Republican-led states have piloted a dramatic infusion of taxpayer funding into the CPC industry. With Republicans in the White House and U.S. Congress, they are certain to ramp up federal funding for antiabortion centers.
Within days of the election, antiabortion leaders started calling on the incoming administration to defund Planned Parenthood and family planning clinics that refer patients for abortion, and redirect that funding to “pro-life” pregnancy centers.
While serial attacks on abortion rights seize the headlines, the anti-choice movement has quietly built an on-the-ground network of unregulated pregnancy clinics—also known as crisis pregnancy centers (CPCs) and antiabortion centers (AACs)—that is eroding access to comprehensive reproductive healthcare and electioneering against abortion rights, mostly under the radar and increasingly on the public dime.
CPCs pose as harmless community resources and licensed women’s health clinics in need of public support. They are, in fact, part of a multi-billion-dollar industry that is directly tied to the extremist legal and advocacy groups that overturned Roe and are now going after medication abortion, contraception, IVF and no-fault divorce.
With a staggering $1.7 billion in annual revenue, an estimated 3,000 locations and 100,000 staff and volunteers, the CPC industry is the grassroots backbone of the anti-choice movement. Radical groups including Heartbeat International, Susan B. Anthony Pro-Life America, Students for Life, Turning Point USA and others—many involved in Project 2025—leverage this 50-state network to influence state policy and, under the guise of providing healthcare, siphon escalating taxpayer dollars into the antiabortion movement.
While CPCs have had some access to federal funding since the 1990s, Republican-led states have piloted a dramatic infusion of taxpayer funding into the CPC industry, especially since the 2022 Dobbs ruling. Now, as the Trump administration and congressional Republicans take power, they are certain to also ramp up federal funding for CPCs, making American taxpayers in every state underwrite these unregulated pregnancy clinics. They will justify doing so claiming CPCs “provide medical care that is driving down maternal mortality.” There is no evidence this is true.
Not only are CPCs entirely ill-equipped to deliver maternal healthcare, their unlicensed practice of medicine, trafficking of medical disinformation, and unguarded collection of sensitive personal health data actually threaten women’s health and safety. Yet, in more and more communities, unregulated pregnancy clinics are the only resources available to pregnant women and teens, as maternal care deserts proliferate nationwide.
The new administration and Congress are poised to make this grim reality worse: by massively boosting the flow of federal taxpayer dollars to unregulated pregnancy clinics.
Unregulated Pregnancy Clinics Increasingly Advertise Medical Services
Crisis pregnancy centers are not medical clinics; they are unregulated religious nonprofits, run by antiabortion advocates. They are not regulated by any of the health, safety, licensing or privacy standards that govern medical offices. Yet these unregulated groups increasingly claim to offer health services.
The first multi-state study of CPC websites, “Designed to Deceive,” found that over 88 percent of CPCs in nine states offered one or more of four purported medical services as of 2021: pregnancy tests, ultrasounds, sexually transmitted infection (STI) tests and “abortion pill reversal” (APR). The study also found the pregnancy tests were largely self-administered, the ultrasounds were non-diagnostic, the STI tests did not lead to treatment, and that APR is a medically unproven intervention the antiabortion movement promotes to stigmatize medication abortion.
Only one in the 607 CPCs studied offered contraception, and only 5 percent offered prenatal care.
Now, the first study of CPC websites in all 50 states, just published in JAMA Internal Medicine, finds a full 91 percent of CPCs nationwide are advertising these same services. Using a new public database of CPC websites called ChoiceWatch.org, researchers found the vast majority of CPCs advertised pregnancy tests, ultrasounds, STI tests and/or APR in the past year. When compared to the 2021 study, the ChoiceWatch study also indicates a significant increase in CPC advertising of ultrasounds (20 percent) and STI tests (24 percent).
The JAMA researchers expressed alarm that unregulated groups are advertising medical services.
“There is a clear need for greater regulation and transparency regarding the medical services they offer,” said John W. Ayers, Ph.D., co-author and vice chief of innovation in the division of infectious diseases and global public health at U.C. San Diego School of Medicine. “Our findings suggest the need for greater scrutiny of CPC practices, particularly their service provision, provider qualifications, and how these conform with regulations or best practices.”
Karan Desai, lead researcher, added, “There is no reporting of CPC practices collected by government health agencies.”
Another serious concern: While masquerading as medical providers, unregulated pregnancy clinics are collecting vast amounts of personal and health information from pregnant people, with no privacy protections. CPCs claim to keep client information confidential; many even lie about being HIPAA-covered. But CPCs are not governed by medical privacy laws and not accountable to anyone for keeping client data private.
This concern is not theoretical. In May, journalist Jessica Valenti reported a massive client health data breach by Heartbeat International, the largest CPC network in the country. In the post-Roe reality, as women seeking abortion are targeted by extremist groups, lawmakers, and legal officers, CPC client data—date of last menstrual period, use of birth control, pregnancy history, drug and alcohol use, interest in abortion, and much more—is ripe for weaponizing in pregnancy- and abortion-related investigations.
CPCs and the Maternal Mortality Crisis
Anti-choice politicians often go well beyond claiming that CPCs provide healthcare; many claim these unregulated pregnancy clinics are filling gaps in prenatal and postpartum care, and addressing the maternal and infant mortality crisis. Louisiana’s CPC tax credit sponsor, for example, described her bill as “a way to address her state’s abysmal record on infant and maternal mortality, preterm births and low birth weight.”
While CPCs are advertising medical services, there is no evidence they are providing pregnancy or maternal healthcare, let alone reducing maternal and infant mortality. Notably, CPCs don’t come close to meeting Level 1 requirements for “Basic Maternal Care” in the American College of Obstetricians & Gynecologist models of maternal care for pregnant women. And CPCs provide no infant or neonatal services.
In reality, the disinformation and delay tactics CPCs use to prevent people from accessing abortion may prevent access to timely prenatal care, which is critical to maternal and infant health outcomes. Moreover, the assertion that CPCs exist to provide healthcare blatantly contradicts the industry’s own reporting that it has increased advertising post-Dobbs to reach “abortion-minded women” – often using taxpayer funds to do so. CPCs are not providing healthcare. They are advertising a limited suite of medical services to intercept pregnant women and teens seeking abortion.
It is the states with the highest rates of maternal and infant mortality, and the abortion bans deepening the pregnancy and maternal health care crisis, that fund the CPC industry. Politicians in these states fund unregulated pregnancy clinics for one purpose: to advance an antiabortion agenda.
For example, as maternal mortality in Texas rose by 56 percent between 2019 and 2022, Texas allocated $100 million in biennial grants to CPCs, which qualify only because they do not provide or refer for abortion. In Louisiana, a new tax credit benefitting CPCs (branded as “maternal wellness centers”) does not require the health department to regulate them, but does require they be affiliated with at least one of the national antiabortion CPC networks.
Tellingly, a Tulane researcher mapping the location of Louisiana’s CPCs found only one out of 32 CPCs was located in a maternity care desert. Michelle Erenberg of Lift Louisiana told Verite News: “If they’re not even located in areas with the greatest need, then how is that funding actually being put to use in providing services that pregnant people need?”
An Unregulated Multi-Billion-Dollar Industry Awash in Taxpayer Funds
In addition to overwhelming evidence that unregulated pregnancy clinics are providing no maternal or infant healthcare, new research reveals that CPCs arguing for taxpayer support are part of a multi-billion dollar industry that brought in over $1.7 billion in 2022 alone.
Yet anti-choice politicians are funneling escalating taxpayer funds into this industry—over $400 million in federal dollars since 2017 and over $500 million in direct state funding since 2021, augmented by mounting tax credits, deductions and exemptions.
The first comprehensive report on federal funding of CPCs, released in June 2024 by Health Management Associates (HMA), found that more than 650 CPCs in 49 states and Washington, D.C. received over $400 million between 2017 and 2023. While some of this federal funding has been scrutinized, especially under the Temporary Assistance for Needy Families (TANF) and Title X Family Planning programs—since CPCs patently do not meet their program goals—HMA found that multiple additional federal programs have also funded CPCs, including the Teen Pregnancy Prevention Program, Title V Sexual Risk Avoidance Education Program, Federal Emergency Management Agency, and COVID emergency CARES Act.
And research from Reproductive Health & Freedom Watch (RHFW) shows that while CPC industry funding is increasing overall, state taxpayer funding is increasing even faster. In a July 2024 analysis, RHFW found that 21 state legislatures allocated over $513 million to CPCs between 2019 and 2022—with seven states creating new CPC funding programs—and that state funding mushroomed by a stunning 78 percent after the 2022 Dobbs ruling.
The CPC industry’s Charlotte Lozier Institute (CLI) valued pregnancy center goods and services in 2022 at $368 million, but RHFW found CPCs reported over $1.5 billion in expenditures to the IRS that year. And, while CLI reports reveal that new CPC clients increased by only 0.8 percent between 2019 and 2022, CPC tax filings show a whopping 45 percent increase in expenditures.
Why did it cost the CPC industry over $1.5 billion to produce less than $370 million in value in 2022? And why have CPC expenditures almost doubled since 2019 when the industry’s own reporting indicates no increase in demand for its services?
An Opaque Industry Fighting Fiscal Oversight, Impact Assessment and Accountability
Despite the CPC industry’s failure to account for the dramatic discrepancy between its expenditures and value, how it spends its already considerable revenue, and why it needs taxpayer support, anti-choice politicians continue to direct public funds to CPCs with no financial oversight or impact assessment.
HMA researchers found that a “lack of transparency and accountability is notable in federal funding distribution to CPCs.” They concluded that “these awards provided federal funding to nonprofit organizations that do not follow national, evidence-based standards and guidelines” that “may constitute non-allowable uses of such support.”
This wholesale lack of accountability is especially striking in the face of mounting evidence of CPC mismanagement, fraud, waste, and illegal use of public funds, including for religious purposes. Even more striking, in the wake of blockbuster exposes of fraudulent use of taxpayer dollars and overbilling by CPCs in multiple states, anti-choice lawmakers have actually boosted public funding while also voting down proposals to tie that funding to stronger fiscal oversight and transparency, licensing and privacy standards, tracking whether CPC clients access prenatal care, and other baseline accountability measures.
Federal lawmakers are similarly shielding CPCs from oversight. Congressional Republicans have aggressively opposed an HHS rule to require states directing TANF funds to CPCs to document how they further TANF statutory purposes. And the House Freedom Caucus has blocked federal data privacy protections for Americans and online protections for children, claiming the laws would shut down thousands of CPCs by legally compelling them to comply with consumer and medical privacy standards.
As anti-choice lawmakers block oversight of CPCs, right-wing legal organizations are working in tandem, aggressively challenging CPC accountability standards and investigations into their activities and impact. To date, legal powerhouses backing the CPC industry An Opaque Industry Fighting Fiscal Oversight, Impact Assessment, and Accountability—Alliance Defending Freedom, American Center for Law and Justice, Becket Fund, First Liberty Institute, National Institute of Life Family Advocates and Thomas More Society—have brought serial legal actions to obstruct efforts to understand, regulate or educate consumers about CPC practices in California, Colorado, Connecticut, Illinois, Massachusetts, New Jersey, New York, Pennsylvania, Vermont and Washington.
In short, despite mounting public funding, the CPC industry and its allies are resisting any transparency or impact assessment, while readying to vie for more tax dollars in 2025.
Some CPC Funding Proposals to Expect
Repurposed Federal Funding
TANF: Expect Trump’s HHS to immediately revoke a proposed rule to prohibit CPC eligibility for TANF—funds meant to provide cash assistance to help poor parents meet basic family needs—and watch for reintroduction of these 2024 House bills: the “Pregnant and Parenting Women and Families Act” to prohibit HHS from restricting TANF funding for CPCs, and the “Let Pregnancy Centers Serve Act” to amend to amend the Social Security Act to clarify state authority to use TANF funds for CPCs.
Title X: Trump is certain to reinstate his first term changes to Title X—the federal program funding family planning and preventive reproductive health services for low-income patients—to prohibit grantees providing abortion referrals from eligibility and open the door for CPCs to apply. The first Trump rule change enabled diversion of $1.7 million in Title X funds to Obria, a CPC network “led by God” and committed to never dispensing contraception. Antiabortion leaders are calling for Trump to institute its prior Title X rules “on Day One.”
Teen pregnancy prevention program: Federal law mandates TPP grants support evidence-based, medically accurate, age-appropriate strategies to influence adolescent sexual behavior and reduce teen pregnancy. Yet HMA found the TPP under Trump’s first term diverted close to $16 million to four anti-contraception CPC networks. The TPP is certain to be a repurposed funding target for Trump’s HHS in 2025.
Anti-trafficking and maternity home funding: In 2021, CPC industry leaders directed CPCs to apply for HHS Administration on Children, Youth and Families grants meant to fight human trafficking and support maternity homes. Expect Trump’s new HHS to tweak these programs to favor CPC funding applications.
Federal Budget and Bills
Budget allocations: On Feb. 3, President Trump is scheduled to submit his proposed federal budget to Congress. Watch for direct funding for CPCs in the budget proposal, and for congressional bills to authorize federal appropriations for CPCs.
The Protecting Life and Taxpayers Act: The Heritage foundation promoted this 2023 bill to require that groups seeking federal funding certify that they will not perform abortions or fund other entities that do, recommending these federal resources go to pregnancy resource centers. Expect Michelle Fischbach (R-MN) to reintroduce it in 2025.
Federal website and HHS grants: Be on the lookout for the “Standing with Moms Act” introduced in 2024 by Katie Britt (R-Ala.) and Marco Rubio (R-Fla.) to create a federal website, pregnancy.gov, where women will register their pregnancies with the government and be referred to CPCs. The 2024 bill mandated the website promote CPC industry disinformation, including on “risks” of abortion” and “abortion pill reversal,” and authorized direct HHS grants for CPCs. (Watch also for Susan B. Anthony Pro-Life America to vie for federal funding for its “Her PLAN: life-affirming safety net” programs—mostly CPCs.)
Mandating schools promote CPCs: Expect a new “Pregnant Students Right Act” introduced in 2024 by Ashley Hinson (R-Iowa) requiring colleges and universities where students “may face pressure that their only option is to receive an abortion or risk academic failure” to provide “resources to help a pregnant student in carrying the baby to term”—e.g. CPCs. Watch for a possible funding provision in a 2025 bill.
New State Bills
Funding bills: In 2025, 23 states will have Republican trifectas; 15 already fund CPCs, as do four states with mixed leadership. Expect state proposals to increase direct funding, create new funding programs and tax schemes to benefit CPCs, and embed CPC funding in state law. In Missouri, for example, Sen. Travis Fitzwater (R) has already pre-filed a bill to create an income tax credit for CPCs and authorize a 2026 ballot initiative to amend the state constitution to “authorize support” for “nonprofit pregnancy resource centers.”
The Care Act: Alliance Defending Freedom has launched a campaign “against government harassment aimed at pro-life pregnancy centers” and is rolling out a model bill for state legislatures to “protect CPCs from government regulation. The first “Care Act” has been pre-filed in South Carolina. Expect the bill in multiple states; watch for funding provisions.
Challenging Taxpayer Support for an Industry Threatening Women’s Health and Safety
As the CPC industry aims to siphon even more public funding in 2025, advocates and public officials can forcefully challenge this industry’s unlicensed practice of medicine, deceptive privacy practices, and access to tax dollars with no public accountability or impact analysis. There is already compelling federal and state action to build on.
U.S. Reps. Raskin (D-Md.) and Frost (D-Fla.) have called for a Government Accountability Office investigation into federal funding of CPCs. “CPCs are not bound by medical and ethical practice standards and often do not provide medically accurate information or health care, and the resources they do provide are tied to undermining maternal health and access to abortion,” they wrote to the GAO. “We have serious concerns that CPCs continue to receive millions in federal aid with little transparency and accountability to the public.”
Campaign for Accountability (CfA) has formally called for attorneys general to investigate deceptive CPC privacy practices in multiple states and just filed a complaint demanding the Louisiana attorney general investigate Heartbeat International (HBI) for reckless exposure of the private health information of 13 CPC clients in his state, as well HBI’s CPC affiliate for deceptively promising clients their information was HIPAA-protected. HHS has determined neither Heartbeat nor its affiliate is a HIPAA-covered entity, opening the door for investigations of CPCs collecting private health information nationwide.
Between 2010 and 2022, over 500 maternity wards closed across the U.S. and the 2022 Dobbs decision has driven scores of maternal and fetal care providers out of abortion-banning states, worsening maternal care deserts and already catastrophic rates of maternal and infant mortality in this country.
In this dire reality, Americans must loudly condemn all efforts by the Trump administration and Congress to escalate diversion of our tax dollars to unregulated pregnancy clinics that further threaten maternal and infant health.
