Anti-abortion politicians are siphoning public dollars meant for low-income mothers and their children to fund anti-abortion crisis pregnancy centers (CPCs) that coerce poor women and teens seeking an abortion to give birth, further condemning them to long-term economic hardship. Being denied a wanted abortion is a proven predictor of maternal and child poverty.
As the Biden administration advances a proposal to prohibit CPCs from future access to these federal funds, the anti-abortion movement is pushing back in force, claiming CPCs save taxpayer dollars and provide vital healthcare and safety net services to poor families. A first-time analysis of the CPC industry’s own reporting wholly contradicts these claims.
In December 2023, the anti-abortion group Charlotte Lozier Institute (CLI) released its report on the value of CPC goods and services provided in 2022, the year Roe v. Wade was overturned. The report followed similar CLI publications on the national impact of CPCs in 2019 and 2017, and was developed in partnership with the CPC umbrella groups Care Net, Heartbeat International and National Institute of Family and Life Advocates.
CLI’s press release announcing the report heralds CPCs as “Meeting the Needs of Families in the Dobbs Era” and claims findings from “a robust survey of 2,750 pregnancy centers in the United States.” The release notes “an increase in demand for pregnancy services and accelerating growth of the pro-life safety net to meet [the] needs” of an estimated 32,000 more babies born annually since the Supreme Court overturned Roe v. Wade.
- Politicians who champion CPCs are liberally quoting this and past Charlotte Lozier reports—in policy proposals, legislative hearings, legal pleadings, agency comments and media messaging—as evidence that the CPC industry is an essential provider of reproductive healthcare and family support post-Dobbs.
- Lawmakers in states with abortion bans and high maternal mortality rates are citing the CLI reports as proof that CPCs are filling gaps in prenatal and postpartum care.
- Anti-abortion politicians are reciting CLI data as proof that CPCs deserve taxpayer funds, including from the federal Temporary Assistance for Needy Families (TANF) program meant to provide direct cash assistance to help poor families with children pay for essential needs like food.
But an independent analysis of the Charlotte Lozier Institute reports finds no verifiable evidence to support any of these claims. In fact, the first-time review of pre- and post-Dobbs CLI reports by Reproductive Freedom & Health Watch reveals these claims to be false.
HHS Seeks to Strengthen TANF Funding Program, Questions CPC Eligibility
On Oct. 2, 2023, the Department of Health and Human Services (HHS) issued a Notice of Proposed Rulemaking, “Strengthening Temporary Assistance for Needy Families (TANF) as a Safety Net and Work Program,” aimed at ensuring states use this federal taxpayer program as required under the law:
- to help low-income families ensure that children can be cared for in their own homes;
- to promote job preparation, work, marriage and two-parent families; and
- to prevent “out-of-wedlock pregnancies” through family planning, sex education and other programs.
The proposed changes follow revelations of fraud and misuse of TANF funds in multiple states, and a precipitous decline in direct TANF cash assistance going to poor families.
According to a study by the nonpartisan Center on Budget and Policy Priorities, 68 percent of families with children in poverty received cash assistance through TANF when the program was created in 1996, but only 21 percent of eligible families were receiving that direct support by 2020.
The study also found that TANF benefit levels in many states now fall far short of what families need to meet basic needs. Study authors noted, “when families hit hard times because they have lost a job, are fleeing domestic violence or are facing a health or mental health crisis, they may have no access to cash assistance.”
Anti-abortion politicians began diverting TANF funds to CPCs in 2002, including in Indiana, Louisiana, Michigan, Missouri, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania and Texas. According to the Center on Budget and Policy Priorities, in the five states that were using TANF for CPCs as of 2020—Indiana, Louisiana, North Carolina, Oklahoma and Texas—“TANF served hardly any families living in poverty.”
HHS has indicated CPCs are unlikely to be eligible to continue accessing TANF funds, as their target clients are women already pregnant and because CPCs do not provide contraception, sex education, job training or other services that would further the program’s purposes.
In December, anti-abortion groups and lawmakers submitted extensive comments to HHS in opposition; all cited Charlotte Lozier Institute “research” to argue that CPCs provide health and social services that meet TANF’s statutory purposes. Congressional Republicans, the U.S. Conference of Bishops and other groups opposing the TANF change repeatedly cited CLI reports as evidence that CPCs provide ”a full range” of healthcare, resource, social service, job training and other services.
Then in January, House Republicans passed HR 6918, the Pregnant and Parenting Women and Families Act, to prohibit HHS from restricting TANF funding for CPCs—a transparent exercise in anti-abortion movement messaging as the bill has no chance of passing in the Senate—with House Republicans serially quoting Charlotte Lozier Institute data as proof that CPCs are providing “vital services” and “empowering states to address the root causes of poverty.”
A House member arguing to prohibit HHS from taking this action used CLI data to claim that CPCs are responding to “increased demand” for their services and assert that CPCs are meeting TANF purposes by providing “wraparound services that promote strong families” and “skills to gain economic self-sufficiency.”
New Analysis of CPC Industry’s Own Reporting Shows No Increase in Services or People Served Post-Dobbs
With influential stakeholders widely citing Charlotte Lozier Institute reports as proof that CPCs are legitimate providers of reproductive health and social services deserving taxpayer support, the nonprofit Reproductive Health & Freedom Watch (RHFW) has conducted the first independent, year-to-year analysis of CLI reports on the CPC industry.
RHFW findings raise serious questions about CLI’s widely-referenced claims about the nature, value and impact of CPC services post-Dobbs, and serious doubts about the credibility of CLI “research.”
The Charlotte Lozier Institute falls far short of the standards of scientific research in its CPC reporting, and is providing flawed ‘research’ that anti-abortion politicians are using to justify diversion of TANF funds to the crisis pregnancy center industry.
While CLI claims its 2022 report to be based on “robust scientific research,” RHFW found CLI provides no data that could be independently verified. CLI does not disclose the list of CPCs surveyed, the survey questions, estimated number of clients served or any other actual data from which it extrapolated findings. CLI provides no methodology for determining valuation of goods and services, “self-reported” client satisfaction rates, or other findings.
Moreover, the RHFW analysis shows that even CLI’s unverified ‘data,’ when compared year-to-year, actually undermines their claims:
- CLI’s president introduces the 2022 CPC report stating, “in the wake of the reversal of the infamous Roe v. Wade, the demands upon centers are increasing daily.” But RHFW’s analysis finds CLI reports an increase of only 0.08 percent in new CPC clients between 2019 and 2022.
- CLI’s press release announcing the 2022 report heralds “accelerating growth of the pro-life safety net” post-Dobbs. But RHFW found CLI reported an actual decline in provision of three of the CPC industry’s six core services between 2019 and 2022: 4 percent fewer pregnancy tests provided; 8 percent fewer “post-abortion” clients seen; and 42 percent fewer students participating in “sexual risk avoidance” (aka abstinence-only) programming—and just a 2 percent increase in new CPCs.
- CLI’s press release states its 2022 report documents CPC “healthcare” services for women and families, post-Dobbs. But the RHFW analysis shows CPCs continued to offer the same three medical-adjacent services they were providing in 2021, which they use to advance their anti-abortion mission, not for a medical purpose: (1) over-the-counter pregnancy tests to draw “abortion-minded” women to their sites; (2) non-diagnostic ultrasound to “increase the number of abortion-minded patients seen” and “empower mothers to choose life“; and (3) sexually transmitted infection “checks” to target sexually active young people. RHFW’s review reveals that CPC services did not expand in 2022 to include contraception, STI treatment, prenatal care, or any other actual healthcare for women or families.
- The one need CPCs appear to be responding to post-Dobbs is for free baby supplies, RHFW’s analysis reveals. CLI reports the most significant increase in CPC services by far between 2019 and 2022 was provision of diapers (64 percent), wipes (43 percent) and baby outfits (52 percent). But the CLI report fails to acknowledge that these supplies are rarely “free,” but conditioned on participation in “Earn While You Learn” or “Baby Bucks” programs, which require pregnant people attend Bible study, abstinence seminars, parenting classes or other CPC programming.
- While reporting no real increase in new CPC clients and an actual decrease in provision of half of the core CPC services between 2019 and 2022, CLI reports the “value” of CPC goods and services increased by over 30 percent from $270 million in 2019 to over $358 million. CLI provides no methodology for how it arrived at this valuation and no information about what the CPC industry spent to provide this purported value.
- CLI failed to account for over $1.2 billion in expenses reported to the IRS in 2022 by a fraction of the CPCs surveyed by CLI, RHFW found, or why it cost the industry so much money to provide so little value.
The Charlotte Lozier Institute identifies itself as “America’s premier scientific institute on life issues.” But the RHFW analysis reveals that CLI falls far short of the standards of scientific research in its CPC reporting, and is providing profoundly flawed “research” that anti-abortion politicians are using to justify diversion of TANF funds to the crisis pregnancy center industry.
There is additional recent documentation of CLI promoting faux research as credible science: In February, the journal Sage retracted a CLI-associated ‘study’ at the heart of the anti-abortion movement lawsuit challenging FDA approval of mifepristone now before the U.S. Supreme Court. Citing multiple problems, including study design and methodology, unsupported assumptions, and misleading data, Sage noted the study’s authors, who are affiliated with CLI, failed to declare conflicts of interest.
Charlotte Lozier Institute’s parent organization, Susan B. Anthony Pro-Life America, is one of the most powerful anti-abortion lobbying groups in the country—the architect of some of the most extreme policies in the states and one of the loudest voices decrying lawmakers seeking to protect IVF in wake of Alabama’s Supreme Court ruling.
CPC-Created Barriers to Abortion Care Cause Devastating Economic Consequences
Economic considerations are a major reason why women seek abortion. According to the Guttmacher Institute, half of abortion patients live in poverty and another quarter are low-income.
Moreover, the landmark Turnaway Study: Ten Years, A Thousand Women, and the Consequences of Having—or Being Denied—an Abortion found that being denied a wanted abortion condemned women and their children to poverty, for years. Turnaway Study researchers found “evidence of a large and persistent increase in financial distress for the women who were denied an abortion that is sustained for the 6 years following the intended abortion. In particular, we find that being denied an abortion increases the amount of debt 30 days or more past due by 78 percent and increases negative public records, such as bankruptcies and evictions, by 81 percent.”
The study found that women who accessed a wanted abortion had better physical and mental health outcomes, were more financially stable, and raised their children under more stable conditions. Women denied a wanted abortion experienced more serious health problems, were more likely to stay tethered to a violent partner and more likely to be left to raise their child alone. Existing children of women denied abortions were over three times more likely to live in households below the federal poverty level, and less likely to achieve developmental milestones.
Being denied an abortion increases the amount of debt 30 days or more past due by 78 percent and increases negative public records, such as bankruptcies and evictions, by 81 percent.
Turnaway Study
In contrast to CLI’s discredited research, the Turnaway Study was a rigorous, longitudinal study conducted by a team of over 40 researchers from nine universities and four research institutes. Its findings have appeared in 50 peer-reviewed papers published in top medical and social science journals.
CPCs Are Siphoning TANF Funds Meant for Mothers Trying to Feed Their Children
Despite anti-abortion movement claims that CPCs exist to help women and families, the CPC industry’s own media reveals its goal remains the same as it has always been: to intercept “abortion-minded” women and prevent their access to abortion care. And the anti-abortion movement claims that TANF funds help CPC provide free material support “to ease the financial pressure facing low-income families” belies CPC industry opposition to direct assistance for poor families and belief that “giving things away free only enables our clients and fosters the entitlement mentality.”
In fact, CPC requirements that pregnant women “earn” baby supplies were instituted in response to an influx of pregnant women planning to carry to term who needed baby supplies—almost half of American families struggled to afford diapers in 2023—who outnumbered the “abortion-minded” women CPCs sought to target.
Far from easing the financial pressure facing low-income families,” CPC “Earn While You Learn” requirements can have a devastating economic impact. One former CPC client told a researcher that after she missed work for a required CPC appointment because she was “desperate” for the resources they offered, she lost her job and then her home.
Tara Murtha, strategic director of communications at Women’s Law Project, speaks to this trap in the new CPC documentary Preconceived.
“CPCs are taking money away from these families, money that has been earmarked for low-income families, and they buy the pack of diapers, or get it donated, and then hold that pack of diapers up and have the very person they took the financial support from forced to navigate their obstacle course of programming in order to get that pack of diapers,” said Murtha. “CPCs use economic scarcity to justify their role in society, but they only exist by virtue of helping to manufacture that economic scarcity.”
The proposed HHS rule to cut CPCs off from TANF funding would be a critical step in breaking this cycle.
Note: McKenna serves as the CPC program director at Reproductive Health & Freedom Watch.
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