WASHINGTON — President-elect Donald Trump has several choices to make in the coming months about whether his second administration will keep access to contraception and abortion as it is now or implement changes.

While Trump can’t single-handedly pass laws or ban abortions without Congress, he and the people he picks for key positions in the federal government will have significant influence on reproductive rights nationwide.

During Trump’s first term, he barred health care organizations that perform or refer patients for abortions from receiving Title X family planning grants, even though there is a moratorium on using federal funds for abortions unless it is the result of rape or incest or the woman’s life is in danger.

Alina Salganicoff, senior vice president and director of women’s health policy at the nonpartisan health research organization KFF, said on a call with reporters Friday that about a quarter of providers have withdrawn or been disqualified from receiving federal family planning grants as a result of this policy.

“The Title X program basically funds family planning services for low-income people,” Salganicoff explained. “It’s basically a small program, it’s around $300 million — but it’s an essential program for people who otherwise don’t have insurance.”

Abortions as stabilizing care

Trump will also have to decide whether to leave in place guidance from the Biden administration, which says a federal law from the 1980s protects health care providers who perform abortions as life-saving care during an emergency that would harm health or a woman’s life.

That law, known as the Emergency Medical Treatment and Labor Act, or EMTALA, has become a point of contention between the Biden administration and Republican states that have implemented abortion bans or strict restrictions after the Supreme Court ended the national right to abortion.

US Health and Human Services Secretary Xavier Becerra wrote in a letter published in July 2022 that under federal law, “no matter where you live, women have the right to emergency care — including abortion.”

EMTALA is at the center an ongoing process between the Biden administration and Idaho over that state’s abortion law. Oral arguments in the 9th Circuit Court of Appeals are set for early December.

The abortion pill

The future of medication abortion, a two-drug regimen approved for up to 10 weeks of pregnancy that is used in about 63 percent of abortions nationwide, will be another area the Trump administration could change without congressional approval.

Salganicoff said there’s no way to know yet whether the U.S. Food and Drug Administration will try to change prescribing guidelines for medical abortion or revoke the 2000 approval of mifepristone altogether.

“We don’t know if they will actually review the approval, but I will tell you that they are likely to review the conditions under which medication abortions, which now account for almost two-thirds of all abortions in this area. country, can be provided,” Salganicoff said.

The Trump administration, she said, will likely focus on revisions made during the Biden administration that allow doctors or other qualified health care providers to prescribe the two-drug abortion regimen via telehealth and then dispense mifepristone and misoprostol to the patient.

Salganicoff anticipates that anti-abortion organizations will also encourage the Trump administration to address recent findings from the We Count Project, which show that 1 in 10 abortions occur after medication abortions are mailed to people in states with significant bans or restrictions in states that they have protective laws.

“This FDA protocol is legal to do that, but clearly that’s going to be a target,” she said.

Mail order abortion drugs

The Comstock Act, a late 19th-century anti-obscenity law that once banned the mailing of boxing, pornography and contraception photos, will also be in the spotlight after Trump is sworn in on January 20 .

The law, which is still current despite not being enforced for decades, could allow the US Postal Service to prevent abortion drugs or any other instrument or instrument used in abortion from being sent through the mail.

“The Justice Department of the Biden administration did a review and said they were not going to enforce Comstock,” Salganicoff said. “Project 2025 sees it differently, and while President-elect Trump has said he won’t enforce Comstock, it’s not clear, and there’s likely to be a lot of pressure to do so.”

Project 2025 is a policy map for a Trump presidency published by the Heritage Foundation. Trump has disavowed any connection to it, although former members of his first administration helped develop it.

Salganicoff said enforcement of the Comstock Act would affect access to medication abortion across the country, even in states that have strengthened reproductive rights in the past two years.

“Clearly, that’s going to create a lot of litigation and challenges,” Salganicoff said.

Larry Levitt, executive vice president for health policy at KFF, said on the call that the Trump administration’s possible increase in people spreading misinformation or disinformation could lead to more confusion about research-based health care.

“I think one thing, especially with the rise of RFK Jr., you know, is the potential for misinformation,” Levitt said, referring to Robert F. Kennedy, Jr., a prominent vaccine opponent who supported the Trump and campaigned extensively. with him.

“We look to the government for reliable data, public health information and scientific information,” Levitt said. “And the potential is now there for government to not only be an effective source of health information, but actually an accelerator of misinformation.”

Last updated 2:51 pm, November 8, 2024