WASHINGTON — President-elect Donald Trump will have to make several decisions in the coming months about whether his second administration will maintain current access to contraception and abortion or implement changes.
While Trump alone cannot enact nationwide laws or abortion bans without Congress, he and the people he selects for key positions across the federal government will have significant influence on reproductive rights across the country.
During Trump’s first term, he banned family planning grants to health organizations that perform abortions or refer patients under Title Women are at risk.
Alina Salganicoff, senior vice president and director of women’s health policy at the nonpartisan health research organization KFF, said in a call with reporters Friday that about a quarter of providers have had federal family planning grants withdrawn or excluded because of the policy.
“The Title X program essentially funds family planning services for low-income people,” Salganicoff explained. “It’s basically a small program – it costs about less than $300 million – but it’s an important program for people who otherwise don’t have insurance.”
Abortions as stabilizing care
Trump will also have to decide whether to maintain Biden administration guidance that says a 1980s federal law protects health care providers who perform abortions as stabilizing care in an emergency that threatens a woman’s health or life would affect.
That law, known as the Emergency Medical Treatment and Labor Act (EMTALA), became a point of contention between the Biden administration and Republican states that implemented abortion bans or strict restrictions after the Supreme Court struck down the nationwide right to abortion.
U.S. Health and Human Services Secretary Xavier Becerra wrote in a letter published in July 2022 that under federal law, “women have the right to emergency care – including abortion care, regardless of where they live.”
EMTALA is the focus an ongoing legal dispute between the Biden administration and Idaho over that state’s abortion law. Oral arguments before the 9th Circuit Court of Appeals are scheduled for early December.
abortion pill
The future of medication abortion, a two-drug therapy approved for pregnancy up to 10 weeks and used in about 63% of abortions nationwide, will be another area the Trump administration is targeting without congressional approval could change.
Salganicoff said there is no way to know yet whether the U.S. Food and Drug Administration will change prescribing guidelines for medication abortions or revoke the approval of mifepristone entirely in 2000.
“We don’t know if they will actually review the approval, but I will tell you that they will probably re-examine the conditions for medication abortions, which now account for almost two-thirds of all abortions in this area. ” Salganicoff said.
She said the Trump administration will likely focus on changes made during the Biden administration that allow doctors or other qualified health care providers to prescribe the two-drug abortion regimen via telemedicine and then deliver mifepristone and misoprostol to the patient by mail to be sent.
Salganicoff expects anti-abortion organizations will also encourage the Trump administration to address recent findings from the We Count Project, which show that one in 10 abortions occurs after medication abortions are mailed to people in states where there are bans or significant restrictions from states that have shield laws.
“This FDA protocol is legal to do that, but that will clearly be a goal,” she said.
Shipping abortion medications
The Comstock Act, a delayed 19th century anti-obscenity law that once banned sending boxing photos, pornography and contraception, will also be in focus after Trump takes the oath of office on January 20.
The law, which is still in effect despite not being enforced in decades, could potentially allow the U.S. Postal Service to prevent the shipment of abortion drugs or other instruments or tools used in abortions.
“The Biden administration’s Justice Department did a review and determined they would not be enforcing Comstock,” Salganicoff said. “Project 2025 sees this very differently, and although President-elect Trump has said he will not enforce Comstock, it is unclear and there will likely be a lot of pressure to do so.”
Project 2025 is a political map for a Trump presidency published by the Heritage Foundation. Trump has denied any connection to it, although former members of his first administration helped develop it.
Salganicoff said enforcing the Comstock Act would hurt access to medication abortion across the country, even in states that have strengthened reproductive rights in the last two years.
“This is clearly going to bring a lot of litigation and challenges,” Salganicoff said.
Larry Levitt, executive vice president of health policy at KFF, said during the call that the Trump administration’s potential collection of people who spread misinformation or disinformation could lead to more confusion about research-based health care.
“I think one thing, particularly with RFK Jr.’s increasing prominence, is the potential for misinformation,” Levitt said, referring to Robert F. Kennedy Jr., a prominent anti-vaxxer who supported Trump and campaigned extensively with him him.
“We look to the government for reliable data, public health information and scientific information,” Levitt said. “And there is now the potential for the government to not only not be an effective source of health information, but actually an accelerator of misinformation.”
Last updated on November 8, 2024 at 3:51 p.m
