The Mexico City Policy is a U.S. government policy that – when in effect – has required foreign NGOs to certify that they will not “perform or actively promote abortion as a method of family planning” using funds from any source (including non-U.S. funds) as a condition of receiving U.S. global family planning assistance and, as expanded by the first Trump administration, most other U.S. global health assistance. The latest expansion, by the second Trump administration, applies to significantly more funding (most non-military foreign assistance), many more organizations (beyond foreign NGOs), and new services and activities (beyond abortion).The policy was first announced by the Reagan administration at the 2nd International Conference on Population, which was held in Mexico City, Mexico, on August 6-14, 1984 (hence its name; see Box 1).1 It was renamed “Protecting Life in Global Health Assistance” (PLGHA) in 2017, and now “Protecting Life in Foreign Assistance” (PLFA) as part of the broader “Promoting Human Flourishing in Foreign Assistance (PHFFA)” Policy umbrella. Among opponents, it is also known as the “Global Gag Rule,” because, in addition to prohibiting service delivery, it also prohibits the promotion of restricted activities, including through lobbying, referrals, and public information campaigns.
Box 1: The Original Language of the Mexico City Policy, 1984
“[T]he United States does not consider abortion an acceptable element of family planning programs and will no longer contribute to those of which it is a part. …[T]he United States will no longer contribute to separate nongovernmental organizations which perform or actively promote abortion as a method of family planning in other nations.”2
When first instituted in 1984, the Mexico City Policy marked an expansion of existing legislative restrictions that already prohibited U.S. funding for abortion internationally. Prior to the policy, foreign NGOs could use non-U.S. funds to engage in certain voluntary abortion-related activities as long as they maintained segregated accounts for any U.S. money received, but after the Mexico City Policy, they were no longer permitted to do so if they wanted to receive U.S. family planning assistance. During those years, U.S. funding for family planning ranged from approximately $300-$600 million annually.
When the policy was expanded by President Trump in 2017 to include the vast majority of U.S. bilateral global health assistance, including funding for HIV under the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), maternal and child health, malaria, nutrition, and other programs, it increased the funding that could be subject to restrictions to more than $7 billion.3 At that time, the Trump administration also moved to further tighten restrictions in how it defined “financial support,” reaching other areas of U.S. development assistance beyond global health and other non-U.S. funding streams. See “What is the definition of ‘financial support’?” below.4
Although President Biden rescinded the policy, President Trump reinstated the MCP through a presidential memorandum on January 24, 2025, directing the Secretary of State to “to implement a plan to extend the requirements of the reinstated Memorandum to global health assistance furnished by all departments or agencies,” which would reach beyond the 2017 expansion. Some organizations and members of Congress had also called for the policy to be expanded to apply to all foreign assistance, and last year, it was reported that the administration intended to include new areas of restrictions related to DEI and gender.
On January 27, 2026, the policy details were released under three separate, but inter-related final rules (interim final rules were first posted on January 23) as part of the PHFFA umbrella (see Box 2). The rules cite the presidential memorandum on the MCP and eight other presidential actions issued in January and February of 2025 that addressed foreign aid, DEI, and gender issues to “ensure that foreign aid is aligned with administration policy and promotes human flourishing.” As such, the PHFFA applies to most non-military foreign assistance and most recipients of foreign aid (not just foreign NGOs). In addition to abortion, it prohibits promoting “discriminatory equity ideology,” including activities related to diversity, equity, and inclusion (DEI), and promoting “gender ideology,” including providing gender affirming care, seeking legal protections based on gender identity, and other related services and activities. The rules indicate that the State Department will work with other agencies that administer foreign assistance to expand the policy further.
Box 2: Promoting Human Flourishing in Foreign Assistance (PHFFA) Policy
The Trump administration released details of its new Promoting Human Flourishing in Foreign Assistance (PHFFA) Policy, which includes the latest expansion of the Mexico City Policy, via three separate, but related, final rules on January 27, 2026. Each rule applies to the same funding streams, types of organizations, and award mechanisms but restricts different activities and services:
With the latest expansion, KFF estimates have found that as much as $39.8 billion in U.S. foreign aid and almost 2,600 prime recipient organizations may be affected (this number should be considered a floor since the policy requirements are passed down when funding is sub-awarded to another organization).
