IPPF’s Member Association in Guyana, the Guyana Responsible Parenthood Association (GRPA), successfully lobbied Guyana’s courts to reinterpret the South American country’s abortion law to allow mid-level health care providers[3]—i.e. nurses, midwives, pharmacists, and rural non-physician clinicians—to provide chemical abortions up to eight weeks gestation. Prior to the court ruling, only medical practitioners such as physicians or health providers under the direct supervision of a licensed medical practitioner were permitted to perform abortion. Following the court ruling, the number of chemical abortions provided by GRPA more than doubled and the number of abortion-related services increased by 68% overall.

IPPF perennially trains youth activists to “challenge abortion stigma” by which IPPF works to change public opinion on abortion by attempting to alter communities that value life and change them into communities where inhumane abortion procedures such as chemical abortion, vacuum aspiration, and dismemberment abortion are considered culturally acceptable.

In its 2016 Annual Performance Report, IPPF highlights the pro-abortion advocacy it effected through its Member Association in Pakistan, the Rahnuma‑Family Planning Association of Pakistan. Rahnuma trained youth activists to influence the debate on abortion on the local level by “refram[ing] abortion as both a public health and human rights issue.” According to IPPF, Rahnuma’s advocacy has reduced “the level of stigma” associated with the termination of the lives of unborn children.

IPPF claims the organization contributed to more legislative and policy changes in 2016 than at any other point in its history. As securing legislative and policy changes is one of the priority objectives outlined in IPPF’s 2016-2022 Strategic Framework, the organization’s push for legislative and policy changes is likely to continue for years to come.

IPPF has long targeted adolescents and young adults with their sex education programming and their contraceptive and abortion-related services by making them “youth-friendly.” IPPF’s new Strategic Framework signals that the organization may target the youth even more actively going forward. The Framework aims to reposition IPPF to “transition from a youth-friendly to a youth-centered organization by: prioritizing and scaling up comprehensive sex education.”

In 2016, IPPF significantly increased its reach among the youth in the domain of sex education. According to the Financial Statements 2016, over 28.1 million adolescents and young adults were given “comprehensive sex education” programming through one of IPPF’s Member Associations, a 9% increase over the number of youth receiving sex education from IPPF in 2015.

On January 23, 2017, President Donald Trump signed a presidential memorandum reinstating the Mexico City Policy. A longstanding fixture of U.S. foreign policy under pro-life administrations, the Mexico City Policy prevents certain U.S. Government funding for foreign nongovernmental organizations that perform or promote abortion as a method of family planning.

Under the Mexico City Policy, IPPF and other foreign pro-abortion organizations that refuse to stop performing or funding abortion are largely ineligible to receive funding from the U.S. Government via global health assistance. The newly reinstated Mexico City Policy has been renamed the Protecting Life in Global Health Assistance Policy.

Other countries have attempted to bridge the funding gap left by the Mexico City Policy for pro-abortion organizations. A campaign spearheaded by the Government of the Netherlands called “She Decides” has raised over $300 million (€260 million) for abortion, contraception, and sexual and reproductive health programs. Major donors to the “She Decides” campaign have included the governments of the Netherlands, Denmark, Belgium, Sweden, the U.K., Canada, Norway, Australia, and others.

The Government of Sweden has further taken the aggressive approach of vowing to defund all organizations that agree to abide by the Mexico City Policy. The Swedish International Development Cooperation Agency (Sida) has further signaled it will freeze all aid to foreign NGOs that agree to abide by the Mexico City Policy.

Most recipients of U.S. Government global health assistance are required to abide by the Mexico City Policy. According to U.S. Government senior administration officials, the new policy applies to more than $8.8 billion in U.S. foreign aid.[4] It is unclear how significant the impact of the Swedish Government’s new policy will be on crucial health services provided by foreign NGOs and the poor in developing countries that rely on them.

[1] Sum of total chemical and surgical abortions performed by IPPF as reported by IPPF Member Associations (n = 134 MAs reporting). See International Planned Parenthood Federation. Annual performance report 2016. London: International Planned Parenthood Federation, 2017.

[2] Total derived from legislative and policy changes IPPF claims to have supported as reported in: International Planned Parenthood Federation. Annual performance report 2015. London: International Planned Parenthood Federation, 2016; International Planned Parenthood Federation. Annual performance report 2016. London: International Planned Parenthood Federation, 2017.

[3] Nurses, midwives, and pharmacists are considered mid-level providers in Guyana but may not be considered mid-level providers in other countries. In the United States, nurses and midwives are not “mid-level providers,” but are rather referred to by their title, i.e. nurse practitioner (NP), clinical nurse specialist (CNS), certified nurse midwife (CNM), or other health care professional as the case may be.

[4] Senior State Department Officials. “Background Briefing: Senior Administration Officials on Protecting Life in Global Health Assistance.” U.S. Department of State, May 15, 2017.

[Second Segment]

Proposal for a Two-Child Policy in Indian State Advances to the Legislative Assembly

A state in north-eastern India has moved one step closer to implementing a population control policy which would enact stiff penalties for government employees who have more than two children.

The Indian state of Assam is considering a proposal to introduce a two-child policy for government employees. If adopted, the measure would make Assam the twelfth state to have enacted such a policy.

The proposal was released by the Assam Health and Family Welfare Department earlier this year. On August 31st, the state Cabinet approved the draft proposal. The fate of the measure now lies in the hands of Assam’s unicameral state legislature where the ruling Bharatiya Janata Party (BJP) enjoys a wide-margin majority.

The Assam Legislative Assembly is expected to take up the proposal sometime during the ongoing legislative session which began last Monday. While certain provisions are expected to be contested by lawmakers, it appears unlikely that the two-child policy will be struck entirely from the bill.

The proposal seeks to prohibit anyone who has more than two children from being considered as a candidate for a government job or office. The proposal would allow the government to pass restrictions barring persons with more than two children from running in local, municipal, or state elections, and would automatically disqualify candidates nominated for government bodies and committees. For Members of the Legislative Assembly (MLAs), elected representatives in Assam’s highest legislative body, the policy would further authorize removal from office upon the birth of a third child.

“Persons will not be eligible to apply for government jobs, and for that matter any kind of government service including that of becoming members of the Panchayat and civic bodies,” said Assam Finance, Planning and Development, Health, and Education Minister Himanta Biswa Sarma, according to the Indian Express. Sarma, a high-ranking MLA and Cabinet member, has been responsible for spearheading the initiative.

“Assam is facing a dangerous population explosion, and this is one of the several measures we have proposed in the draft population policy,” Sarma claims, using language popularized in the 1960’s by “population bomber” Paul Ehrlich whose predictions of demographic doom have long been debunked.

While several districts bordering Bangladesh and along the Brahmaputra River have seen a large influx of migrants in recent years, the decades-long decline in the total fertility rate in Assam may have otherwise provided a demographic challenge for the state. According to the Ministry of Health and Family Welfare’s 2015-2016 National Family Health Survey (NFHS-4), Assam’s total fertility rate is 2.2 children per woman, which sits slightly below the replacement fertility rate for India as a whole (2.6 for the period 2015-220), according to the most recent data from the United Nations Department of Economic and Social Affairs (UNDESA).[1]

In Assam’s urban areas, the situation is even more dire. According to NFHS-4 data, total fertility in Assam’s urban areas is 1.5, far below the replacement rate.

Local government positions in the Panchayats and municipal bodies are not only crucial local democratic institutions in India, they can also provide important career opportunities to certain segments of the population. Indian law requires a certain percentage of Panchayat seats be filled by women and members of protected Scheduled Castes (SCs) and Tribes (STs). According to the Government of Assam, the state employsover 25,000 men and women elected to a Panchayat office.

The two-child policy would not only affect government employees, however. The proposal would also seek to tie development aid and government-subsidized local credit lending to meeting population targets and quotas.

Panchayats that meet or exceed their targets in implementing the proposed population policy could be eligible to receive grants or other awards. Local “self help groups,” community-based committees in India consisting of local business leaders and entrepreneurs that operate as private investors and credit lenders on the local level, would be eligible for special government grants if their members have no more than two children each.

“The two-children [sic] norms will be applicable for also [sic] in employment generation schemes like giving tractors, proving homes and other government benefits,” Sarma said according to NTA Post. “Families with more than two children will also not be eligible for various benefits under different government schemes,” the Indian Express quoted Sarma saying.

The policy further proposes to set aside 10% of government funding for Panchayats to be used for performance-based disbursement for a number of project areas, including in the area of reproductive health. Rural health care workers active in providing contraceptives in India such as Accredited Social Health Activists (ASHAs) and Anganwadi workers would also be provided with “incentives” to “encourage adoption of family planning and spacing methods by eligible couples.”

“Districts will be judged and awarded performance award [sic] with grants on effective implementation of this policy,” the draft proposal reads.

The setting of quotas or targets to meet population goals, however, is a violation of the international consensus agreed to by 179 nations in the Program of Action at the International Conference on Population and Development (ICPD) in Cairo which stated:

demographic goals, while legitimately the subject of government development strategies, should not be imposed on family-planning providers in the form of targets or quotas for the recruitment of clients.[2]

The ICPD firmly established that family planning programs must be free of coercion and must allow couples to free decide for themselves their fertility goals without the threat of government interference.

An initial draft of the Assam population policy proposal was released to the public for comments and feedback on March 27th. After receiving input from citizens, NGOs, and the media, the Assam state Cabinet revised the proposal, releasing a new draft on May 11th, but with only minor modifications to the original draft, retaining the two-child policy.

Several other states across India have adopted two-child policies for government employees including Rajasthan, Andhra Pradesh, Orissa, Maharashtra, Gujarat, Uttarakhand, and Bihar. Other states including Himachal Pradesh, Madhya Pradesh, Haryana, and Chhattisgarh have since repealed two-child policy laws.

Two-child policies in India have had a wide impact on couples’ right to freely strive for their fertility goals. According to a recent study by S Anukriti of Boston College and Abhishek Chakravarty of the University of Essex, at least 2% of couples in states where a two-child policy was implemented changed their fertility intentions in order to remain eligible for possible future election to a Panchayat post.[3]

The implementation of two-child policies in other states has given way to coercion as women seek to retain eligibility for themselves or their spouses for government employment. The policies have also encouraged some men to abandon their wives when they have exceeded their birth quota.[4]

To retain eligibility, many women resort to abortion. And as studies have shown, states where two-child policies are implemented are significantly more likely to see an increase in sex-selective abortion among upper-caste women.[5]

Menka, a woman elected to a gram panchayat in Orissa, was interviewed by Nirmala Buch in her study “Law of the Two-Child Norm in Panchayats: Implications, Consequences and Experiences.”[6] For Menka, the two-child policy was a potent motivator for seeking out a sex-selective abortion. When the doctors told her that she was pregnant with a boy, she decided to keep the pregnancy, but when she gave birth to a daughter instead, she lamented. “If I had known, I would have aborted,” Menka told Buch, “Now I have lost my position and there is no son.”[7]

[1] ] United Nations Department of Economic and Social Affairs, Population Division (2017). World Population Prospects: The 2017 Revision.

[2] International Conference on Population and Development, September 5-13, 1994, Report of the International Conference on Population and Development, “Programme of Action of the International Conference on Population and Development,” ¶ 7.12, U.N. Doc. A/CONF.171/13/Rev.1, Sales No. 95.XIII.18 (1995).

[3] Anukriti S, Chakravarty A. Political aspirations in India: evidence from fertility limits on local leaders. IZA Discussion Paper No. 9023; 2015. Available at SSRN:

[4] See Buch N. Law of the two-child norm in panchayats: implications, consequences and experiences. Economic and Political Weekly 2005; 40(24), 2421-2429.

[5] Anukriti (2015).

[6] Buch (2005).

[7] Ibid.


Third Segment:

Once More into the Breach: Former Senator Rick Santorum Spearheads Pro-life Initiative

Jonathan Abbamonte

SEPTEMBER 20, 2017

Last week, pro-life lawmakers launched a last-ditch effort to ‘repeal and replace Obamacare’ and defund Planned Parenthood before the end of the 2017 fiscal year.

On September 13, Senators Lindsey Graham (R-SC), Bill Cassidy (R-LA), Dean Heller (R-NV), Ron Johnson (R-WI) jointly unveiled their plan for health care reform. Former Senator Rick Santorum has been instrumental in spearheading the initiative and working with members of Congress to adopt the policies outlined in the bill.

The proposal provides an innovative solution for health care reform by subsidizing health insurance through the allocation of block grants to state governments. The measure will give states more say on health care policy. Like the House bill and the failed Senate bills proposed earlier this year, the Graham-Cassidy bill would protect unborn lives and the conscience rights of millions of Americans.

The proposal would block the vast majority of federal funding for Planned Parenthood for the period of one year. As the nation’s most prolific abortion provider, Planned Parenthood terminates the lives of more than 320,000 unborn children every year. For the past two years, the organization has been the center of controversy surrounding their alleged trafficking and sale of the body parts of aborted babies.

The Graham-Cassidy proposal would even go one step further than the Senate bills from earlier this year by also prohibiting tax-free contributions to Health Savings Accounts (HSAs) from being used to pay for health care plans that include abortion coverage.

Senate lawmakers have until September 30th to pass the bill for the 2017 fiscal year. If lawmakers fail to meet the September 30th deadline, they would still be able to bring up the same bill after the 2018 fiscal year appropriations bill is passed, but the pro-life provisions in the bill would have to wait for another year before being implemented.

As a reconciliation bill, the Graham-Cassidy measure only needs 50 votes to pass in the Senate. However, both Senators Susan Collins (R-ME) and Rand Paul (R-KY) have already come out against the bill, leaving Republicans with no margin for error in garnering support. Senator John McCain (R-AZ), who sank the Senate’s effort to pass the so-called ‘skinny bill’ in July, has expressed optimism for the bill but has fallen short of endorsing it. The Congressional Budget Office (CBO) plans to have a preliminary assessment of the bill by sometime next week.

On the issue of health policy more generally, the Graham-Cassidy bill proposes to give the states more say in setting the rules for health care policy, permitting states to apply for waivers on several ACA regulations. States would be able to decide if they want to reduce costs by allowing health insurance companies to charge more for pre-existing conditions or for other reasons and would allow states to set the minimum essential benefits that insurers must provide.

States would be able to manage their health care plans more conservatively or liberally as the political climate may dictate with some left-leaning states likely to transition to a single payer option under the Graham-Cassidy bill, according to Avik Roy in an article published with Forbes. Senator John Kennedy (R-LA) has proposed an amendment to the Graham-Cassidy bill prohibiting states from using block grants to create single payer systems.

The Graham-Cassidy bill would increase the annual maximum tax-free contribution individuals and families can make to their HSAs. Citizens over 55 years of age would also be able to make catch-up contributions to their HSAs. The proposal would eliminate the individual and employer mandates and would repeal the Obamacare medical device tax. Unlike the House bill, the Graham-Cassidy bill would not penalize individuals for a lapse in coverage, a policy change that is helpful in ensuring that low-income or unemployed Americans are not penalized but one that could also increase the cost of health insurance overall.

Under the Graham-Cassidy proposal, block grants given to the states for the purposes of subsidizing individual and small group health plans would gradually replace the ACA individual premium tax credits, cost-share reduction payments, and Medicaid expansion. The Graham-Cassidy bill would allow states to introduce high-risk pools to help individuals with expensive health conditions gain access to affordable insurance. However, states would have to elect to create high-risk pools with the block grants provided to them by the federal government and it is uncertain whether such pools would be sufficient to cover at-risk individuals. A nationwide entitlement-based high-risk pool would assure that persons with expensive health conditions are able to receive affordable care.

Like the ACA, the Graham-Cassidy bill prohibits insurance companies from turning away applicants for pre-existing conditions or current health status. Individuals will also be eligible to remain on their parents’ health plans up to 26 years of age.

The bill will provide more equitable distribution of federal funding for health care across the states. Under the ACA, federal funding is matched to state funding, allowing wealthier states to gain access to proportionally more federal funding than less wealthy states.

The Senate proposal appears poised to improve financial accountability for health care. According to Alan Greenspan, former Chairman of the Federal Reserve, in a released statement, “Getting money and decision-making out of Washington—and into the hands of governors who are legally bound by balanced budget amendments in their state constitution—is a giant step forward.” The bill would endlimitless entitlement spending authorized under the ACA, forcing states to only spend money budgeted for, encouraging states to find more efficient and cost-effective ways to spend taxpayer dollars.

With the elimination of cost-sharing payments and premium tax credits, however, it remains unclear how the proposal will impact the health insurance market, particularly for low-income Americans. There could also be hidden risks to local state economies and national cohesion by allowing states to so differentially regulate on a large sector of the economy.

While Americans continue to debate the merits and drawbacks of the Graham-Cassidy health care reform proposal, all Americans can agree that any health care policy must, and in a fiscally responsible way, be attentive to the health care needs of all Americans, most especially the sick, the poor, and the unborn.

Laws to close loopholes in the ACA are greatly needed to protect the conscience rights of millions of Americans from being forced to purchase, or to subsidize through federal taxes, health care plans that include abortion coverage.

Under the Affordable Care Act (ACA), federal subsidies can be used to finance health care plans that include coverage for elective abortion, contrary to long-standing federal policy under the Hyde Amendment which prohibits this practice for federal appropriations to the Department of Health and Human Services (HHS). Despite pro-life opposition at the time the ACA was being debated in 2010, pro-abortion Democratic lawmakers ultimately blocked the bi-partisan Stupak-Pitts Amendment which would have mandated Hyde-like protections for the ACA.

Instead, the ACA stipulates that federal money should be deposited into an account separate from the abortion portion of the health care plan and itemized as a separate charge on the customer’s bill. Pro-lifers have long criticized the maneuver as little more than an accounting gimmick, allowing for federal funds to nonetheless subsidize health care plans that pay for abortion procedures.

In 2014, the Government Accountability Office (GAO) found that several insurance companies were not itemizing the abortion surcharge. The GAO found that Washington Health Benefit Exchange was not even collecting an abortion premium as stipulated by the ACA and was forced to modify their billing practices and notify the IRS of the amount the Exchange owed for failing to segregate funds.

While the Hyde Amendment prohibits federal funding for health care plans that include abortion coverage in all 50 states, the ACA forced several states to pass laws in order to opt out of funding abortion plans in the exchanges. Only 25 states so far have laws in place to restrict ACA federal subsidies and premium tax credits for insurance plans that include abortion coverage. In some states, every health care plan offered through the exchanges includes coverage for elective abortion.

The Graham-Cassidy bill, by way of contrast, would prevent funding for abortion in health care plans in all 50 states.  It would protect the conscience rights of American living in states such as California, New York, and Oregon, whose state governments have passed laws forcing insurance companies to include coverage for elective abortion in all state-specific health care plans sold in these states.

Will the Graham-Cassidy bill succeed in a politically divided Senate? Stay tuned.


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