By Georgeanne M. Usova, ACLU Legislative Counsel

After four years of attacks on our reproductive rights and health by the Trump administration and the anti-abortion legislators it has emboldened around the country, there is much to repair. When President-elect Biden and Vice President-elect Harris take office, their administration must make it a top priority to not just undo the damage, but to take bold, visionary steps to make reproductive health care — including abortion — accessible to all, regardless of their income or ZIP code. Congress, too, has a key role to play in ensuring that everyone is afforded the dignity to make our own decisions about our lives.

Here are just a few of the many items that should top our elected officials’ to-do list:

Reverse dangerous Trump administration regulations targeting reproductive health care, including:

  • The refusal of care rule, which aimed to dramatically expand health care institutions’ and workers’ ability to withhold and obstruct access to essential, even life-saving medical care and information — with no regard for patients’ well-being.While it was rightly struck down in court, it is one of many attempts by the Trump administration to invoke religious or personal beliefs to justify discrimination, particularly against LGBTQ people and people seeking reproductive health care. The Biden administration must ensure that religious liberty is never used as a license to discriminate, and that patients’ needs always come first in health care.
  • The rule undermining the ACA’s birth control benefit, which allows employers and universities to deny their employees or students insurance coverage for contraception by invoking religious or moral objections. This is yet another example of how the Trump administration has discriminated against those seeking health care under the guise of protecting religious liberty. In July, the Supreme Court allowed this discriminatory rule to take effect, potentially robbing hundreds of thousands of people of their no-cost birth control coverage, and forcing employees and students to instead pay out of pocket. The Biden administration must guarantee that no one is denied birth control coverage because of where they work or where they go to school.
  • The rule that has devastated Title X, the 50-year-old family planning program that has provided 4 million patients with low or no incomes with affordable birth control, cancer screenings, STI testing and treatment, and other critical preventive care. The rule prohibits family planning clinics that participate in the program from referring patients for abortion care and imposes other onerous and dangerous requirements. It has resulted in the widespread loss of Title X providers and reduced access to family planning services for those who rely on the program. The Biden administration must restore and rebuild the critical Title X program.

Ensure safe access to medication abortion during the pandemic and beyond.

During the pandemic, the Trump administration went all the way to the Supreme Court to make it as difficult as possible for people to safely access medication abortion care — specifically mifepristone, a prescription medication that has been used to safely end early pregnancies and treat early miscarriages for 20 years. The administration has refused to allow patients to obtain their prescription by mail, insisting that patients travel to a health center solely to pick up a pill, subjecting patients to needless COVID-19 risks. This is despite the Food and Drug Administration having suspended similar requirements for other, far less safe medications during the pandemic. The ACLU won in court, blocking the in-person requirement during the pandemic, but the Supreme Court will soon consider the Trump administration’s request to reinstate it.

This in-person dispensing requirement is part of a longstanding package of outdated, medically unnecessary FDA restrictions that, even prior to COVID-19, have obstructed access to medication abortion — particularly for people with low incomes and communities of color. The Biden administration must immediately pause enforcement of the mifepristone in-person dispensing requirement during the public health emergency. And the FDA should undertake a comprehensive review of the full set of restrictions on mifepristone to ensure that, beyond the pandemic, patients’ access to this safe, effective medication is based on the latest science and medical evidence. 

Make the Hyde Amendment history once and for all. 

President-elect Biden has pledged his support for ending the Hyde Amendment, a harmful ban on abortion coverage for people enrolled in Medicaid and other insurance programs. For decades, Hyde and related bans have pushed abortion care out of reach for people struggling to make ends meet, particularly women of color — the same communities that face severe health care disparities as a result of structural inequality and are now being hit hardest by the pandemic and economic crisis
Now it’s time for Biden to take the critical first step toward ending these discriminatory coverage bans by striking Hyde and all related abortion coverage restrictions from his first budget. This, along with calling on Congress to pass the EACH Woman Act to lift coverage bans, will send a clear message that this administration will work to make abortion not only legal, but also accessible to all. 
Enact a nationwide safeguard against state restrictions.

States have passed more than 460 politically motivated laws to push abortion care out of reach over the last decade çefforts buoyed recently by Trump’s appointment of multiple Supreme Court justices. These laws range from bans on abortion from the earliest days of pregnancy, to laws that interfere with the provider-patient relationship like forced ultrasounds and mandatory delay periods, to clinic shutdown laws that force patients to travel long distances (paying for transportation, lodging, and child care in the process) to obtain care. These restrictions have so severely eroded access to care across vast regions of the country, leaving the right to abortion effectively hollow for many people. 

President-elect Biden should also call for swift passage of the Women’s Health Protection Act to address the crisis of state attacks on abortion access. WHPA would put a stop to these state attacks and, paired with EACH, would make care more affordable and accessible for people throughout the country.




As we look back at the last four years and toward a new administration, there’s no question that there’s a lot of work to do — but we’re ready to go. And our elected officials should be too.