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GAO-18-508R 1 (2018-07-12)

handle is hein.gao/gaobacpml0001 and id is 1 raw text is: cAO U.S. GOVERNMENT ACCOUNTABILITY OFFICE 441 G St. N.W. Washington, DC 20548 July 12, 2018 The Honorable Greg Walden Chairman Committee on Energy and Commerce House of Representatives The Honorable Michael C. Burgess Chairman Subcommittee on Health Committee on Energy and Commerce House of Representatives Health Resources and Services Administration: Efforts to Help Ensure Health Center Compliance with Prohibitions on the Use of Federal Funds for Certain Abortions Nearly 26 million people in the United States rely on federally funded health centers for their health care. In fiscal year 2017, 1,380 health center grantees with more than 11,000 service delivery sites provided care for underserved individuals and families, including people experiencing homelessness, agricultural workers, residents of public housing, and veterans. The Health Resources and Services Administration (HRSA), an agency within the Department of Health and Human Services (HHS), awards grants to health centers so the centers can provide primary care and other services. However, health centers cannot use federal funds from HRSA for abortions, unless the pregnancy is the result of rape or incest, or the life of the pregnant woman would be endangered unless an abortion is performed.1 HRSA is responsible for helping to ensure that its grant funds are not used for any unallowable costs at health centers, including prohibited abortions. HRSA has also provided funding through cooperative agreements to the National Association of Community Health Centers (NACHC), the national health care advocacy organization for health centers.2 The cooperative agreements are for NACHC to provide training and technical assistance to health centers. 1Annually, Congress prohibits HHS from funding certain abortions through appropriations legislation. This restriction is commonly referred to as the Hyde Amendment, named after the sponsor of the initial prohibition enacted in 1976, Representative Henry J. Hyde. In recent years, the restriction has applied to all abortions except where the pregnancy is the result of rape or incest, or where a woman suffers from a physical disorder, physical injury, or physical illness, including a life endangering physical condition caused by or arising from the pregnancy itself, that would, as certified by a physician, place the woman in danger of death unless an abortion is performed. See Consolidated Appropriations Act, 2018, Pub. L. No. 115-141, div. H, tit. V, §§ 506-7, 132 Stat. 348, _ (2018). Additionally, Executive Order 13535 applies the prohibition to the authorization and appropriation of federal funds to health centers through the Community Health Center Fund established under the Patient Protection and Affordable Care Act. 75 Fed. Reg. 15599, 15600 (Mar. 29, 2010). 2In general, federal agencies use grants and cooperative agreements to transfer a thing of value to the recipient entity to carry out a public purpose as authorized by federal law. Cooperative agreements are used when substantial involvement by the federal agency is expected in carrying out the activity, and grants are used when substantial GAO-18-508R Abortion Funding Prohibitions Page 1

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