Issue Overview
The Unregulated Pregnancy Clinic (UPC) industry is large and widespread. More than 2,600 pregnancy centers operate in all 50 states,92 most of which affiliate with one or more of three national organizations: Care Net, Heartbeat International, and National Institute of Family and Life Advocates (NIFLA). Between 2019 and 2022 alone, the UPC industry reported over $5.6 billion in revenue, more than $4.9 billion in expenses, and $2.3 billion in assets.93
UPCs often present themselves as free medical clinics to mislead clients seeking abortion. Their primary goal is to prevent clients, through persuasion, misinformation, or delay, from having an abortion.94 While these organizations have the right to oppose abortion, most use misleading tactics, including ads, signs, and websites presenting their facilities as conventional medical clinics, even, at times, as abortion providers.95,96 Inside, they often resemble medical offices, with waiting rooms and exam rooms outfitted with medical equipment, and staff in lab coats and scrubs. Clients must often fill out intake forms that ask for private health information.97
UPC clients have reported that they believed they were at an actual medical clinic,98,99 where staff made false claims about reproductive health care under the guise of medical authority. UPCs often target people who are young, have lower incomes, and may not be familiar with the difference between a traditional medical clinic and a UPC. These clients are vulnerable; many may be afraid. This vulnerability is exploited when someone who may or may not be an appropriately licensed medical professional makes alarming medical claims to someone in a state of stress. That’s routinely the UPC strategy: use medical impersonation to push falsehoods about the safety of standard reproductive health care.100
Residents of [State] are being inundated with ads for UPCs. Online ads, billboards, and signs frequently make UPCs appear to be standard medical clinics staffed by licensed medical practitioners, when, overwhelmingly, they are not.
The best way to diminish the negative impact of UPCs is to promote fact-based reproductive health care. Between 2021 and 2024, state legislatures allocated over half a billion in taxpayer dollars ($513 million) to the UPC industry.101 It is time to counterprogram against the UPCs’ ubiquitous “Pregnant? Need Help?” style ads.
We also need to promote more accessible, trustworthy resources. UPCs operate and advertise several centralized hotlines and online directories to direct clients their way, such as Heartbeat International’s Option Line102 and Directory of Pregnancy Health Centers,103 Care Net’s National Hotline104 and directory of UPCs,105 the Pregnancy Decision Line,106 and the “Pregnant, Need Help” Hotline.107 While similar resources exist for all-options clinics, they must be easier to use, more widely promoted, and better known.
[NOTE: Unregulated Pregnancy Clinics (UPCs) often posture as abortion clinics and reproductive health care providers, ambiguously advertising themselves as such. Massachusetts created a program which, in part, sought to inform people that UPCs are not medical clinics. This measure addresses the same problem from the opposite direction, helping to advertise regulated reproductive health care clinics. Conservative states have spent $1 billion to promote UPCs and much of that goes into advertising. It is time for more progressive states to step up and counterprogram against the UPCs’ ubiquitous “Pregnant? Need Help?” style ads. This measure is particularly timely because it is anticipated that the current federal Administration and U.S. Congress will direct hundreds of millions of dollars in new federal funding to directly support UPCs.]
[BILL DRAFTING NOTE: This might be a bill or a budget amendment.]
SECTION 1. SHORT TITLE
This Act shall be called the “The Reproductive Care Access and Information Act.”
SECTION 2. FINDINGS
The legislature finds that:
1. Unregulated Pregnancy Clinics (UPCs) [local advocates may want to use another name, so consult with them] are facilities that purport to offer unbiased reproductive health care information, goods and services, but instead they are primarily intended to prevent clients from seeking reproductive health care.
2. Nationwide, UPCs spend hundreds of millions of dollars each year promoting their facilities as if they were regulated medical clinics.
3. Residents of [State] are being inundated with billboards and online advertising that frequently make UPCs seem like medical clinics staffed by licensed medical practitioners, when, overwhelmingly, they are not.
4. The state should provide or support telephone and Internet directories for unbiased reproductive medical services, and those directories must be advertised.
SECTION 3. PROMOTION OF REPRODUCTIVE HEALTH CARE
After section XXX, the following new section XXX shall be inserted:
(A) PROGRAM TO PROMOTE REPRODUCTIVE HEALTH CLINICS
1. The Department of Health is directed to create or support telephone and online directories of reproductive health facilities which direct users to medical clinics that provide a full range of pregnancy services, including birth control, emergency contraception and abortion, and to social service agencies providing infant care supplies.
2. The telephone resource must be a toll-free number staffed by live operators 24 hours per day, seven days per week, and the website must be highly user-friendly, ensuring accessibility for users with limited internet skills.
3. Both the toll-free number and the website must allow callers and users to:
(a) Identify a selection of the nearest medical clinics that provide a full range of pregnancy services, including birth control, emergency contraception and abortion; and
(b) Contact those clinics by providing street addresses, web addresses and phone numbers.
4. The Department may create a new toll-free number and website for this program, or it may partner with other states or with one or more nonprofit organizations using existing or newly-created resources.
5. Once the toll-free number and website are created, the Department shall promote these resources through existing government means of communications as well as through paid advertising.
(B) APPROPRIATION
For the [fiscal year] Fiscal Year: $5,000,000 [or appropriate amount] is appropriated to the [Department of Health] to create and advertise toll-free telephone and website directories of medical clinics that provide a full range of pregnancy services.
SECTION 4. EFFECTIVE DATE
This law shall become effective on July 1, 20XX.
