U.S. Federal Agencies and Reproductive Rights

These federal agencies have the most influence on U.S. reproductive health and rights policies.

Agency officials across the federal government implement and enforce laws, make funding decisions, collect and analyze data, and create rules affecting everyday lives across the country. The following agencies have the most influence on reproductive health and rights policies.

Leading America’s foreign policy, the U.S. State Department works to empower and protect women and girls—including promoting their sexual and reproductive health and rights—as a central part of U.S. foreign policy and national security. Through the State Department, the U.S. is the largest donor to maternal health and voluntary family planning programs worldwide, including the provision of life-saving obstetric care in crisis settings.

Associated Agencies in the State Department

> Office of the Secretary of State: The Office of the Secretary of State supports the operations and coordination of the Secretary’s foreign policies. Notably, the Office assists the Secretary in overseeing funding for international health programs, interpreting and implementing the Global Gag Rule (when/if applicable), and providing U.S. support for the advancement of international declarations. 

>United States Mission to the United Nations: The Mission is responsible for carrying out the United States’ participation in the world body the United Nations. Mission staff represent the U.S.’s political, economic, social, legal, military, public diplomacy, and management interests at the United Nations. 

>United States Agency for International Development (USAID): USAID is an independent federal government agency that receives overall policy guidance from, and reports to, the Secretary of State. USAID leads the U.S.’s international development and disaster assistance through partnerships and investments, including in global health, gender equality and women’s empowerment. 

>Office of Global Women’s Issues: The Office of Global Women’s Issues promotes the rights and empowerment of women and girls through U.S. foreign policy. 

>Office of International Religious Freedom: The Office of International Religious Freedom promotes universal respect for freedom of religion and belief as a core aspect of U.S. foreign policy. 

>Bureau of Legislative Affairs: The Bureau of Legislative Affairs coordinates all of the Department’s legislative activity, serving as the main liaison to Congress and advising Department leadership on strategy. 

>Bureau of Population, Refugees, and Migration: The Bureau of Population, Refugees, and Migration is the Department’s humanitarian bureau, promoting U.S. interests by providing protection, easing suffering, and addressing issues impacting persecuted and forcibly displaced people around the world. 

>Bureau of International Organization Affairs: The Bureau of International Organization Affairs develops and implements U.S. policy at the United Nations and other multilateral organizations, employing diplomacy as a tool to advance U.S. policy and ensure that international organizations become more efficient and effective. 

>Bureau of Democracy, Human Rights, and Labor: The Bureau of Democracy, Human Rights, and Labor works to instill and promote universal values, including respect for the rule of law, democratic institutions, and human rights, in U.S. foreign policy. The Bureau helps to support democratic institutions and prevent democratic backsliding, promote accountability, uphold international labor standards, and advance the human rights and equity of marginalized racial, ethnic, and religious communities, Indigenous people, people with disabilities, and members of the LGBTQI+ community.

The U.S. Department of Health and Human Services (HHS) is the government’s principal agency for protecting the health of all Americans. HHS invests in strategies to expand equitable access to comprehensive, community-based, innovative, and culturally and linguistically appropriate health care services while addressing social determinants of health. It is the largest federal department in terms of budget and funds domestic reproductive and maternal health programs, as well as sets rules for reproductive health coverage in federal programs. 

Associated Agencies in HHS

>Immediate Office of the Secretary: The Office of the Secretary is responsible for operations and coordination for the work of the Secretary of Health and Human Services. It includes the Offices of the Deputy Secretary, Chief of Staff, and General Counsel.

>Food and Drug Administration: The Food and Drug Administration (FDA) regulates products like drugs, biological products, and medical devices. FDA determines whether certain products can be sold in the marketplace and what restrictions should be placed on them; this includes birth control, medication abortion, fertility drugs, labor and delivery medications, and STI treatment. 

>Centers for Disease Control and Prevention: The Centers for Disease Control and Prevention (CDC) is the nation’s leading science-based, data-driven, service organization that protects the public’s health. CDC manages data collection from state and local health departments in an effort to better understand health trends, including voluntary reporting of abortion vital statistics. 

>Centers for Medicare & Medicaid Services: The Centers for Medicare & Medicaid Services (CMS) provides health coverage to more than 160 million through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. CMS administers the federal portion of the Medicaid program, which is the largest public payer of reproductive health services and provides health coverage for more than 16 million women of reproductive age. CMS also enforces health care laws like the Emergency Medical Treatment and Active Labor Act (EMTALA), which requires federally funded hospitals to treat pregnant people experiencing emergency complications. 

>Office for Civil Rights: The Office for Civil Rights (OCR) enforces federal civil rights and privacy laws to protect individuals in health care settings from discrimination and breaches of confidentiality. OCR investigates reproductive health-related discrimination, for example pregnancy discrimination in hospitals or impermissible sharing of abortion records. 

>Office of Intergovernmental and External Affairs: The Office of Intergovernmental and External Affairs (IEA) includes the Center for Faith-based and Neighborhood Partnerships, HHS’s liaison to faith-based and community organizations. 

>Office of the Assistant Secretary for Health: The Office of the Assistant Secretary for Health (OASH) is the primary advisor to the Secretary on matters involving the nation’s public health and is responsible for the Department’s strategic and policy direction. OASH includes the Office of Population Affairs, which runs the Title X program for domestic reproductive health services, Surgeon General, Office on Women’s Health, and Office of Minority Health. 

>Office of Global Affairs: The Office of Global Affairs (OGA) is the diplomatic voice of HHS. The office fosters critical global relationships, coordinates international engagement across HHS and the U.S. government, and provides leadership and expertise in global health diplomacy and policy to contribute to a safer, healthier world. 

>Office of Inspector General: The Office of the Inspector General (OIG) provides objective oversight to promote the economy, efficiency, effectiveness, and integrity of HHS programs, as well as the health and welfare of the people they serve. OIG guides more than 1,600 auditors, evaluators, investigators, data analysts, attorneys, and management professionals who carry out OIG investigations, such as how federal funds are being used to support reproductive health providers.

The U.S. Department of Justice (DOJ) is the world’s largest law office and the central agency for enforcement of federal laws. DOJ monitors, evaluates, and can take legal action against all state and local legislation, regulations, and enforcement actions that violate federal law. DOJ acts as the federal government’s lawyer, providing legal guidance on agency action, and defending agencies and federal laws in court, including cases before the U.S. Supreme Court (SCOTUS). DOJ is the chief department in charge of defending domestic reproductive rights policies when challenged in court. (Notably, DOJ has authority over the Comstock Act, which could be misused in the Trump Administration as a de facto abortion ban.)

Associated Agencies in the DOJ

>Office of the Attorney General: The Office of the Attorney General (OAG) supports the U.S. Attorney General, who serves as the head of the Department of Justice and chief law enforcement officer of the federal government. OAG provides advice and opinions to the President and to the heads of the executive departments when so requested.

>Office of the Solicitor General: The Office of the Solicitor General (OSG) supervises and conducts government litigation at SCOTUS. OSG is involved in approximately two-thirds of all the cases that the U.S. Supreme Court decides on the merits each year. 

>Office of the Associate Attorney General: The Office of the Associate Attorney General supports the Associate AG, the third-highest ranking official in DOJ. The Office provides assistance and advice to the Attorney General and Deputy Attorney General. 

>Civil Rights Division: The Civil Rights Division (CRD) works to uphold the civil and constitutional rights of all persons in the United States, particularly the most vulnerable members of our society. The Division enforces federal statutes prohibiting discrimination on the basis of race, color, sex (including pregnancy, sexual orientation, and gender identity), disability, religion, familial status, national origin, and citizenship status. 

>Office of the Deputy Attorney General: The Office of the Deputy Attorney General (ODAG) supports the Deputy Attorney General, DOJ’s second-ranking official.

The Executive Office of the President (EOP) provides the President with the support that he or she needs to govern effectively. The office consists of several sub-offices and agencies, such as the Gender Policy Council, Domestic Policy Council, and Office of Management and Budget. This department is overseen by the White House chief of staff and ultimately reports to the President. In friendly administrations, these agencies meet with members of the public to solicit feedback and determine priorities, including on reproductive rights policies and programs. 

Associated Agencies in the EOP

>Office of Management and Budget: The Office of Management and Budget (OMB) produces the President’s Budget, an important, although non-binding, document that provides Congress with an appropriations roadmap based on the President’s priorities. The President’s Budget provides funding estimates for how Congress should appropriate money for programs like Title X and health law enforcement; the Budget has historically contained anti-abortion riders that the Center advocates against. OMB also examines agency programs, regulations, and guidance to ensure that they comply with the President’s policies. For example, OMB conducts “12866 meetings,” in which public stakeholders can provide OMB with information about why it should or should not approve a regulation consistent with the President’s agenda.