PRI Review – September 6, 2018


  • Half-Hearted Measures
  • Title X
  • China Policy

First segment: The Half-Hearted Half-Century

He has failed, he has failed, he has missed his chance

He has just done things by half…

– Robert Service, The Men Who Don’t Fit In


The history of the American Church since Vatican II is riddled with the ruins of abandoned doctrines and responsibilities. The result has been a half-baked mélange of happy-talk, left-wing politics, and content-free moral teaching.

And the major victim in this train wreck was Humanae Vitae.

When Humanae Vitae was promulgated in July 1968, our bishops seemed paralyzed. The savage power of the sexual revolution acted like a non-stop eraser on the blackboard displaying two thousand years of Church teaching. What Pope Benedict XVI called the Culture of Death was in charge, and it rolled over America’s Catholic hierarchy like a steamroller, flattening what was once a richly-structured heritage into a two-dimensional pancake of reaction and collapse.

Perhaps we should call it a donut – because there’s a big empty hole in the middle where the truth used to be.

Humanae Vitae could have been the teaching that formed the foundation of half a century of the Church’s stalwart defense of life, the family, children, and marriage.

But instead, every doctrine and practice that offended the secular culture was buried, while new efforts by the hierarchy to pander to the Culture of Death sprouted everywhere. Folk Masses, pop psychology, faux-religious palaver, and “with-it” priests were the rage. In their struggle to be up-to-date in a rapidly-changing world, our bishops were constantly behind the curve and trying breathlessly to catch up. In many cases, they held on to an empty husk of half-truths, doling out pleasantries while trying to please the City of Man.

In the Church’s noble and timeless tradition, the prudential application of the truths of the faith regarding social and political life has always been subordinate to the magisterial teachings. Prudential approaches can vary; magisterial truths never do.

Vatican II restated this timeless truth in Lumen Gentium, “The Dogmatic Constitution on the Church.” Yet those magisterial teachings that were most needed to clear the confusion were ignored. They were tough, yes, but that wasn’t the problem: they were unpopular. So they were put on ice.

Had our bishops been honest, they could have said, “we will be silent on the magisterial truths of the faith required for salvation because we are cowards; but let us tell you our opinions regarding the issues that in fact belong to the laity – national health care, taxes, the economy, welfare programs, immigration … Yes, we know we’re trespassing on the laity’s turf, but we need to do something with our time, don’t we? After all, we’re bishops.”

They quietly pretended that their views on partisan political issues were the most pressing magisterial teachings of the Church.

Yes, they “just did things by half.” No moral teaching, just politics – lots of it. The lesser of the two halves became the whole. Here they reversed the normal role of authoritative Church teaching – carefully to make distinctions and clarify them; instead, they magically squashed two dimensions of Church teaching into one, and a paltry one at that.

We should note that, in making this move, the bishops chose to embrace the political agenda of left-wing Democrats. Let’s be clear about this fundamental observation: They would have been equally in error had they chosen to champion the agenda of the paleo-conservative wing of the Republican party, or the libertarians, or the monarchists, or the integralists. The simple fact is, partisan hackery is simply not their job. Teaching and defending the timeless truths of the faith is.

What a Trail Of Tears!

This half-baked habit has done profound and lasting damage. Remember the HHS Mandate, requiring Catholic institutions to pay for contraceptive coverage? The bishops were right to oppose this moral outrage, of course. And they could have opposed the policy with moral arguments – after all, every contraceptive act is a concrete violation of natural law and God’s law. But who would listen? They hadn’t taught that doctrine for years. So they responded with appeals to “religious freedom” – a legal abstraction with the moral content sadly missing.

Then came “Same-Sex Marriage.” Bishops were right to oppose that moral outrage as well. But they could not oppose it by stating the obvious – that sodomy is a deadly sin – why, that would be offensive! And who would know what it meant, anyway, except for a few Biblical Protestants?

So they invoked the “dignity of marriage,” which the sodomites immediately insisted applies to them every bit as much as it applies to the genuine article.

In both cases, the bishops got the opposition right, but they had abdicated the moral argument.

In short, having long since abandoned Humanae Vitae, is was simply impossible for them to call on an informed and educated laity to defend “The laws of nature and of nature’s God.” They had just done things by half.

Nowhere had this “laryngitis,” as Cardinal Dolan calls it, damaged the bishops more than in the sexual abuse-and-cover-up scandals. Many seminaries after Vatican II told future priests not to bother with Humanae Vitae because, after all, “it would soon be overturned.” Well, that masterful document explains that there are a lot more sexual sins than contraception. In fact, the act of sodomy denies the natural law as well, and in a much baser fashion.

Bad ideas have very bad consequences. With Humanae Vitae in the closet, sodomy came out of the closet, big time.

“In the past thirty years or so, scientific, psychological, and medical understandings of child sexual abuse evolved significantly,” wrote Donald Cardinal Wuerl to his brother priests in the Washington Archdiocese this past August 13. What was missing? The fact that sodomy was a deadly sin then and it is a deadly sin now. But this artless dodge has been a central ingredient in the bishops’ self-justification narrative since 2002. They have consistently sought to deny the role of homosexuality in the scandals, while insisting that they “didn’t know” that child rape was all that bad.

Well, if “science, psychology, and medicine” didn’t know (a dubious proposition), the Catholic Church knew. The Gospel knew.  You know, “millstones” and all that.

Yet our bishops perpetuated the prevarication. The document, “Questions and Answers Regarding the Canonical Process for the Resolution of Allegations of Sexual Abuse of Minors by Priests and Deacons” on the USCCB site doesn’t mention the word “homosexual” at all. And in thousands of words, the USCCB’s famous report entitled “The Nature and Scope of the Problem of Sexual Abuse of Minors by Catholic Priests and Deacons in the United States” published in 2004 mentions the term only once. Please observe the passage in which it appears:

“Individuals who molest children may be heterosexual, homosexual, or bisexual with regard to victim selection.” (Page 36)

It took the laity on the bishops’ own “National Review Board” to point out that over 80% of the abuse was “homosexual in nature.”

Half baked? Yes, and the bishops kept on baking: the report examined cases, but not causes. The “Charter” the USCCB adopted in 2002 contained the disciplinary procedures to be applied to “priests and deacons” but not to bishops. And the court cases that resulted (because well over 100 of the bishops had covered up for abusers) were civil (demanding monetary damages paid by the faithful), not criminal (demanding the jailing of guilty bishops).

Yes, the guilty bishops among those gathered in Dallas in 2002 could have simply walked out of the hall and handed themselves over to law enforcement; those who had remained silent about the crimes of their confreres could have quietly left their miters at the door and retired.

But they didn’t. They just did things by half.

At their 2002 meeting in Dallas, our bishops adopted the “Child Protection Charter” but unanimously refused the motion of one bishop to study the causes of the scandals. They created all sorts of policies, protocols, and procedures, but refused even to look at the content.

At the time, we got the impression that they didn’t really want to know. Today we know better. The truth is staring us in the face: They knew, but they didn’t want us to know. They just wanted to move on. In February 2002, Kevin Farrell, today a cardinal in the Vatican but then auxiliary Bishop of Washington, said the scandals were “over.” They aren’t over, and today we’re paying the price.

The cause of the scandals then and of the scandals now was homosexuality. And when it comes to Humanae Vitae, Homosexuality is the flip side of contraception: both practices violate the laws of nature and of nature’s God, contraception regarding normal sexual relations, and homosexuality regarding same-sex relations.

Catholic author Mary Eberstadt calls homosexuality the “elephant in the sacristy” – what today has become the elephant in the chancery and the Vatican. Because a majority of our shepherds refused to teach Humanae Vitae for fifty years, apparently many of them didn’t practice it either.

Instead, for half a century they stumbled along with a [bunch] of half-hearted efforts to make peace with modernism, the sexual revolution, and the Culture of Death. The result was predictable: the loss of truth led to a loss of faith and the departure of some fifty million of the faithful from the pews. Our challenge today is to recover the truth – and to demand it of those who are consecrated to teach it – ALL OF IT! These days we are seeing instead countless feeble attempts to cover up the scandals caused by the loss of truth.

Cause and effect, cause and effect. Abandon Humanae Vitae, invite disaster. And today they are reaping the whirlwind. Today our shepherds in the United States are in the midst of an unprecedented crisis. Let us pray that they do not respond with another half-hearted, half-baked “solution.” Those days are over.

[First break[


Second Segment: New “Protect Life Rule” Would Cut Funding to Abortion Providers—But There’s Still Room for Improvement


In June, the Department of Health and Human Services (HHS) issued a new rule proposal that, if adopted, would stop funding for abortion providers through the Department’s Title X family planning program. This “Protect Life Rule” is a good first step, but there are several ways it could be strengthened.

As currently written, the Protect Life Rule would prohibit Title X funding for organizations that perform, promote, offer referrals for, or lobby for abortion unless they maintain a “bright line” of separation between Title X services and abortion. It would prevent abortion providers from offering Title X services in the same facilities and clinics where they perform abortions. Importantly, it would also do away with a Clinton-era regulation that requires all Title X grantees to provide abortion counseling and referrals.

The Protect Life Rule is expected to hit abortion providers like Planned Parenthood hard. Planned Parenthood spends nearly $60 million in funds derived from Title X grants every year, according to a recentreport from the Government Accountability Office. Title X is the second largest source of government funding for Planned Parenthood, representing approximately 11% of all federal and state funds the organization receives.

Democratic governors in 14 states have already sent aletter to HHS Secretary Alex Azar asking him to disapprove the Protect Life Rule, threatening to explore “all possible avenues, including legal options” to stop the policy from taking effect if he doesn’t. Signatories include Democrat Governors Gina Raimondo of Rhode Island, Steve Bullock of Montana, Kate Brown of Oregon, Roy Cooper of North Carolina, and Ralph Northam of Virginia.

Despite the governors’ threat, ghe Protect Life Rule is not likely to be ruled unconstitutional by the federal courts. A nearly identical version of the Protect Life Rule was put in place by HHS under the Reagan and first Bush administrations. When a legal challenge to this Reagan-Bush Title X rule was brought to the Supreme Court in Rust v. Sullivan (1991), the Supreme Court sided decisively in favor of the government. The Court upheld the rule on both statutory and constitutional grounds.[i]

Federal law under the Public Health Service (PHS) Act prohibits Title X funds from being spent in “programs where abortion is a method of family planning.”[1] But despite this provision of the PHS Act, under the Clinton, second Bush and Obama administrations, HHS has allowed abortion providers to use the same facilities, waiting rooms, exam rooms, phone numbers, staff, workstations, and the same financial and patient records for both Title X services and for abortion.

Currently, providers that offer Title X services in facilities that are also used for abortion are only required by the government to pro-rate the costs when utilizing common areas. This has raised serious concerns that federal funds are being commingled with the provider’s abortion activities. It has also raised fungibility concerns that Title X money is being used to indirectly support a Title X grantee’s abortion business by providing revenue for the same facilities that engage in abortion activities. Under current federal regulations, Title X grantees are also required to offer abortion counseling and to provide abortion referrals upon client request, a practice clearly contrary to both the spirit and letter of the PHS Act.

The Protect Life Rule, if adopted by HHS, would help prevent the commingling of Title X funds with abortion services and it would be a step in the right direction in protecting the conscience rights of health care workers.

But while the Protect Life Rule is a significant improvement over the status quo, the proposed rule still falls short of ensuring that Title X funds are not being used to support abortion in Title X projects. The rule also still needs improvement in the area of safeguarding the conscience rights of health care workers in Title X programs. Below, we have listed some recommendations for how HHS can improve the Protect Life Rule. To see a more detailed and complete explanation of these points, you can read our full comment submitted to HHS here.

Our recommendations are:

  1. Stop Title X projects from offering passive abortion referrals

Currently, federal regulations allow Title X grantees to provide abortion referrals to Title X clients if they ask for one or when “medically indicated.”[2] Title X doctors are allowed to provide patients with the names, addresses, and phone numbers of abortion clinics but are not permitted to take further action such as scheduling an appointment at an abortion clinic on the patient’s behalf.

The Protect Life Rule would limit, but not eliminate, the ability of Title X providers to provide abortion referrals. The Protect Life Rule explicitly prohibits Title X projects from providing direct abortion referrals such as providing and identifying for the patient names, addresses and phone numbers of abortion providers. The Rule would also prohibit Title X clinics from providing “any other affirmative action to assist a patient to secure such an abortion.”[3]

However, the Rule, by design, carves out a specific loophole for abortion referrals. The Rule allows Title X doctors to provide patients who want an abortion with a list that includes contact information for both comprehensive health providers and local abortion providers. Title X doctors would only be able to provide this list to patients who have clearly stated that it is their intention to have an abortion and doctors would also be free not to provide this list if they so choose.

While the Rule would prohibit Title X providers from identifying for their patients which providers on the list offer abortion, ultimately, Title X doctors, under this mechanism, would still be providing their patients with information on where they can obtain an abortion. All the patient would have to do in order to find out which ones offer abortion would be to simply call each provider on the list. To illustrate just how easy this is, consider the following fictional scenario which would be completely legal under the Protect Life Rule:

Patient: Can you tell me where I might be able to get an abortion?

Title X Doctor: Federal regulations do not allow me to tell you where you can obtain an abortion, but I can provide you with a list of local health providers. Some of these providers on this list provide abortion.

Patient: Which ones provide abortion?

Title X Doctor: Federal regulations do not allow me to identify which ones provide abortion, but I would just recommend going through the providers on this list in order, calling them one by one and they will be able to tell you right away if they offer abortion care [sic].

And of course, the first provider on this list would be an abortion provider. It would not be identified as an abortion provider on the list itself but there is nothing in the Protect Life Rule that would prohibit a Title X provider from listing an abortion provider first nor is there anything to prevent Title X doctors from advising their patients to call through the list in order. And there you have it, an abortion referral under the new HHS proposed rule.

It is not clear why HHS has created this loophole in the Protect Life Rule. According to the HHS’ own reasoned analysis for the Rule, the PHS Act’s prohibition on abortion “includes any action that directly or indirectly facilitates, encourages, or supports in any way the use of abortion as a method of family planning” (emphasis added).[4]

A version of the Protect Life Rule that was in place during the Reagan and first Bush administrations also included the abortion referral loophole. HHS attempts to justify its position for including the loophole in its proposed rule by pointing to a provision in the annual budget act that stipulates that “all pregnancy counseling shall be nondirective.”[5]

While federal law does require that all pregnancy counseling provided through a Title X program be “nondirective,” there is nothing requiring Title X projects to offer pregnancy counseling in the first place. Indeed, even the HHS in the new proposed rule makes it clear that Title X projects are not supposed to provide pregnancy services of any kind. In its reasoned analysis for the proposed rule, HHS states:

“. . . pregnant women must be referred for appropriate prenatal care services, rather than receiving them within a Title X project, because those services are not part of family planning services within the Title X program.”[6]

There is absolutely no need, then, for Title X projects to be providing pregnancy counseling as these services are outside of the scope of the Title X program. And consequently, HHS should revise its proposed rule to prohibit Title X grantees from providing abortion referrals of any kind, including through providing clients with lists that include information on abortion providers.

HHS needs to decide whether it considers pregnancy counseling a part of Title X programming or it not. The HHS’ current position is logically untenable. It cannot claim to provide pregnancy counseling in some situations and not others. This inconsistency significantly weakens the Department’s position should the Rule be challenged in court.

  1. Stop Title X funding for organizations that perform or promote abortion at off-site locations

Under current federal regulations, abortion clinics are eligible to receive Title X grants.

The Protect Life Rule would prevent facilities that perform abortion from receiving Title X funding. The Protect Life Rule would require Title X grantees to use separate facility entrances and exits, different waiting rooms, exam rooms, phone numbers, accounting and patient records, websites, and workstations for Title X services and for abortion. The Protect Life Rule would thus require Title X grantees to maintain “physical and financial separation” from abortion activities.

However, the Protect Life Rule would not stop funding to organizations that provide abortion at separate off-site locations. To illustrate what this means, consider the following scenario. Under the Protect Life Rule, a Planned Parenthood clinic that provides abortion (we’ll call this “clinic 1”) would not be able to receive Title X funding. But a Planned Parenthood clinic (in the same city let’s say, we’ll call it “clinic 2”) that does not offer abortion inducing drugs or in-clinic abortions on-site may still qualify for Title X funding—that is if they agree to remove all abortion brochures and information from that clinic and if that clinic agreed not to provide abortion referrals, et cetera. In this scenario, both clinic 1 and clinic 2 would be operated by the same Planned Parenthood affiliate, that is to say, they would both be operated by the same organization. But clinic 2 would be eligible to receive Title X funding and the other would not.

Imagine now a scenario where a potential client is seeking Title X services. It is not stretch of the imagination to conceive that the client may accidentally go to clinic 1 expecting to receive Title X services. After all, clinic 2 on the other side of town does. Why would clinic 1, which is operated by the same organization, not also have Title X services? It seems like a logical assumption. But since clinic 1 isn’t bound by the Protect Life Rule, the clinic is free to offer the client abortion information and counseling, something the client would not have otherwise have been forced to endure had they gone to clinic 1 instead.

And since both clinic 1 and clinic 2 are operated by the same organization, there are also fungibility concerns with funding clinic 2. By providing Title X funding to clinic 2, the government is indirectly supporting the abortion business of clinic 1 by providing a source of revenue for the organization as a whole. By funding clinic 2, the government is necessarily endorsing the organization on the whole as well. This could create a false impression for many Americans that the Title X program promotes abortion.

In order to prevent this, HHS needs to revise the Protect Life Rule to require Title X grantees to maintain complete “organizational separation” when engaging in prohibited abortion activities. This means that an organization that wishes to engage in abortion activities must do so with an organization that is legally distinct from the organization receiving Title X funding.

Under this arrangement, the Title X grantee would still be able to engage in abortion activities, but they would have to use a different organization in order to do so. And while even this arrangement is not entirely satisfactory (i.e. the grantee still gets federal funds while being allowed to promote abortion with another organization), it is about the best pro-life advocates can hope for until Roe v. Wade is overturned and the right to life for the unborn is restored.

The Supreme Court in FCC v. League of Women Voters of California (1984) ruled that it is impermissible for the government to force an organization to surrender a fundamental right as a precondition for receiving a government grant. However, in FCC v. League of Women Voters of California and in Reagan v. Taxation With Representation (1983) the Court found that it is permissiblefor the government to require grantees to establish a separate organization with which to engage in First Amendment activities that the government does not want to subsidize. Consequently, HHS cannot require organizations applying for Title X grants to surrender their First Amendment right to free speech (remember, the Protect Life Rule prohibits Title X projects from promoting or lobbying for abortion). However, HHS is able to require Title X grantees to establish a separate organization for engaging in abortion-related activities that the American taxpayers don’t want to pay for.

  1. Exempt health care workers in Title X projects from having to provide assistance or referrals for contraceptive methods that violate their religious beliefs

There are also concerns, under the HHS proposed rule, that there are not sufficient safeguards in place to protect the conscience rights of health care workers when faced with having to provide assistance or referrals for contraceptive methods which may violate their religious beliefs.

Federal regulations currently allow Title X grantees to only provide Natural Family Planning if they so choose, just so long as the Title X project on the whole offers “a broad range” of family planning methods and services.[7] As a result, organizations receiving Title X grants would not have to provide contraceptive methods that they do not want to provide. However, this does not stop Title X grantees from forcing their employees to provide or assist in providing contraceptive methods that may violate their religious beliefs.

Furthermore, the PHS Act and federal regulations appear to require Title X grantees to provide referrals for contraceptive methods that do not provide themselves.[8] This arrangement could be problematic for some organizations or health care workers that may be opposed on religious grounds to providing referrals for certain contraceptive methods.

Federal law under the Church Amendments prohibit Title X grants from requiring any health care worker to perform or assist in an abortion or sterilization in violation of their religious or moral beliefs. The Church Amendments also allow organizations receiving Title X funds to refuse to make abortion or sterilization available in their clinics or facilities. But neither the Church Amendments nor the Department’s regulations on Title X specifically exempt health care workers from having to participate in in their employer’s activities in providing other contraceptive methods besides permanent sterilization.

The Religious Freedom Restoration Act of 1993 (RFRA), however, states that the government “shall not substantially burden a person’s exercise of religion.”[9] The government can only abridge the right to free exercise of religion if (and only if) it can prove that a) such a restriction advances a “compelling interest” of the government and b) that such an interest is advanced in the “least restrictive means” possible.[10] Essentially, RFRA makes it clear that any attempt to restrict the free exercise of religion by the government is subject to strict scrutiny, i.e. it is subject to the most rigorous standard of judicial review.

In Burwell v. Hobby Lobby Stores, Inc. (2014), the Supreme Court ruled that the Obama administration’s HHS Contraceptive Mandate, forcing all employers to pay for all FDA-approved methods of contraception in their employee’s health care plans, was a violation of RFRA.

As federal regulations on Title X appear to require Title X grantees to provide referrals for all family planning methods except abortion, the situation is not wholly different from the Hobby Lobby case. Thus, HHS, in compliance with its statutory requirements under RFRA, should revise its proposed rule to specifically exempt health care workers in Title X projects from being required to offer referrals or assistance in providing family planning methods which violate their religious beliefs.

  1. Make it clear that providing training or technical assistance in support of abortion are prohibited under the Protect Life Rule

The Protect Life Rule makes it clear that Title X projects “may not perform, promote, refer for, or support, abortion as a method of family planning, nor take any other affirmative action to assist a patient to secure such an abortion.”[11] It would seem from this that HHS would consider training and technical assistance for abortion as activities that “support” abortion.

Indeed, it would clearly seem contrary to the PHS Act if Title X grantees were allowed to use Title X funds to provide training on abortion methods, training on abortion lobbying, or technical assistance for abortion clinics by tracking abortion service statistics or abortion equipment inventory.

However, HHS should not leave room for interpretation on this point. Training and technical assistance are noteworthy and distinct activities on par with performing, promoting, or referring for abortion. §59.16 of HHS’ proposed rule further specifies that Title X projects may not lobby for abortion, take legal action on abortion issues, advertise for abortion, or pay dues to associations that promote abortion as a significant part of their activities. Providing training or technical assistance for abortion is not an uncommon activity for organizations that engage in abortion advocacy. Thus, a specific prohibition on training and technical assistance (TA) in support of abortion—or for that matter, training or TA in support of organizations that promote abortion as a more than insignificant part of their activities—would provide greater clarity in implementing the Department’s regulations.

As we noted above, the Trump Administration’s “Protect Life Rule” is a good first step, but adopting these four suggestions would strengthen it even further.

[i] See Rust v. Sullivan, 500 U.S. 173 (1991); see also Compliance with Statutory Program Integrity Requirements, 83 Fed. Reg. 25,502, 25,503 (Jun. 1, 2018) (proposed rule to be codified at 42 C.F.R. pt. 59).

[1] Public Health Service Act, sec. 1008 (codified as amended at 42 U.S.C. § 300a–6).

[2] See 42 C.F.R. § 59.5(b)(1).

[3] 83 Fed. Reg. 25,502, 25,531 (proposed rule to be codified at 42 C.F.R. § 59.14(a)).

[4] Compliance with Statutory Program Integrity Requirements, 83 Fed. Reg. 25,502, 25,505 (Jun. 1, 2018) (proposed rule to be codified at 42 C.F.R. pt. 59).

[5] Consolidated Appropriations Act, 2018, Div. H, Title II, Pub. L. No. 115–141, 132 Stat. 716-17 (2018).

[6] Compliance with Statutory Program Integrity Requirements, 83 Fed. Reg. 25,502, 25,505 (Jun. 1, 2018) (proposed rule to be codified at 42 C.F.R. pt. 59).

[7] See 42 C.F.R. § 59.5(a)(1); see also Public Health Service Act, sec. 1001 (codified as amended at 42 U.S.C. § 300(a)).

[8] The PHS Act requires States applying for federal Title X funding to demonstrate to the HHS a “plan for a coordinated and comprehensive program of family planning services” (Public Health Service Act, sec. 1002 (codified as amended at 42 U.S.C. § 300a(a))). Implicit in the term “coordinated” is the ability of Title X providers to offer referral services. Under current federal regulations, Title X grantees are required to “Provide for coordination and use of referral arrangements with other providers” (42 C.F.R. § 59.5(b)(8)). Thus, it would seem that the Department would require Title X grantees to provide referrals for contraceptive services that they do not provide themselves. The Protect Life Rule would only modify this requirement by prohibiting Title X doctors from making abortion referrals but would not otherwise provide any exemptions for health care worker objecting to contraceptive methods referrals on religious grounds.

[9] Religious Freedom Restoration Act of 1993, Pub. L. No. 103-141, 107 Stat. 1488 (codified as amended at 42 U.S.C. § 2000bb–1(a)).

[10] Id. at 42 U.S.C. § 2000bb–1(b).

[11] 83 Fed. Reg. 25,502, 25,531 (proposed rule to be codified at 42 C.F.R. § 59.14(a)).

[Second Break]


Third Segment: China Stepping Up Measures to Boost the Birth Rate


Provincial and Local Party Committees are “Mobilizing the Masses” to Reproduce

Since the Chinese Party-State abandoned its one-child policy two years ago, birth rates across in China have remained stubbornly low. Communist Party officials are beginning to worry that, despite being allowed to have a second child, many couples are choosing not to.

Perhaps that is why the two-child policy is being referred to as a “comprehensive two child policy” or a “full two children policy,” The implications are that couples are not only limited to two children but that they should also be encouraged to fill their two-child quota.

Facing the prospect of population aging and a contracting labor force, China adopted a two-child policy in 2015, in the hopes that the rule change would help spark a baby boom. The Chinese Government also took some steps to lessen the planned birth policy restrictions such  as offering registration (hukou) to children born ‘illegally’ under the previous one-child policy.

Soon after the new policy was announced, provincial-level governments revised regulations to extend the amount of time women can take off for maternity leave. Chinese national policy recommends that women be given 98 days maternity leave, with an additional 15 days for difficult births and multiple births. Province-level regulations add additional time to the national standard. After the two-child policy was adopted, most provinces have extended province-level maternity leave time to 1-3 months on top of the 98 day national standard, allowing women in most provinces to take anywhere from 128-188 days maternity leave. Tibet is the most generous in this regard, allowing women as much as a full year of maternity leave.

Despite these changes, birth rates in China have continued to decline over the past year and a half. As a result, some local Party committees are now taking more proactive measures to boost the birth rate. If successful, these policies will be replicated at the provincial and, possibly, ultimately, at the national level.

Earlier this year in June, Shihezi City, a city in China’s far western Xinjiang Uyghur Autonomous Region, revised its ordinances to encourage couples to have two children by extending maternity leave for women who give birth to their second child, allowing women to count prenatal doctor visits as work time, and requiring that employers pay women the same salary when on maternity leave as when working. Moreover, Shihezi also now offers women giving birth to their second child a 500 yuan allowance for hospital delivery and 1,000 yuan allowance for a cesarean section delivery. The Shihezi Government will also provide parents with subsidies for milk powder until the child is three years old.

In July 2016, a few months after revising its family planning regulations to begin implementing the two-child policy, the Hubei provincial government rolled out a pilot program designed to encourage couples to have a second child. The program provides a variety of benefits including free basic fertility services, pre-natal and post-natal exams, pre-pregnancy “eugenics” exams, and provides subsidies for basic childbirth hospitalization fees. Since then, 34 counties and cities in Hubei Province, including two mid-size cities, have adopted aspects of the program.[1]

Last summer, Yichang City, a mid-sized city[2] in Hubei Province, began implementing a policy where women giving birth to their second child are given a 2,500 yuan subsidy to pay for hospital delivery fees. Yichang has also decided to offer parents with two or more children financial support to pay for early childhood education. Couples who qualify could receive education grants as much as 10,000 yuan per child. Similarly, Xiantao City, another city in Hubei, provides 1,200 yuan for the hospital delivery costs associated with the birth of a second child.

Another city in Hubei Province, Xianning City, went even further with a new policy issued earlier this month. The new policy, entitled “Advice on How to Speedily Implement a Full Two Children Support Policy,” extends the maternity leave period in Xianning from 128 days to 6 months and additionally adds a full month of paternity leave. The new policy also provides families with two children with access to extensive, exclusive benefits including subsidies for housing, more favorable terms on loans for buying a house, reduced-cost or free medical services associated with childbirth, and reduced tuition for early childhood education.

One city in China’s Shanxi Province is even providing cash subsidies to couples to help offset the cost of getting married. Engaged couples can apply for financial support for a variety of nuptial-related purchases, including wedding rings, autos, wedding venues, honeymoons, and household appliances.

Yichang City raised eyebrows in 2016 when its Health and Family Planning Commission issued an open letter calling on all Communist Party members in the district to “take the lead in responding to the Party Central Committee’s call” to have a second child. Younger Party members were advised to lead by example, exhorting them that “doing it starts with me,” while older comrades were told to “educate and supervise their children” in order that they might encourage their children and grandchildren to have a second child. Party members of all ages were urged to “take various measures to mobilize the masses to actively achieve a ‘full two children policy.’ ”

But it is not only local city governments that are introducing sweeping policies to promote fertility. Provincial-level governments are also beginning to jump on board the new pro-natal bandwagon. In July, Liaoning Province released its Population Development Plan 2016-2030, outlining a series of proposals for policies to increase the number of births in the province. The Liaoning Population Development Plan calls forimprovement in the areas of taxation, health and maternal insurance, education, and housing policy to encourage couples to have a second child and to reduce the burden of costs associated with childbirth and childrearing. Liaoning also proposes to extend the period for maternity leave, invest in child-care centers, scale-up the capacity of maternal and child health facilities, and promote policies that allow nursing and pregnant women to have the flexibility to care for their children without having to sacrifice their jobs in the process.

The Chinese central government also may soon play a larger role with birth encouragement subsidies. Last month, China’s cabinet, the Office of the State Council, issued a notice stating that Beijing will soon issue national standards for such policies and that local governments will be reimbursed for associated costs.

According to Steven Mosher, President of the Population Research Institute and an internationally-renowned China expert, this latest move by Beijing is a clear signal that the Chinese Government will take a much more authoritative role in promoting births across the country.

“The Chinese Party-State is clearly moving quickly towards the development of a national policy when it comes to encouraging everyone to have two children, and it is moving to put some financial muscle behind the effort,” Mosher says.

“China’s tax regime is heavily biased against provincial and local governments,” Mosher says, “They only receive about half the tax revenue, but they are currently responsible for about 80 percent of all expenses, including in the area of pensions, education, and health.”

Observers have called Beijing’s plan to cover some of the costs of family planning subsidies “a major reform.” The policy is slated to take effect in 2019.

The Communist Party has made a number of moves as of late that suggest that it may soon abolish birth limits under its planned birth policy in order to spur population growth. Yesterday, the Standing Committee of the National People’s Congress (NPC), China’s rubber-stamp congress, released a statement indicating that the draft of the new Civil Code “will no longer retain the relevant content of family planning,” according to CNN. While the NPC’s statement did not indicate whether the Communist Party will do away with government-mandated birth limits, the move has further added to already mounting speculation that the Chinese Government may soon abolish its two-child policy. The new Civil Code is slated to be completed by 2020.

In recent months, the state-controlled media have been publishing “opinion pieces” about the need to reverse China’s low birth rate.  It wasn’t so long ago that articles in the People’s Daily were urging the masses to stop having children “for the good of the country.” In a remarkable about face, articles are now published encouraging births. An article that recently appeared in the People’s Daily asserted that increasing the birth rate is a matter of national concern, stating “the birth of a baby is not only a matter of the family itself, but is also an event of national importance.” Similarly, a recent articlepublished Xinhua News Agency criticized “young people who are unwilling to bear and raise children,” saying that this shows that “the new pro-natal policies in support of two children families are absolutely necessary.”

Other proposals to create incentives to motivate couples to have children have been proposed. An article that appeared in the Xinhua Daily on August 14 even went so far as to propose a tax on all Chinese citizens under the age of 40 to fund a “maternity fund” that would be used to finance social support payments and benefits to couples who have a second child. Individuals without a second child would be able to withdraw funds from the “maternity fund” only when they retire. The Xinhua Daily piece ignited a firestormon Chinese social media and even garnered attention abroad as the proposal was criticized as a coercive and was being compared to the steep fines under the one-child policy that were levied on couples who exceeded their government-mandated birth quotas.

“The fact that such an article would be published by a Communist Party mouthpiece like the Xinhua Daily means that these proposals are under active consideration in official circles,” Mosher says.

Mosher cautions that the Chinese Communist Party, which only a short time ago resorted to force and coercion in preventing couples from having more than one or two children, could resort to more coercive measures if their attempts to boost the birth rate are not successful.

“With provincial and local Party committees “mobilizing the masses” to reproduce, can even more coercive measures be far behind?” Mosher says, “The Chinese Communist Party has never acknowledged, much less apologized for, the tens of millions of forced abortions and forced sterilizations that occurred under its one-child policy. And it never will.”