Nineteen states (AK, FL, GA, IN, IA, KS, LA, MO, NE, NC, ND, OH, OK, SC, TN, TX, UT, WV, WI) collectively spend more than $200 million per year to fund Unregulated Pregnancy Clinics (UPCs). But, in general, this money is not used or needed for the products or services purportedly supplied.
More than 2,600 UPCs operate in all 50 states, most of which affiliate with one of three national organizations: Care Net, Heartbeat International and National Institute of Family and Life Advocates (NIFLA).
National data show that these UPCs have enormous income outside of state funding. Based on IRS 990 forms, about 2,100 pregnancy center locations had more than $1.9 billion in revenues in 2023 (the last year where data is available). So, that year, the average pregnancy center had revenues from all sources of about $905,000 a year. And their funding rises every year.
The same national data demonstrates that UPCs hold a staggering amount in assets. Those 2,100 UPCs reported that they hold $2.5 billion in assets, which averages almost $1.2 million in assets per facility.
Because individual UPCs rely heavily on volunteers, and they only average about 1 ½ new clients per day, their expenses are just a small fraction of their revenues. Some examples:
Minnesota: A UPC received $75,000 yearly but spent just 7% on client services, with 93% going to salaries and administration. Another got $65,000 annually while serving only 20 clients.
Montana: 16 UPCs reported spent $3.78 million to provide $1.2 million in services to 6,200 clients ($600 per client).
Florida: UPCs charged the state $150 per hour for counseling—five times more than the $32.07 rate paid to registered nurses for home health visits.
In most states, there is little transparency in the grant reporting or accounting process. While it is routine for other types of state grantees to submit reports and evaluations, it seems common for UPCs to fail customary reporting requirements.
Also, it is routine for state grantees of all types to account for the use of funds honestly and straightforwardly. Nevertheless, many pregnancy centers charge the state far more for products used and services administered – such as pregnancy tests, ultrasounds, STD/STI tests, diapers, packs of baby wipes, baby clothing outfits, car seats, strollers, cribs, and containers of baby formula – than they paid. These mark-ups may exceed 50 or 100 percent of the product’s actual price.
Clearly, taxpayer dollars should not be wasted or misallocated. The legislature and the state administration have an obligation to ensure that funds granted to any nonprofit are spent efficiently and effectively. The American Medical Association urges that: “any entity offering crisis pregnancy services…be transparent with respect to their funding and sponsorship relationships.” That’s not too much to ask.