Update |

Election Ups, Downs, and What to Expect  

First, let’s not kid ourselves the midterm elections were a lot. There were important wins. There were really devastating losses. And there was a lot that fell in between those extremes. We’re holding all of that as we think through what this moment means for our movement and for the providers and people seeking abortion care we love so much. Below, the PRH policy team breaks down the opportunities, challenges, and hard work we foresee over the next two years in states, in Congress, and with the Biden-Harris Administration. 

State by State

The TL;DR: as with all elections what happened across states varied greatly, but there was a clear theme– voters overwhelmingly support access to abortion. There were important wins for abortion from state ballot initiatives to governors’ races to legislators being elected who unapologetically expressed support for reproductive and sexual health care. In this moment when states are moving quickly to ban abortion, this momentum really matters.   

Right now, sixteen states have extreme abortion bans in place, and we expect nearly half of the states to move to ban abortion during the next state legislative sessions. This grim reality is what makes the events on election night so incredible – in California, Michigan, and Vermont people voted to protect reproductive rights in their State Constitutions. And voters in Montana and Kentucky defeated anti-abortion ballot measures that would have been devastating for abortion access. And these weren’t the only wins for abortion rights. Voters in Arizona and Pennsylvania, states that were poised to attack reproductive health care this year, elected pro-abortion Governors. And Maryland, while generally a protective state, elected the third Black governor in our nation’s history who is very supportive of abortion access, an important factor in the coming months as more people are forced to travel to states like Maryland because of restrictive abortion laws.  

We won’t sugar coat and claim that it was all good. Unfortunately, many states remain controlled by anti-abortion and anti-trans lawmakers. For example, legislators in Florida have already confirmed they are planning to pursue further abortion restrictions in the upcoming legislative session. And Texas legislators have filed several bills intended to limit access to lifesaving gender-affirming care. 

What does this mean in the long term?  

We are preparing to see a mix of legislative responses from states: in some cases, increasing protections and supports for access to abortion; and in others we are preparing to push back against increased attacks on reproductive and sexual health care, including abortion, contraceptive, and gender-affirming care. At PRH we will continue to support the folks in communities on the ground, including our network of nearly 500 physician advocates, to push for a world where everyone has access to the care they need, when they need it, in their own communities. And we’ll continue to keep you apprised of the rapidly changing environment and ways you can engage along the way!  

Congress – a split in leadership

The TL;DR: People across the country felt the impacts of the Supreme Court’s decision to overturn Roe v. Wade, and largely voted to elect leaders who would protect abortion access. This is huge. It means anti-abortion lawmakers and Republicans have only a narrow majority in the House of Representatives and Democrats retained control of the Senate (final outcome also to be determined by a runoff election in Georgia). A historic and important outcome.  

The bottom line is abortion matters (duh, we knew that)! It’s popular (we knew that too!). And we gave a clear mandate to our elected politicians that they must fight like hell for us in this moment (and we get to say ‘we told you so!’).  

What does this mean in the short term? We need our elected leaders to get it into gear and move a whole host of major priorities before the new Congress starts in January and anti-abortion lawmakers take control of the House.  

  • We expect the House to take a historic vote on the EACH Act, which would ensure abortion justice by reversing the discriminatory Hyde Amendment and related abortion coverage restrictions. Everyone deserves access to abortion free from unnecessary barriers, including cost, regardless of where they live or how much money they earn.  
  • We expect the Senate to pass the Pregnant Workers Fairness Act, which would ensure pregnant people are able to get the reasonable, temporary workplace accommodations they need to care for themselves and their families. There is absolutely zero excuse not to. It’s bonkers that in 2022 pregnant people are still being pushed out of their jobs for requesting simple supports such as a stool to sit on or a glass of water at a work station.  
  • We expect the House and Senate to pass an appropriations bill with critical funding to address key priorities, such as addressing our nation’s maternal mortality crises, including a mandatory extension of postpartum Medicaid coverage for one year, significant investments in the Title X Family Planning Program, and we expect strong opposition to any harmful appropriations riders that would limit access to abortion care.    
  • We expect the Senate to abolish the filibuster and pass critical voting rights legislation and legislation to undue harmful bans on abortion. The filibuster is a racist, crusty old procedural tool that requires sixty Senators to pass any legislation. It has been used time and again to stop progress and it has got to go. The filibuster is what is standing in the way right now of the Senate passing voting rights legislation and the Women’s Health Protection Act. We desperately need both. We will not stop until we get it.  

How can you help right now?  

It is undeniable that this is a packed agenda and the end of the year is quickly approaching. PRH is going to be moving full steam ahead to see as many of these priorities to the finish line as we can and you can help!  

  • Tell your Representative you want a vote on the EACH Act!  
  • Tell your Senator they must pass the Pregnant Workers Fairness Act now!
  • Tell your Member of Congress you want to see them pass critical funding for Title X, address our maternal mortality crises, and put an end to harmful appropriations provisions that limit access to abortion such as the Hyde Amendment!  
  • Tell your Senator you want them to abolish the filibuster and pass critical voting rights protections and pass the Women’s Health Protection Act! 

What will the split in leadership mean in the long term?  

Having a split Congress is not an easy thing. It means that we can expect it to be very difficult to pass legislation, unless it has significant bipartisan support. It also means we can expect anti-abortion representatives in the House to use their power to spread mis/disinformation about reproductive and sexual health care, hold harmful hearings, and take votes on legislation that would be harmful to our communities. While this reality might be disheartening – we will hold firm. We know they don’t represent us or the majority of people across this country and we will do everything we can to hold them accountable and to show up for what’s right. And the good news is we can count on the Senate to do the same and stop anything harmful from passing into law – and we’ll hold them to that!   

Administration – President Biden has a clear mandate from voters!

 The TL;DR: It couldn’t be clearer if you had it tattooed on your forehead. Abortion is popular! It’s a winning issue! Voters really care about abortion access! The Administration should not sit back – it must continue to do everything in its power to protect and expand abortion access.  

The Biden-Harris Administration has arguably done a lot since the Supreme Court’s decision came down, but now is not the time to stop whatever momentum we have. There is a large majority of states that have moved (or will this next state session!) to ban abortion and push it entirely out of reach for many people. This is a crisis moment, and one election does not change that – it’s going to take all of our ongoing, collective effort to address the root of the harm that is flowing from the overturn of Roe and this includes ongoing efforts from the Biden-Harris Administration.  

We still need the Administration to:  

  • Declare a Public Health Emergency. Declaring a public health emergency would give the Administration some additional powers as well as give providers and patients additional flexibilities to provide care via telehealth, including in places with restrictive laws.  
  • Protect Access to medication abortion care. The Administration should do everything in its power to continue educating the public about the safety and efficacy of medication abortion care, combatting mis/disinformation about medication abortion care, and preempt harmful state laws that attempt to restrict access to medication abortions.   
  • Protect people who are at risk of criminalization. In this moment patients and providers are at heightened risk of being criminalized because of their pregnancy outcomes. This is not a theoretical concern. For decades, pregnant people across the country have been arrested, subjected to prosecution, detained, sent to jail, separated from their children, and have had medical interventions forced upon them because of their pregnancy outcomes, including for self-managing their abortions or seeking care after experiencing a miscarriage. The Biden Administration must continue to grapple with the fallout from the Supreme Court’s decision and the increasing number of bans on abortion and bring their full weight to bear when patients and providers are subjected to criminalization.  

Even with some important good news, we know this moment is hard. We’re in the thick of it with all of you and we promise to keep pushing for the important changes we need to see so that all of us can live freely with dignity and security. We’re glad to be in community with you. Stay tuned for more important updates and ways to engage.  

With love,  

The PRH Policy Team