Should States Have to Report Abortion Data to the CDC in Order to Get Medicaid Funding for Family Planning Programs? (H.R. 3580)

What is H.R. 3580?

(Updated July 1, 2021)

This bill — the Ensuring Accurate and Complete Abortion Data Reporting Act of 2019 — would require states to report abortion data to the CDC in order to receive targeted Medicaid funding for family planning programs. It’d also ensure states are given technical assistance to help with data collection. 

Data points that would be required to be collected under this bill would include: 1) the number of abortions and 2) number of children who survived abortion attempts in each state. States that failed to collect this information, or which falsified this information, would be penalized by losing eligibility for family planning services funding from Medicaid for a time.

Argument in favor

Accurate abortion data is needed to inform a variety of federal public health policymaking decisions. Currently, the CDC’s abortion data isn’t accurate enough and some states don’t report abortion data to the agency at all. Withholding Medicaid funding for family planning programs from states that don’t report abortion data to the CDC would likely increase reporting.

Argument opposed

Like Idaho’s implementation of a mandatory “complications from abortion” reporting requirement last year, this bill is an attempt to use government interference in women’s private medical decisions to intimidate women out of seeking abortions. While not all states report abortion data to the CDC, enough do to provide the federal government with enough abortion data for policymaking purposes.

Impact

Women seeking abortions; abortion providers; states; abortion data collection by states; abortion data reporting by states; the CDC; and Medican funding to states for family planning programs.

Cost of H.R. 3580

A CBO cost estimate is unavailable.

Additional Info

In-Depth: Rep. Ralph Norman (R-SC) introduced this bill to incentivize states to report abortion data to the Center for Disease Control (CDC) and ensure more accurate abortion counts across the country: 

“The reality is we have no idea how many abortions are actually performed each year in this country. States are asked to provide these numbers to the federal government, but they are not required to do so, which allows states like California and Maryland to intentionally withhold this data. Meanwhile, these states have no problem using federal tax dollars for family planning services. There’s a special provision in Medicaid that provides family planning funds to states, and those dollars can even be used by those who are not otherwise eligible for Medicaid.”

In an appearance on the Family Research Council’s podcast “Washington Watch with Tony Perkins,” Rep. Norman said the current data collection on abortion is voluntary. He also said current data isn’t necessarily accurate because it comes from Planned Parenthood affiliates that may not be trustworthy. 

Original cosponsor Rep. Gary Palmer (R-AL) expounds on the importance of accurate reporting on abortion:

“Accurate and transparent reporting on abortion and children who survive abortion attempts is essential to public health research and to determining sound policy. Reporting abortion data has been voluntary for too long, and this has led to states withholding many data points routinely requested by the CDC. We must standardize and enforce reporting processes in this area and ensure that states have necessary assistance in collecting the required abortion data. States should not be allowed to distort or provide faulty data in an effort to cover up the true numbers of innocent lives lost by abortion.”

March for Life is among a number of anti-abortion organizations that supports this bill. It says: 

“For years government data on abortion and women’s health has been missing statistics from entire states. Sadly Guttmacher Institute, founded as the research arm of our nation's largest abortion provider, has more complete data than the CDC. To say that there is a need for unbiased abortion reporting data is a gross understatement. We wholeheartedly applaud, support and thank Rep. Norman and Rep. Palmer for this commonsense bill which will bring abortion reporting out of the shadows and ultimately advance women’s health.”

In a paper produced at the Vanderbilt University Law School, J. Jackson Hill IV found issues with abortion data collection at both the CDC and the Guttmacher Institute — the two primary collectors of abortion statistics. Hill noted, “[f]rom 2001-2008, the CDC calculates that its numbers only account for 65-69% of abortions that were reported by Guttmacher.” He concluded that the “bribe” option of using conditional spending to incentivize abortion data reporting is the best approach to solving this problem.

In July 2018, Planned Parenthood of the Great Northwest and the Hawaiian Islands sued the state of Idaho in federal court over new abortion reporting requirements that it argued were unconstitutional and intended to stigmatize women seeking medical care. Idaho’s law — which went into effect on July 1, 2018 — created a list of “complications of abortion” which health professionals would be required to report when they occurred. The list included things that can typically occur in the immediate aftermath of an abortion, such as bleeding, as well as rare reactions that doctors typically consider unrelated to abortion procedures (such as an allergic reaction to anesthesia).

In its suit, Planned Parenthood contended that Idaho’s law arbitrary singled out just one medical procedure for the reporting requirement and that the law didn’t do enough to ensure women’s medical information would be kept private. It also argued that the law was convoluted, putting healthcare providers at risk of civil and criminal penalties for guessing wrong when attempted to follow the vague reporting requirements. Hannah Brass Greer, chief legal counsel for Planned Parenthood of the Great Northwest and the Hawaiian Islands, said: 

“This is another attempt by Idaho politicians to shame and stigmatize people seeking abortion care and to spread the myth that abortion is dangerous. These reporting requirements burden patients and their medical providers and represent another example of government overreach by Idaho politicians.”

Ultimately, Idaho lawmakers modified the law to remove some of the language that Planned Parenthood alleged was “unconstitutionally vague.” Subsequently, U.S. District Judge David Nye dismissed the case after the Idaho Attorney General’s office and attorneys for Planned Parenthood of the Great Northwest and the Hawaiian Islands asked to have the case closed. Deborah Ferguson, one of the attorneys representing Planned Parenthood, called the lawsuit “successful in that it obviously spurred the [Idaho] Legislature to modify the statute.” Grier added: 

“The Idaho Legislature has amended the harmful reporting law because our lawsuit showed them this unconstitutional measure unnecessarily placed politicians between a woman and her doctor. This is a win against the types of laws meant to out abortion providers for no medical reason.”

This bill has the support of March for Life, the National Right to Life Committee, U.S. Conference of Catholic Bishops, Susan B. Anthony List and the Family Research Council.

Of Note: Since 1969, the CDC has partnered with states to collect aggregate statistics on abortion, which it compiles to produce national estimates and its annual Abortion Surveillance Report. As data becomes available, the CDC’s Division of Reproductive Health also prepares surveillance reports. While states aren’t required to submit abortion data to the CDC, the Guttmacher Institute reports that “the overwhelming majority do.” 

The CDC’s Abortion Surveillance report is used for a number of purposes in the field of public health, including to: 

• Identify characteristics of women who are at high risk of unintended pregnancy;
  
• Evaluate teen pregnancy and unwanted pregnancy prevention programs’ effectiveness;
  
• Calculate pregnancy rates, on the basis of the number of pregnancies ending in abortion, in conjunction with birth data and pregnancy loss estimates; and
  
• Monitor changes in clinical practice patterns related to abortion (i.e., changes in the types of procedures used, and weeks of gestation at the time of abortion) and calculate the mortality rate of specific abortion procedures.

Data collection varies between states: 

• 46 states require hospitals, facilities and physicians providing abortions to submit regular and confidential reports to the state; 
  
• 8 states require providers to indicate the method of payment, such as insurance or self-pay, for the procedure; 
  
• 27 states require providers to report postabortion complications; 
  
• 16 states require providers to give some information about the woman’s reason for seeking the procedure; 
  
• 6 states require providers to report whether the fetus was viable; and
  
• 14 states require providers to indicate if the state mandates for abortion counseling and parental involvement were satisfied.

In previous reports, the CDC has analyzed the shortcomings in its data. Two major weaknesses it found (which this bill would help address) were 1) the fact that not all states, including California, Maryland and New Hampshire, send data to the agency and 2) that “the level of detail received on the characteristics of women obtaining abortions varies considerably from year to year and by reporting area.”

Media:

• Sponsoring Rep. Ralph Norman (R-SC) Press Release
  
• Alabama Political Reporter
  
• Family Research Council (FRC) Washington Watch with Tony Perkins Podcast
  
• One News Now
  
• Guttmacher Institute (Context)
  
• CDC's Abortion Surveillance System FAQs (Context)
  
• RealClearPolitics (Context)