President-elect Donald Trump’s victory has cast a long shadow over abortion rights in the United States, despite voters in seven out of ten states approving ballot measures to safeguard access to the procedure. While Trump has stated he won’t support a federal ban, his administration’s actions, through executive orders and agency appointments, could significantly restrict abortion access nationwide, potentially impacting millions of women and exacerbating existing healthcare disparities. Experts warn of a chilling effect on reproductive healthcare, particularly for low-income individuals and people of color, raising serious concerns about the future of abortion rights in America.
Key Takeaways: A Storm Brewing Over Abortion Rights
- Despite widespread state-level support for abortion rights, President-elect Trump’s victory poses a significant threat to access to the procedure.
- Trump’s administration could utilize existing laws like the Comstock Act and leverage executive power to implement widespread restrictions, potentially bypassing Congress.
- Targeting medication abortion, which accounts for 63% of all abortions in the U.S., is a high-priority concern, with potential restrictions on telehealth access and the drug mifepristone.
- Appointments of anti-abortion officials to key agencies like the FDA and DOJ could further restrict abortion access through regulatory changes and enforcement.
The Looming Threat of the Comstock Act
A significant concern among abortion rights advocates is the potential for the Trump administration to enforce the Comstock Act of 1873. This law, while largely unenforced for decades, prohibits the sending of abortion-related materials through the mail. A Trump administration could interpret this broadly to block the shipment and distribution of abortion pills like mifepristone and misoprostol, as well as medical equipment used in abortion procedures. Julie Kay, co-founder and executive director of The Abortion Coalition for Telemedicine, highlights the potential for sharp restrictions or an outright ban on medication abortion through this avenue. This action would require appointing a strategically chosen U.S. attorney general, a move requiring Senate confirmation.
A Battleground of Interpretations and Legal Challenges
While the Biden administration considers the Comstock Act outdated, anti-abortion advocates and figures within Trump’s inner circle, including Vice President-elect JD Vance, strongly advocate for its enforcement. This stance is also shared by numerous anti-abortion organizations. The potential enforcement would likely face legal challenges, potentially reaching the Supreme Court. Notably, Justices Alito and Thomas have previously expressed openness to using the Comstock Act to restrict abortion access, raising concerns about the court’s potential ruling.
Appointing Anti-Abortion Actors to Key Agency Roles
Another significant threat lies in the potential appointment of anti-abortion leaders to key federal agencies. The Department of Health and Human Services (HHS), the Food and Drug Administration (FDA), and the Department of Justice (DOJ) all play crucial roles in regulating and enforcing abortion-related policies. Kelly Baden, vice president for policy at the Guttmacher Institute, emphasizes the instrumental role these agencies have played in protecting abortion rights in a post-Roe v. Wade landscape. The FDA, in particular, holds significant power over medication abortion, as illustrated by recent legal battles and Supreme Court cases.
The FDA and Mifepristone: A Potential Target
A Trump administration could direct the FDA to severely restrict or potentially eliminate access to mifepristone, a key drug in medication abortion. While a recent Supreme Court decision upheld the FDA’s 2023 approval of mifepristone, a Trump-appointed FDA could attempt to roll back prior expansions of access, reinstating requirements that demand in-person dispensing. This would effectively eliminate the increasingly popular telehealth option for obtaining medication abortion which accounts for nearly 1 in 5 abortions in late 2023. This restriction, according to Alina Salganicoff of KFF, would create a “chilling effect” on abortion access, leading to increased travel burdens, delays, and denials of care.
Beyond Restrictions: The Threat of Rescinding Approval
The most extreme scenario involves the FDA rescinding mifepristone’s approval altogether. Such an action would disregard substantial scientific evidence supporting the drug’s safety and efficacy. While Trump vaguely hinted at such a move, the subsequent attempt by Vance to walk back these remarks highlights the inherent uncertainty and political maneuvering surrounding this critical issue. These actions underscore the deeply divisive partisan political climate and the precariousness of abortion rights in the U.S.
Reviving Old Rules, Gutting Biden’s
Beyond aggressive new initiatives, a Trump administration could swiftly roll back existing policies implemented by the Biden administration that expanded abortion access. This includes reinstating the domestic gag rule, which prohibits federally funded Title X family planning providers from offering referrals or counseling about abortion. Eliminating access to family planning resources could severely restrict the scope and accessibility of reproductive services. This would not only limit access to abortion but also create a cascading negative effect on reproductive health.
Undoing Progress: A Swift Reversal of Policy
Baden warns that the potential reversal of the gag rule, and the dismantling of other Biden-era policies, could represent a significant blow to reproductive healthcare. The rapid speed of this potential policy shift emphasizes the vulnerability of abortion access under a Trump administration. The potential elimination or reduction of resources for access would negatively impact low-income individuals and people of color disproportionately, further exacerbating existing health inequalities.
Katie O’Connor, senior director of federal abortion policy at the National Women’s Law Center, summarizes the situation grimly: “**The more restrictions we see on abortion over the next four years, the worse health outcomes are going to be. People are suffering and dying unnecessarily.**” The future of abortion access in the U.S. hangs precariously in the balance, awaiting the concrete actions of the incoming Trump administration. The coming years will be a critical test for the future of reproductive freedom in the country.
