Many progressives found themselves pleasantly surprised with Joe Biden after his first 100 days in office. He’s willing to go big, embrace the legacy of FDR and LBJ, and pass trillions in investments on party-line votes if Republicans don’t offer real solutions. In his first joint address to Congress last month, Biden laid out his agenda and made an unapologetic, empathetic case for big solutions to big crises: not just the pandemic and economic collapse, but also climate change, gun violence, systemic racism, immigration, and more. From the well of the House, Biden proudly advocated for just about every progressive reform that his administration supports. Yet he was silent on one major issue: the decimated state of access to safe, legal, and affordable abortion and the Republican Party’s continually escalating efforts to make it worse.
If you have an unwanted or unviable pregnancy, access to abortion is infrastructure. It can make or break your economic security and your health. About one in four women will have an abortion during their lifetime. Yet, thanks to decades of coordinated attacks from abortion opponents, most U.S. counties don’t have an abortion provider. Six in ten women of reproductive age live in states where policies on abortion access are more hostile than supportive. Many patients are forced to travel hundreds of miles, pay hundreds if not thousands of dollars out of pocket, and endure humiliations like forced ultrasounds, medically inaccurate anti-abortion “counseling,” and gauntlets of protesters who can more easily target abortion clinics for harassment when there are so few remaining. If the conservative Supreme Court overturns Roe v. Wade, abortion would probably be banned altogether in 22 states.
Biden discussed none of this in his joint address, even though states like Arizona and Texas are making headlines for extreme anti-abortion bills. Republican state lawmakers have already filed over 500 bills to restrict abortion this year, compared to over 300 by the same time in 2019. This includes outright abortion bans that defy Roe v. Wade—a deliberate strategy to hand the Supreme Court a case that would overturn the landmark ruling.
Attacks on abortion access are getting more intense, not less, in the wake of Donald Trump’s defeat. The abortion rights established under Roe v. Wade have already been chipped away to the point that they only apply if you have financial means or live in the right zip code. And if Biden doesn’t go bigger on abortion, things will only get worse.
It’s true that Biden has taken some positive steps for reproductive health. He’s started to roll back some of Trump’s harsh restrictions on both domestic and global reproductive health programs and appointed reproductive rights champions like Health and Human Services Secretary Xavier Becerra. Perhaps most significant is the Biden administration’s actions on the abortion pill, or mifepristone, the first of two medications given to terminate an early pregnancy through 10 weeks. Last month, the FDA temporarily lifted some restrictions on the abortion pill, allowing it to be shipped by mail during the pandemic. It was a needed move, but a late and limited one: the change only came in April when Biden could have ordered it on day one, it’s only temporary, and it won’t help people living in the 19 states that effectively ban such deliveries. Meanwhile, lawmakers in 13 states are already trying to make the abortion pill even harder to access.
A bigger step came last week, late on a Friday, when the FDA quietly announced in a court filing that it will review all of its restrictions on mifepristone. (The eve of the weekend is a famed Washington time for putting out information you hope will get little or no attention. That’s whispering when the administration should be proudly proclaiming.) The abortion pill is safer than Tylenol but more heavily regulated than fentanyl. You can’t get it at a pharmacy, and it can only be dispensed in person at certain healthcare centers by specially licensed doctors who specifically register as abortion providers. This review is just an initial step. But if Biden’s FDA “follows the science,” as the president often urges in other contexts, and lifts its medically unnecessary restrictions on mifepristone, it could single-handedly and massively expand abortion access. In states that don’t have various laws prohibiting this, at least, the abortion pill could be prescribed by regular doctors and dispensed at regular pharmacies, just like other drugs that are even less safe like Lipitor or Flonase.
This was the vision advocates had for mifepristone when it was first approved in the last months of the Clinton administration before the FDA saddled it with excessive regulations in the vain hope of warding off political backlash. While some state laws would still block that vision from being fully realized nationwide, the FDA lifting its restrictions would make it far less common for patients to be forced to drive for hours just to pick up a pill that they will take at home.
But even Biden’s biggest moves are just initial steps—promising ones, of course, but also the minimum of what’s expected from a pro-choice administration. They’re not enough to meet the moment. Many reproductive justice advocates gave middling reviews of Biden’s first 100 days in office, partly because they feel he can do much more on policy and partly because he hasn’t yet shown the same vocal, unapologetic support for abortion rights that he has for other issues. He hasn’t even uttered the word “abortion” in public since taking office, much less forcefully spoken out about the record number of state restrictions introduced this year.
This kind of omission is problematic both from a symbolic and a practical perspective. It reinforces the social stigma that considers “abortion” a dirty word and deed, instead of basic health care and a human right—and validates the idea that abortion is too risky or unimportant to fight for politically. It also leaves a rhetorical vacuum that conservatives are more than happy to fill with climate-denial-style disinformation, which then gets used to justify banning or restricting abortion.
Biden has plenty of bold policies he could loudly champion if he wants to give abortion access the FDR treatment. Some he has yet to endorse, and some are ideas that he campaigned on but hasn’t yet indicated that he will make a priority.
The big issue that the Biden administration can’t solve on its own and needs Congress for is what to do about all of those state restrictions. Biden officially supports the idea of codifying Roe v. Wade into law nationwide, which could help—but he still isn’t pushing a specific proposal to do so, even though several exist. Realistically, abortion providers and patients need even stronger protections than Roe offers to block onerous state laws en masse. One proposal, the Women’s Health Protection Act, would do just that by barring states from interfering with abortion in a way that they don’t with other health care services. This would likely nullify those state laws that make it harder to get the abortion pill, along with all the other laws that target abortion care for no medically or scientifically justifiable reason. If Biden insists Congress pass the Women’s Health Protection Act, he will make it clear that he understands what’s at stake. Even if such a bill could be vulnerable to a Supreme Court challenge, it’s a fight worth waging.
Biden says he wants to end the Hyde Amendment‘s decades-long ban on public funding for abortion, but he hasn’t been building the public case for it—even though doing so would strike a blow against both economic and racial inequality, two of his favorite issues. Because the 44-year-old amendment blocks Medicaid from covering abortion except in rare cases, it makes abortion unaffordable and inaccessible for low-income people, who are disproportionately people of color. That was a feature and not a bug for the measure’s original sponsor, Rep. Henry Hyde of Illinois, who openly admitted that his measure targeted poor women. Ever since, “no taxpayer dollars for abortion” has been a racially coded right-wing rallying cry that Democrats have only recently started pushing back on as unjust and discriminatory.
Because the Hyde Amendment is not a permanent law but an annual rider in the must-pass appropriations bill, eliminating it is politically plausible. It doesn’t need to be repealed; it just needs not to be renewed. Biden can propose a budget that doesn’t include Hyde and back it up with a veto threat. He could go even further by supporting the EACH Act, which would permanently reverse Hyde by requiring public insurance plans to cover abortion.
Pushing all of these measures “would go a long way to demonstrating that this administration supports bolder action on abortion access,” said Jacqueline Ayers, vice president of government relations and public policy at Planned Parenthood Action Fund.
Biden has a lot on his plate, and sweeping abortion reforms will be tough to get through Congress. But in his joint address, Biden urged Congress to send a long list of bills to his desk, regardless of whether they stand any chance of overcoming a Republican filibuster: bills for immigration reform, LGBTQ rights, voting rights, unionization, a $15 minimum wage, and equal pay for women. Getting rid of the Hyde Amendment, for instance, is a lot more achievable than any of those as long as the filibuster remains intact. It’s hardly a guarantee, especially with Joe Manchin in the Senate, but pro-choice policies aren’t always a dealbreaker for Manchin. And Biden would have the support of six in ten Americans who support Medicaid funding for abortion.
Biden also needs to make sure the Senate approves as many pro-choice judges as possible while it still can since Trump has packed the judiciary with anti-choice ones. And Biden can do more that doesn’t require Congress, like stopping states from excluding health care providers from Medicaid just because they provide abortion. His administration should also take a strong stance against prosecuting people who self-manage an abortion with pills or who have a miscarriage, a nightmarish-sounding scenario that happens in America more often than you’d think.
Erin Matson, co-founder and executive director of the abortion advocacy group Reproaction, argued that in addition to all of this, Biden should look for creative solutions to the problem of abortion care being unnecessarily segregated from other routine medical care. He could offer incentives for existing medical offices to expand their abortion offerings or for new clinics to open. He could even make this part of his broader vision for infrastructure or economic recovery and include it in packages that could pass using reconciliation. It’s the kind of outside-the-box thinking the president will need.
And one of the easiest ways Biden could go big on abortion is to talk about it openly and often, said Renee Bracey Sherman, founder and executive director of We Testify, an organization that fights stigma around abortion by sharing the stories of real people who have them. She said that if Biden really considers himself pro-choice, he needs to tell the American people a clear story about abortion and why expanding access to it matters. He can and should use his trademark empathy and relatability to remind voters of the human reality of abortion, something he’s done often when it comes to sexual assault survivors and the transgender community. He can tell everyone who needs an abortion and is struggling to get one, “I’ve got your back.”
“He seems to be able to say that for everything else,” Bracey Sherman said. “Why can he not say it for abortion?”
There’s no real reason for Biden to be so shy about this. While it’s often seen as a third-rail issue that deeply divides Americans, about 7 in 10 Americans support legal abortion, and only a small, vocal minority want to see it banned. A majority of Catholics also support legal abortion, as Biden does, and Catholic women have abortions at the same rates as other women. Deeper polling shows that even if many Americans feel personally ambivalent about abortion, the overwhelming majority want the experience of those who have one to be affordable, without added burdens, and informed by medically accurate information—which is decidedly not the experience in states with hostile abortion laws.
Years of grassroots reproductive justice advocacy have pushed many elected Democrats to stop playing defense on abortion. This shift forced Biden, who had already evolved considerably on abortion, to change his mind on the Hyde Amendment to become a viable 2020 nominee. Now, Biden can still choose to be a leader. As Barack Obama’s vice president, Biden showed courage on another social justice issue by coming out in support of same-sex marriage on national television ahead of Obama, Hillary Clinton, and many other national Democratic figures. It earned him applause. He has the chance to show that courage again with an issue that’s even more popular with Americans. If Biden wants to be an FDR-style leader, he shouldn’t pass it up.