Reproductive Healthcare – Vote in the 2024 Presidential Election. With the facts and without all the noise.

If you vote primarily on a conviction that life begins at conception and abortion should be outlawed, Trump is your man. He rightfully claims credit for appointing the three Supreme Court justices who overturned 50 years of precedent in overturning Roe v Wade. If your primary issue is that you want women and their partners and doctors to be allowed, within certain limits, to make their own choices about carrying pregnancies to term – no matter what state they happen to live in – then Harris should get your vote.

But Reproductive Healthcare is in fact about a lot more than access to abortion. In the years since Roe v Wade was overturned, Americans have seen how that change has vastly complicated medical care for pregnant women in states that have passed abortion bans or restrictions. Story after story has emerged from states with restrictive laws about doctors denying urgently needed healthcare to women with problem pregnancies because they fear litigation. These stories would multiply by the thousands if Trump and a Republican Congress fulfill their promised agenda, in Project 2025, for a national abortion ban. Trump’s current position (to “let the states decide”) is not a coherent one: if the principle is to prevent the federal government from ruling on abortion access, left unsaid is why should that principle should be any different for state governments.

The two candidates’ positions on these issues will directly affect how Americans and our healthcare system manage reproduction and child-bearing. That includes matters like access to contraception and, on the other side of that coin, pregnancy assistance programs such as in-vitro-fertilization (IVF). Here’s how both candidates line up on all of the related issues.

Harris

Kamala Harris has been an outspoken defender of reproductive rights & freedoms since her days as attorney general in California. Harris supports full implementation of the contraception coverage requirement in the ACA, and also supports policies that would expand access to contraceptives for military members and their families. The Biden-Harris administration restored rules of the federal Title X family planning program (that Trump had eliminated) requiring clinics to offer a full range of contraceptives and pregnancy counseling options and re-allowing clinics that offer abortions (using non-federal funds) to access Title X funding. Under the Biden-Harris administration, the FDA approved the first over-the-counter oral contraceptive pills and continues to work to enhance access. Harris supports guaranteed rights to IVF and as vice-president has spoken out against the Alabama Supreme Court decision that brought this issue to the table.

Harris supports enactment of a federal law to restore Roe v. Wade’s national standard of abortion legality up to fetus-viability. She has been the leading voice of the Biden-Harris administration’s stance on abortion.

The administration has defended abortion access in two Supreme Court cases, issued guidance affirming that abortions necessary to address pregnancy-related emergencies are protected by the Emergency Medical Treatment and Active Labor Act, and revoked abortion-related restrictions the Trump administration had expanded on providing family planning funding to international partners and non-governmental organizations.

Trump

Donald Trump appears to care little for the provision of affordable, accessible reproductive healthcare. Planned Parenthood, for example, provides a broad range of care and services related to family planning and the health of a woman’s reproductive system, and complies with the legal requirement that costs associated with abortion cannot be paid for using federal funds but must be funded separately. Nevertheless, as president, Trump prohibited family planning clinics offering abortion, such as Planned Parenthood, from receiving funding for any maternal or reproductive health service from the federal Title X family planning program. Approximately 25% of participating reproductive health clinics were forced to close as a result.

Trump also issued regulations allowing any employer with a “religious or moral objection” an exemption from the ACA’s contraceptive coverage requirement and approved several limitations that the state of Texas placed on use of Medicaid funding for family planning services. Trump has said that he supports access to IVF care, but there are references in the Republican party platform to strategies that could be used to prevent IVF.

Under Trump, a woman’s ability to secure an abortion – or to access reproductive healthcare might be deemed to be related to an abortion – will vary enormously depending upon where she lives.

Aware that national polls put support for abortion rights at greater than 60%, Trump recently has proclaimed that if he is elected, under his administration women “won’t be thinking about abortion.” It should be clear that this will not be true for women who live in the 21 states with strict limits on abortion access.