The presidential election has thrown the United States’ position on various policy issues into question, one of the most contested and critical among them the constitutional right to safe, legal abortion. President-Elect Trump has made it clear that he supports a repeal of Roe v. Wade, and has indicated that opposition to abortion is a critical deciding factor in his choice of Supreme Court nominees. While focusing concern on the Supreme Court is absolutely justified, it is important to note that the election of Donald Trump will have serious impacts on reproductive health far and beyond the highest court – impacts that will be felt nationally, at the state level, and even abroad.

Below are three ways in which the election of Donald Trump will most immediately impact reproductive health, rights and justice:  

Return of the “Global Gag Rule”:

The Mexico City Policy, colloquially referred to as the Global Gag Rule, was enacted in 1984 by Ronald Reagan. The rule prohibits any international organization that is receiving U.S. aid from providing abortion services, and even prohibits aid workers from talking about abortion with the women they serve (in essence, a “gag”). It’s important to note that U.S. funding for abortion has been illegal since the 1973 passage of the Helms Amendment – this policy does not prevent direct funding for abortion, but instead guts funding for any organization that provides women’s reproductive health care with their own dollars. The resulting health impacts are severe: international aid organizations must choose between continuing to provide comprehensive reproductive healthcare and losing a significant portion of their funding, or cutting critical programs that provide care for millions of women and families abroad.  

The Global-Gag rule is a classic example of the ongoing political fight over reproductive rights: President Bill Clinton revoked the global-gag rule on his first day in office, President George W. Bush reinstated it, and President Obama once again revoked it shortly after his inauguration. Global reproductive rights health experts fully expect Trump to reinstate this rule upon entering the White House, with severe consequences for women and communities across the globe.

Repeal of the Affordable Care Act & No-Cost Contraception:

Since its implementation, the Affordable Care Act (“Obamacare”) has provided millions of American women with increased access to affordable, high-quality reproductive health care. Most significantly, the ACA mandates that insurers cover women’s preventive services at no cost to the consumer, including STI screenings, mammograms, pap-smears, and FDA-approved birth control. It is estimated over 30 million women rely on contraception provided at no cost under the Affordable Care Act. The ACA resulted in a total savings of more than $1.3 billion in contraceptive costs in 2013 alone.  

Unfortunately, the ACA faces an uncertain future under President Trump. Trump has been clear in his disdain for Obamacare: He repeatedly campaigned on a repeal of the law, and will be sworn into office alongside a Republican House and Senate that have collectively voted more than 60 times to repeal the ACA.

But while a repeal of the Affordable Care Act certainly appears likely, President Elect-Trump may not even need Congressional approval to dismantle the ACA’s no-cost birth control provision. Birth control coverage is not written into the legislation of the Affordable Care Act; as noted above, it is a result of the Department of Health and Human Services deciding (despite intense anti-abortion lobbying) to include it as a tenant of women’s “preventative” care. To overturn the mandate, Trump would simply have to direct HHS to remove contraception from this list. He is unlikely to find an opponent in newly-announced HHS Secretary Price, who previously called the contraception mandate a “trampling on religious freedom and religious liberty in this country.”

Emboldening Anti-Choice State Legislators:

While there is a tendency for policy-makers to focus only on Trump’s impact on federal policy, it is important to note that Trump’s election is already having an impact on reproductive rights at the state level. Anti-women’s health legislators in several states have been emboldened by the election of Trump, who in his campaign went as far as openly endorsing “some form of punishment” for women who access abortion.

In Texas, state regulators recently approved a rule mandating burial services for aborted fetuses. The requirement – which was opposed by the American Medical Association and represents a severe departure from established medical practice – is viewed widely as an attempt to further shame women who choose to access safe, legal abortion. On Tuesday, Ohio legislators passed a bill to ban abortion after six weeks after conception, a point at which many women do not even know they are pregnant. Although the bill was previously denounced by both Republicans and Democrats as unconstitutional, anti-abortion leaders cited Donald Trump’s election as a primary motivator for the bill’s current success.   

While states have been passing anti-women’s health measures at an alarming rate (a total of 231 anti-abortion measures have been passed by states over the last 5 years alone) Trump’s election will almost certainly lead to even more extreme attacks on reproductive rights at the state level.

 

Alena Yarmosky is the former Director of Advocacy & Communications NARAL Pro-Choice Virginia  and a Master of Public Policy candidate at the Goldman School of Public Policy