Trump’s Republican Trifecta Sets Up Massive Transfer of Tax Dollars from Reproductive Health Clinics to Unregulated Crisis Pregnancy Clinics

Trump, Republicans and antiabortion extremists are dismantling reproductive care for low-income women, funneling them into ideological clinics masquerading as health centers.

Within days of the 2024 election, antiabortion leaders were calling on the incoming Trump administration to “defund” Planned Parenthood and redirect federal funds to “pro-life” pregnancy centers. As of this summer, all three Republican-dominated branches of our federal government are working in tandem to realize this mission: to replace the infrastructure of publicly funded, evidence-based reproductive healthcare with a network of unregulated pregnancy clinics (UPC)—also known as crisis pregnancy centers—nationwide.

Together, the Trump administration, 119th Congress and the John Roberts-led Supreme Court are engineering a massive repurposing of federal tax dollars away from Planned Parenthood and the Title X family planning program, while also boosting direct federal funding streams, to further bankroll the $2 billion UPC industry and position it to replace reproductive health clinics in all 50 states.

As Republicans aggressively move this project forward on multiple fronts—with Congress and the Court stripping Planned Parenthood of Medicaid reimbursement eligibility, and Trump stripping Planned Parenthood and other family planning providers of Title X grants—UPC industry leaders have been vigorously lobbying for those funds, to “replace that broken model with real life-affirming support for women.”

The UPC industry has long maneuvered to “replace” Planned Parenthood. The Obria Group, for example, was founded in 1981 as a “medical model” crisis pregnancy center network, for the express purpose of drawing funding away from Planned Parenthood. In 2005, Texas created its UPC grant program—now the largest state funding program in the country—with the explicit intent to redirect public funds from Planned Parenthood to crisis pregnancy centers.

But since the fall of Roe, antiabortion operatives have been ramping up a narrative that these unregulated pregnancy clinics are the answer to growing reproductive and maternal healthcare deserts across the country. Now they claim UPCs are providing comprehensive healthcare, filling gaps in prenatal and postpartum care, even addressing the maternal and infant mortality crisis. 

These claims are manifestly false.

UPCs are largely religious nonprofits that pose as health clinics while operating free of the health, safety, licensing and patient privacy standards that govern Planned Parenthood health centers and other medical offices. Not only is this industry entirely ill-equipped to provide maternal or infant healthcare—UPCs do not come close to meeting American College of Obstetricians and Gynecologists’ (ACOG) Level 1 requirements for Basic Maternal Care, as they provide no neonatal services—their very mission, to prevent people from accessing abortion, is in direct conflict with providing actual, even lifesaving, healthcare.

In fact, shocking new revelations about UPC ultrasound and ectopic pregnancy practices show these antiabortion sites pose an urgent threat to pregnant people and the public health. New research from Reproductive Health and Freedom Watch documents that all three major UPC networks are training staff and volunteers not to scan women they suspect have ectopic pregnancies. Rather than prioritizing patient safety, UPC staff are instructed not to diagnose this life-threatening condition, not to follow up with at-risk women and, above all, not to assume liability.

As one industry trainer told UPC staff this spring:

“She’s already got a provider. Dump it back on them.”

The UPC industry is also taking in billions in revenue that it does not appear to spend on pregnancy services of any kind. UPCs reported almost $2 billion in revenue in 2023 and client services worth only $258 million in 2022.

All three major UPC networks are training staff and volunteers not to scan women they suspect have ectopic pregnancies.

Moreover, this industry operates essentially free of oversight of taxpayer funds it already receives. Since 2017, millions in federal tax dollars have gone to UPCs under multiple funding streams, including Temporary Assistance for Needy Families, the Title V Maternal and Child Health (MCH), Teen Pregnancy Prevention (TPP), and Sexual Risk Avoidance Education (SRAE). A 2024 report found a notable “lack of transparency and accountability” in federal grants to UPCs, with funds going to “organizations that do not follow national, evidence-based standards and guidelines.”

On the state level, the scale of public funding without accountability is staggering: Between 2019 and 2024, Republican-led states awarded UPCs over half a billion in taxpayer dollars, despite serial reports of fraud, waste and illegal use of these funds in multiple states.

Baptist News Global recently reported that “ballooning” state funding of UPCs “has been awarded with little or no oversight, resulting in a cascade of waste and abuse documented by reporters. … It’s not clear what those taxpayer funds have yielded because states have been lax in oversight and reporting. Funds are awarded, but few questions are asked.”

Now, in the face of this entirely discrediting record, Republican officials are barreling ahead to infuse this unaccountable, unregulated ideological industry with an exponential increase in federal funding—absent any evidence it needs more taxpayer dollars, given its swelling private reserves, and despite ample evidence of wasteful, even fraudulent, use of taxpayer dollars it already receives.

“Defunding” Planned Parenthood Part 1: Medicaid

On June 26, the Supreme Court ruled in Medina v. Planned Parenthood South Atlantic that South Carolina can exclude Planned Parenthood from the Medicaid program because it provides abortion care.

Losing Medicaid funding puts at least 200 Planned Parenthood health centers across the country at risk for closure …

Since Medicaid reimbursement for abortion is already prohibited under the 1976 Hyde Amendment, the ruling targets all other Planned Parenthood services: cancer screening, FDA-approved contraception, prenatal care, vaccinations, sexually transmitted infection testing and treatment, and more. South Carolina argued, and the Court ruled, that because it provides abortion—which accounts for just 4 percent of Planned Parenthood services—it should not be reimbursed for any services for Medicaid-eligible patients.

The Court also rescinded patients’ and providers’ right to challenge that exclusion under federal law, and gave any state the green light to block Planned Parenthood from its Medicaid program.

Then, on July 3, congressional Republicans passed HR 1, the so-called One Big Beautiful budget reconciliation bill, which prohibits health providers that offer abortion from Medicaid reimbursement for any health services. Trump signed it into law on July 4; antiabortion actors celebrated the “defunding” of Planned Parenthood.

Planned Parenthood plays a singular and irreplaceable role in the U.S. healthcare system as the nation’s leading provider of sexual and reproductive health services and the only source of healthcare for millions of Americans. Three-quarters of its health centers are located in rural or medically underserved areas. Over half of its patients are covered by Medicaid or the Title X family planning program. Losing Medicaid funding puts at least 200 Planned Parenthood health centers across the country at risk for closure, and more than 1 million low-income Americans at risk to lose access to care.

Not only is the Republicans’ one-two punch to defund Planned Parenthood this summer a backdoor ban on abortion nationwide—it is a sweeping effort to dismantle the reproductive healthcare safety net for low-income and uninsured Americans, and endow unregulated pregnancy clinics governed by conservative Christian mission to replace evidence-based care with ideological control.

Planned Parenthood Federation of America has sued to challenge the Medicaid ban. On July 28, a federal judge issued a preliminary injunction blocking the provision and ordering the administration to continue reimbursing Planned Parenthood clinics for Medicaid-covered services as the legal challenge proceeds. Maine Family Planning, also targeted in the budget bill, has filed a separate lawsuit to block the ban.

UPC Industry Lobbies for Federal Funding to “Fill the Gaps”

UPC industry leaders have long lobbied for the federal dollars covering Planned Parenthood patients.

In 2017, National Institute of Family and Life Advocates (NIFLA) CEO Thomas Glessner stated that Planned Parenthood “must be defunded” and that the funding should go to “pro-life centers instead of abortion profiteers, (where) vulnerable women would be far better off.” 

In 2023, the Texas-based UPC group Human Coalition published “The Complete Guide to Defunding Planned Parenthood: A Life-Affirming System of Care Can Make PP Obsolete.”

But over the past year, the industry and its allies have mounted a full-court press.  

Project 2025 calls for federal regulations to disqualify Planned Parenthood from Medicaid and end “religious discrimination in grant selections.” Journalist Jessica Valenti calls this what it is: “code for giving federal dollars to crisis pregnancy centers.”

The global UPC network, Heartbeat International (HBI), filed an amicus brief in the Medina case asserting “the life-giving work performed by pregnancy centers as further evidence that South Carolinians can receive excellent care without the state’s two Planned Parenthood locations.”

CatholicVote.org’s Kelsey Reinhardt responded to the ruling by urging lawmakers “to redirect support to organizations that uphold the dignity of both mother and child—especially the thousands of pregnancy resource centers that offer real help to women.”

USA Today columnist and “pro-life mom” Nicole Russell wrote, “Women need health care, but Planned Parenthood should function without taxpayer subsidies. Thousands of other providers also are available to help women with medical care,” hyperlinking to the nationwide CPC Map website.

Alliance Defending Freedom, which represented South Carolina in Medina, is the group behind the case that overturned Roe and over 20 lawsuits to block UPC transparency measures. ADF celebrated the ruling to “direct Medicaid funding … to comprehensive health care rather than entities that exist primarily to perform abortions.”  

UPC industry actors also pressed this message around the budget bill.

In June, HBI CEO Jor-El Godsey hosted a Facebook event to “demand Congress DEFUND the abortion industry and replace their broken model with real, life-affirming support for women.” 

Following its passage, Godsey wrote, “This bill is not about restricting care; it’s about restoring true care.”

When the Planned Parenthood clinic in Tyler, Texas, announced it would close in the wake of the bill, Texas Right to Life posted: “We pray that pregnancy resource centers near Tyler will continue to rise to meet the need—stepping in where Planned Parenthood once profited.”

House Speaker Mike Johnson Falsely Claims UPCs Are Federally Qualified Health Centers

In the lead-up to the budget vote, Students for Life sponsored “Big, Beautiful Mobilization Month to Defund Planned Parenthood.”

Messaging promoted disinformation about Planned Parenthood and mobilized activists to broadcast this message:

“Redirect Tax-Dollars to Life-Saving Healthcare: We don’t need Planned Parenthood because women can receive ethical, life-affirming care from almost 20,000 Federally Qualified Health Centers & 3,000+ Pregnancy Resource Centers.”

Tellingly, House Speaker Mike Johnson (R-La.) had already told an antiabortion gathering that unregulated pregnancy centers are federally qualified health centers. 

In his keynote speech for Susan B. Anthony Pro-Life America’s April 2025 gala, Johnson said Trump’s “big beautiful bill … is going to redirect funds away from big abortion and to federally qualified health centers as has been discussed, that’s right. I’m so grateful to SBA and the Charlotte Lozier Institute that have been so instrumental in raising awareness about these important centers, which provide comprehensive care for the vulnerable. … I’m so proud of the over 2700 pregnancy resource centers around the country helping more and more women to choose life.”

According to the Health Resources and Services Administration, federally qualified health centers (FQHCs) provide comprehensive sliding-fee health services including preventive, dental, mental health, substance abuse, hospital and specialty care for an underserved area or population, operate under an ongoing quality assurance program and qualify for federal funding and reimbursement from Medicare and Medicaid.

By contrast, pregnancy centers are unregulated religious nonprofits, typically affiliated with national antiabortion groups, which offer pregnancy-related counseling, resources and three medically-adjacent services (pregnancy tests, non-diagnostic ultrasounds, STI tests) and oppose contraception, abortion and comprehensive sexuality education. They are not classified as medical practices and do not charge for services, so are exempt from the regulations, clinical oversight, health and safety standards and privacy laws that govern FQHCs.

But Johnson’s conflation of UPCs with FQHCs should be understood as forecast, not flub. Congress has only funded actual FQHCs through September. The National Association of Community Health Centers reports that short-term funding is severely impacting FQAC’s ability to “recruit and retain staff” and that “42 percent of health centers have only 90 days or less of cash reserves.”

[Unregulated pregnancy clinics] are not classified as medical practices and do not charge for services, so are exempt from the regulations, clinical oversight, health and safety standards and privacy laws that govern [federally qualified health centers].

“Defunding” Planned Parenthood Part 2: Title X

Title X is the only federal program funding family planning and preventive reproductive health services for low-income patients. During his first administration, Trump’s HHS changed the Title X rules to prohibit programs providing abortion referrals from eligibility and awarded $1.7 million in Title X funds to The Obria Group, a pregnancy center network “led by God” and committed to never dispensing contraception.

When he was reelected, antiabortion leaders called for Trump to reinstitute his previous Title X changes and reopen the door for UPCs to apply. 

On March 31, 2025, Trump’s administration abruptly froze $65.8 million in Title X funding for 16 recipients in more than 20 states.

As of this summer, 12 of those grantees operating close to 300 clinics—including all the Planned Parenthood health centers affected—remain stripped of that funding.

Planned Parenthood is one of the largest Title X providers in the country. As of late July, the funding freeze has forced closure of at least 32 Planned Parenthood clinics across nine states, including states where abortion is banned and Planned Parenthood only provides other care.

A combined loss of Title X and Medicaid will effectively defund Planned Parenthood.

Using Title X to this end has long been an antiabortion movement tactic; in 1997, “pro-life” strategist Michael Schwartz wrote, “After they are barred from getting Title X funds, that can be expanded to any funds under Labor/HHS and then to all federal funds from any source.” UPC network NIFLA published Schwartz’s strategy memo.

As Trump strips Title X funding from Planned Parenthood and other evidence-based providers of comprehensive care, his administration is preparing to redirect funding from contraception to a fringe infertility approach pushed by conservative groups opposed to vitro fertilization (IVF) and FDA-approved contraception, including Project 2025 and its sponsor The Heritage Foundation.

This summer, HHS posted a $1.5 million Title X grant to create an “infertility training center” to support “root cause infertility diagnostic treatments and referrals.” Title X-funded programs already provide basic infertility services, including testing, counseling and free ovulation kits. This “root cause” approach—also known as “restorative reproductive medicine”—has been publicly criticized by ACOG as “non-medical” and “unproven.” 

The American Society for Reproductive Medicine warns policymakers:

“It is crucial to be vigilant against misleading terminology, such as “Restorative Reproductive Medicine” (RRM) … which can be used to promote ideologically driven restrictions that could limit patient care. What distinguishes RRM is not medical practice but ideology. It typically excludes IVF and related treatments on moral or religious grounds, not clinical evidence.”

The proposed “fertility training center” will also funnel funds to the UPC industry by “enhancing referrals between Title X-funded clinics and root cause infertility specialists.”

The UPC industry is rife with such “specialists.” Dr. Karen Poehailos, for example, a “restorative” fertility consultant and Medical Provider for the RMM group FEMM Health, serves as assistant medical director for NIFLA and on the Medical Advisory Team for Heartbeat International’s Abortion Pill Rescue Network. NIFLA, Heartbeat International and Care Net all offered RRM training at their national conferences this past year.

As we watch for a straight-up Title X rule change to officially disqualify Planned Parenthood from eligibility, enable UPCs to qualify and as extremist groups push the administration to reject public funding for IVF, Trump has eliminated the Centers for Disease Control’s IVF team and abandoned his promise to mandate insurance coverage for IVF. 

Now his HHS is siphoning federal funds away from contraception for a fertility treatment endorsed by UPC industry actors who oppose contraception and IVF. The objective: to advance a conservative religious agenda that promotes childbirth and undermines evidence-based care, both on the public dime.

A combined loss of Title X and Medicaid will effectively defund Planned Parenthood.

Boosting Direct Federal Funding for UPCs

Department of Health and Human Services

In May, Senator Katie Britt (R-Ala.) reintroduced her MOMS Act to create a federal grant program for UPCs at the Department of Health and Human Services (HHS). The bill also directs HHS to create a federal website where women will register their pregnancies with the government and be referred to UPCs.

UPCs already access millions in federal grants annually through multiple HHS programs. In a press release announcing the MOMS Act, Britt identified declining U.S. birth rates as the primary reason an additional direct-grant program for UPCs at HHS is needed, indicating her bill would “increase access to adoption agencies, pregnancy resource centers, and other relevant public and private resources available to pregnant women.”

Since Republicans are rapidly defunding public resources for pregnant women and their infants, and these HHS grants would be prohibited to any entity providing or referring for abortion, it is clear this bill is a vehicle to funnel new federal dollars to private UPC industry groups.

It is also a backdoor fetal personhood bill. An “Unborn Child Support” provision in the MOMS Act would allow states to apply child support obligations from “the month in which the child was conceived.” The bill is currently in committee.

Department of Housing and Urban Development

On Aug. 5, the Gwinnett County, Ga., Board of Commissioners narrowly approved $450,000 in Housing and Urban Development (HUD) funding for the Georgia Wellness Group (GWG) UPC—$400,000 of which will fund a maternity home.

Until this year, GWG was part of the Obria crisis pregnancy center network, whose founding CEO promoted white nationalist aims. The former CEO went public about Obria’s deceptive medical brand, which was accused of wasting and misusing federal funds by HHS under the first Trump administration. HUD funding will augment over $1.7 million that GWG/Obria received between 2021 to 2024 in HHS Sexual Risk Avoidance Education grants.

Georgia advocates mobilized opposition and called on county officials to “back safe and affordable housing that is NOT contingent on pregnancy decisions.” Instead, commissioners approved the grant during their August meeting before allowing public comment.

Commissioner Jasper Watkins III, who voted in favor, said the funded projects are “nonpartisan and non-faith-based, as required by federal law.” But federal Forms 990 filed by GWG, say one of the program’s mission is “to engage, educate and equip young parents with a Christ-centered foundation” and that the HUD grant is slated in part for “maternal mental health care in partnership with Sugar Hill Church.”

Watkins also claimed the group is “a licensed, accredited health care provider that employs board-certified doctors, certified nurse midwives, nurse practitioners and credentialed medical staff.” According to the state Department of Community Health website, GWG holds a “laboratory” license that does not appear to govern patient care, and the group identifies no medical professionals on staff on its website or tax filings. Watkins did not note any evidence that GWG has experience in providing housing.

HUD provides community development block grants to states, cities and counties “to develop viable urban communities by providing decent housing and a suitable living environment, and by expanding economic opportunities.” Local governments award community grants to advance that mission. The 2024 report on federal funding of UPCs did not find HUD to be a funding stream between 2017 and 2023, but researchers noted that block grant awards to CPCs “sometimes was difficult to access or lacked detail.” 

Public attention to this summer’s Georgia grant reveals that HUD has been a funding stream for at least this UPC for multiple years. Georgia Wellness, aka Obria/Pregnancy Resource Center of Gwinnett, received $486,919 in HUD funding for “facility acquisition” in 2023 and $100,00 for “equipment purchase” in 2024.

This begs the question: How many other UPCs around the country have received HUD funding through an opaque block grant process that belies public scrutiny? 

Public attention to the Georgia grant has also shined a light on this use of HUD dollars for a UPC maternity home. Since private maternity homes are largely unregulated, it’s not clear whether GWG will be subject to any oversight of its home or any assessment of whether a $400,000 grant to house “up to six pregnant women and their babies for up to 18 months after birth” is a cost-effective investment of public funds. 

Moreover, according to journalist T.J. Raphael, whose Liberty Lost podcast chronicles the heartbreaking legacy of religious coercion at Liberty University’s maternity home:

“These maternity homes have a very explicit quote unquote Christ-centered message … women who go through these places are told that they need to redeem themselves with adoption, redeem themselves for the sin of premarital sex.”

Raphael’s investigation echoes recent exposures about coercive maternity home practices in states around the country. The Associated Press has reported a resurgence of these homes since Dobbs, and “a fraught history of trauma, secrecy and shame.” 

Raphael told Ms. that more than a third of maternity homes have ties to UPC industry leader Heartbeat International and its nationwide Maternity Housing Coalition. In 2023, HBI reported a 52 percent increase in “start up” homes in the year after Dobbs, and a 21 percent increase in HBI-affiliated pregnancy centers operating the homes. 

“I really view it as sort of a pipeline of crisis pregnancy center to maternity home to faith-based adoption agency,” said Raphael. “Over 80 percent of adoptions in the United States are done through faith-based institutions.”

Georgia officials have now pumped almost half a million in HUD dollars into that pipeline, and Project 2025 is calling for federal funding of faith-based adoption agencies. 

In the meantime, the UPC industry is on the attack to secure its access to the public coffers. On Aug. 5, before the Gwinnett County hearing on the Georgia Wellness grant, advocates and lawmakers who had opposed the funding received threat letters from an Atlanta law firm. The letters, charging them with defaming Georgia Wellness with “false and defamatory statements,” were signed by an associate whose biography touts affiliation with the American Center for Law and Justice, a conservative legal group founded by Pat Robertson and led by Trump allies, Jay and Jordan Sekulow. 

American Center for Law and Justice is one of the conservative legal groups behind UPC industry litigation, including a current lawsuit against Massachusetts officials and advocates representing a UPC, claiming it has smeared the state’s public education campaign, and calling for a slick public relations “counter-campaign.” With offices in Washington, London, Strasbourg and Moscow, ACLJ is also one of the groups behind Project 2025. According to a report by the European Parliamentary Forum for Sexual and Reproductive Rights, the group is “one of 10 Christian Right organisations (that) account for the lion’s share of U.S. anti-gender activism in Europe.” 

Georgia state Rep. Marvin Lim posted the threat letter he received on Instagram, “The Georgia Wellness Group sent me, to my official email, a cease and desist letter, right before a hearing. Talk about scare tactics. By all means, sue and get our discovery requests about your practices. … If they’re going to use their free speech to misrepresent science, I’m certainly going to use mine to shine light on the truth.”