Shuffling federal funds to pro-life centers not an easy task

CEO Jim Harden of CompassCare Pregnancy Services in New York estimates the organization’s five centers provide upwards of $3 million worth of free medical care to women each year. Like many pro-life pregnancy centers, CompassCare does not receive any government money, and Harden doesn’t plan to change that anytime soon.

“We could theoretically apply for funding,” said Harden. “But we’d have to submit to the state’s regulations around their definition of ‘comprehensive reproductive healthcare,’” which includes endorsement of abortion.

With a more pro-life administration in the White House, some pro-life groups want to defund Planned Parenthood and give that funding to pro-life centers. But supporting pregnancy centers with money that otherwise would have gone to the abortion giant might not be so straightforward because many pro-life providers are ineligible for some funding programs, face discrimination, or—as in Harden’s case—opt out voluntarily.

Less than two weeks before President Donald Trump’s inauguration, Rep. Michelle Fischbach, R-Minn., reintroduced the Defund Planned Parenthood Act. Days after his return to the White House, Trump issued an executive order reaffirming the Hyde Amendment, which prohibits federal funding of abortion. Earlier this month, the Trump administration began withholding a portion of federal funding from 13 Planned Parenthood affiliates that used the funds to subsidize things like birth control and screening for sexually transmitted infections.

On April 2, the U.S. Supreme Court heard arguments in Medina v. Planned Parenthood South Atlantic over whether states can exclude Planned Parenthood as a Medicaid provider. The Ethics and Religious Liberty Commission of the Southern Baptist Convention joined with other pro-life groups to file a friend-of-the-court brief in the case. In a statement, ERLC called for defunding Planned Parenthood, adding that the taxpayer dollars should go “to pregnancy resource centers and other organizations that provide comprehensive care and support for mothers and families—without performing abortions.”

Since the first pro-life pregnancy centers—also called crisis pregnancy centers or pregnancy resource centers—opened in the late 1960s, most have relied on donor support. According to 2022 data from the pro-life Charlotte Lozier Institute, pregnancy centers nationwide that year provided roughly $367 million worth of free services for families in need, including ultrasounds, baby clothing, and sex education presentations.

Many states do not offer much, if any, support for pro-life pregnancy centers though funding programs aimed at sponsoring the centers have gained traction in some conservative states. But state-level support for the centers is increasing. Between 2022 and 2023, Arkansas, Iowa, Tennessee, and West Virginia earmarked pro-life center funding for the first time, and states overall allocated almost $77 million more in 2023 than they had the previous year. Eighteen states now offer alternatives to abortion funding, with Texas and Florida designating a combined $100 million yearly for in-state pro-life providers.

Still, of the roughly 2,600 pro-life pregnancy centers nationwide, only about 17% receive state or federal funding. Some centers worry that funding will come with strings attached, and others point to bureaucratic steps that complicate funding requests.

The pro-abortion Reproductive Health and Freedom Watch reported earlier this month that what it called “unregulated pregnancy clinics” have received millions of dollars in taxpayer funding “without the budgetary oversight typically required of licensed medical facilities.” A 2024 study from the University of California, San Diego, tallied how many of the centers nationwide promote abortion pill reversal, which the study claimed “lacks FDA approval or scientific support and may cause harm.” Other reports and mainstream media outlets have accused pregnancy centers of spreading misinformation about the risks of abortion, bringing funding for pregnancy centers under a microscope.

“We have serious concerns that [these centers] continue to receive millions in federal aid with little transparency and accountability to the public,” Reps. Jamie Raskin, D-Md., and Maxwell Frost, D-Fla., wrote in a July letter to the Government Accountability Office.

Jor-El Godsey, president of Heartbeat International, believes these accusations are baseless. “The idea that pregnancy centers are not accountable for what they receive and how they spend it is a bit far-fetched,” he said, adding that the centers are accountable to their boards of directors, donors, and, if they have tax-exempt status, the government.

But even when government funding is available, the difficulty of securing it prevents many pregnancy centers from making requests, said Heritage Foundation scholar Melanie Israel. “Applying for those grants and staying in compliance … is a really time-consuming process,” she said. “A lot of organizations have people who work for them full time, specifically just handling grants. It’s a massive undertaking.”

That’s why pregnancy center conglomerates like Obria Medical Clinics are more likely than smaller centers to apply for federal grants. First launched in 1970, the federal Title X Family Planning Program allocates funding for services like contraception and STD testing for low-income or uninsured individuals. It’s one of the main federal grants given to Planned Parenthood.

Of the nearly $700 million the abortion provider annually receives from government grants, a little over $20 million comes from Title X. That portion could theoretically be redirected towards larger pregnancy centers. But the majority of government money going toward Planned Parenthood comes from Medicaid.

“Give the $700 million to pregnancy resource centers instead,” pro-life nonprofit Live Action said in a March 9 social media post. Even if the Supreme Court ruled that states can exclude Planned Parenthood as a Medicaid provider, defunding the abortion giant would not necessarily lead to more pro-life funding.

“It’s defunding in the sense that you will no longer be allowed to participate in this program,” said Israel. She clarified that Planned Parenthood’s Medicaid funding couldn’t easily sponsor abortion alternatives. Most pregnancy resource centers wouldn’t be eligible to serve as Medicaid providers, since few offer healthcare services beyond ultrasounds. That’s not to say the abortion provider corners the market for Medicaid-sponsored services. In 2019, health clinics that did not offer abortions provided Medicaid-covered care for almost six times the total number of all Planned Parenthood patients, according to the Charlotte Lozier Institute.

Some centers intentionally don’t apply for government funding due to concerns about having to comply with federal or state regulations about how to spend the money.

Temporary Assistance for Needy Families (TANF) is a federal program for low-income families, in part designed to “reduce the incidence of out-of-wedlock pregnancies.” The federal government allows states to distribute TANF funds to providers. Missouri, Ohio, Louisiana, and Indiana direct TANF funds to pregnancy resource centers.

During the Biden administration, the Department of Health and Human Services proposed a rule prohibiting pro-life pregnancy centers from receiving TANF money. Many centers stopped receiving TANF funds.

“Either they actively became ineligible, or they worried that there would be requirements to refer or counsel or say positive things about elective abortion if they participated in the program,” said Katie Glenn Daniel, director of legal affairs and policy counsel at Susan B. Anthony Pro-Life America. The Biden administration withdrew the proposal in late 2024.

Legislative efforts could protect pregnancy centers from such funding discrimination. In March, Rep. Chris Smith, R-N.J., reintroduced the “Let Pregnancy Centers Serve Act,” which would, among other things, prohibit the federal government from discriminating against pregnancy centers that receive federal financial aid on the basis of their pro-life beliefs.

But for now, some pregnancy centers outside of conservative states might remain wary of applying for federal or state dollars. “A lot of pregnancy centers in other states like New York are very, very hesitant to even apply to receive funding, because it comes with strings attached that would violate our conscience,” said CompassCare’s Harden.

Harden believes that pro-life pregnancy centers will remain committed to providing alternatives to abortion, since they have operated without much state or federal support for decades. But he agreed that government funding without requirements to endorse abortion could help them provide even more services to more women and babies. “Pregnancy centers basically do everything except for abortion. And meanwhile, abortionists do nothing but abortion, and for a fee, and we do everything for free,” said Harden. “We should be the ones getting all this money.”