A volunteer clinic escort holds a sign outside a Planned Parenthood clinic in Columbia, South Carolina, on Friday, March 28. (Photo by Skylar Laird/SC Daily Gazette)

U.S. Supreme Court justices will hear arguments Wednesday about whether South Carolina can remove Planned Parenthood clinics from the state’s Medicaid program because they offer abortions in a case that could imperil health care options for patients with low incomes.

At the center of the lawsuit is a conflict over whether a section of the Medicaid Act gives people who use Medicaid the right to choose their providers.

“While it might be just South Carolina’s name on this court case, it will have huge impacts nationwide,” said Vicki Ringer, Planned Parenthood South Atlantic’s director of public affairs in the state. “It will allow all of these red states that have been trying so hard to close down Planned Parenthood, and it will take away medical care for so many low-income people throughout our region of the country.”

Opponents of Planned Parenthood said Republican South Carolina Gov. Henry McMaster should be able to direct Eunice Medina, the new head of the state Department of Health and Human Services, to remove the organization’s Charleston and Columbia clinics from the list of qualified Medicaid providers.

If the court rules broadly, it could allow other states to make the same move — and some already have. The case is also part of a broader strategy across the country to drain Planned Parenthood funding for all services, including reproductive health care aside from abortion. Efforts by abortion-rights opponents to do so go back decades in the United States.

Republican President Donald Trump’s administration has taken interest in the case, Medina v. Planned Parenthood South Atlantic. The acting U.S. solicitor general will argue in favor of South Carolina health officials during a portion of the Supreme Court hearing this week.  

Lawyers for Alliance Defending Freedom, a conservative advocacy firm instrumental in major anti-abortion cases that have appeared before the Supreme Court, represent South Carolina officials in the lawsuit.

“This case is about whether states have the flexibility to direct Medicaid monies to best benefit low-income women and families,” John Bursch, senior counsel and vice president of appellate advocacy at Alliance Defending Freedom, said in an email.

Planned Parenthood’s two South Carolina clinics offer abortion up to six weeks in compliance with state law. But staff also provide birth control, emergency contraception, prenatal and postpartum exams and STI testing and treatment, among other services. 

“Being able to deny Medicaid patients the ability to select their own qualified provider tells low-income women, especially, that once again ‘You’re not important. Your decision-making doesn’t matter. We are here to decide for you what is best,’” Ringer said.

The picture in South Carolina

McMaster’s executive order against clinics that also offer abortions — deeming them “unqualified to provide family planning services” — has been blocked by lower courts since 2018. Throughout a nearly seven-year court battle, appellate judges have repeatedly ruled in favor of Planned Parenthood South Atlantic, and the Supreme Court has rejected requests to take up the case — until now.

“South Carolina has made it clear that we value the right to life. Therefore, taxpayers should not be forced to subsidize abortion providers who are in direct opposition to their beliefs,” McMaster said in a Feb. 10 statement.

Nearly half — 48% — of South Carolinians surveyed in May 2024 oppose the six-week ban that’s in place, while 31% support it, and the rest were not sure or refused to answer, according to a Winthrop University poll last year. 

Ringer said South Carolina lawmakers’ anti-abortion positions are at odds with residents’ views on the issue.

“It’s political pandering, but it’s to a population that doesn’t agree with them,” she said. “They think because they’re elected, then that means we’re an anti-abortion, so-called ‘pro-life’ state.”

Like many states, South Carolina only allows Medicaid coverage of abortion in cases of rape, incest or to save a patient’s life.

Julia Walker, a spokesperson for the regional affiliate, said 10% of patients who routinely visit the South Carolina clinics for family-planning services use Medicaid.

Just 0.2% — $88,464 — of the $35 million the state spent on Medicaid-covered family-planning services went to Planned Parenthood in the 2022-2023 fiscal year, SC Daily Gazette reported. Medicaid is a reimbursement program, meaning providers foot the bill and seek at least partial reimbursement for an appointment or procedure.

A case study in Texas

Arkansas, Missouri and Texas — Republican-led states — have ended some clinics’ Medicaid eligibility for reproductive health care services because they provided abortions at one time or are affiliated with Planned Parenthood.

Still, clinic doors remain open in those states, despite ongoing lawsuits and right-wing wrangling that blocked Medicaid patients.

“Let’s be clear about where Texas was even before they cut Planned Parenthood out of Medicaid,” said Melaney Linton, president and CEO of Planned Parenthood Gulf Coast, which still has six locations in the greater Houston area. “Texas already was suffering some of the nation’s worst rates of maternal and infant mortality, and highest under and uninsured populations.”

Most of Houston is in Harris County, an area that has one of the highest Black maternal death rates nationwide. Black women in the county had a pregnancy-related mortality rate of 83.4 deaths per 100,000 live births from 2016 to 2020, according to a report last year.

The maternal mortality rate in Texas from 2018 to 2021 was 28.1, compared with 23.5 nationwide, according to federal data.

Black Texans are 2.5 times more likely to die from childbirth-related issues than white Texans, according to the state’s Maternal Mortality and Morbidity Review Committee.

A judge ruled in March 2021 that Texas could stop Planned Parenthood from receiving Medicaid funds. Linton said the state’s actions cut off an estimated 8,000 Planned Parenthood patients.

Linton offered an example of a former patient who struggled to find a Medicaid provider who would accept her insurance and give her the birth control she was seeking. Only 34% of providers accepted Medicaid and had IUDs and birth control shots readily available for new patients, according to a University of Texas at Austin research brief.

“Politicians like to talk about how they care about women and infants and families,” Linton said. “If they did, they would do everything they can to make sure that women have more access to birth control, not less.”

Six months after Texas suspended Planned Parenthood’s Medicaid funds for reproductive health care services, the state enacted a six-week abortion ban. Teen birth rates skyrocketed in Harris County and across the entire Lonestar State for the first time in 15 years, data shows.

Linton said what happens in Texas is often replicated in other parts of the country, and the same will probably hold true for the South Carolina case before the U.S. Supreme Court this week.

“Every American should be concerned about that,” she said.

Long waits and limited options

If the Supreme Court rules in South Carolina’s favor, Bursch, the Alliance Defending Freedom attorney, said Medicaid patients can instead access family-planning services at publicly funded health care clinics instead of the Planned Parenthood clinics in Charleston and Columbia. The state has 53 public health clinics that offer family-planning services, 32 federally qualified health centers and 14 Title X federally-funded family-planning clinics, including Planned Parenthood’s Columbia clinic.

But public clinics are struggling financially, said Dr. Katherine Farris, the chief medical officer at Planned Parenthood in the Carolinas and the Virginias, in a news conference Friday. A patient may have to wait three months for an intrauterine device appointment at some of them, but at Planned Parenthood, she said, the patient can walk in and get an IUD insertion the same day.

Ringer and Linton also said finding a provider that accepts Medicaid and can see a new patient promptly is not so simple. 

“Doctors who at one time did take Medicaid aren’t anymore. It is a losing prospect for many providers,” Ringer said. “I’ve seen what Medicaid reimburses, and for many of the services we provide, we lose money on them. But because we are a safety-net provider, that means we provide care to people no matter what. If you can or can’t pay, we are going to take care of you.”

South Carolina and Texas are 2 of 10 states that have not expanded Medicaid under the Affordable Care Act passed in 2010, Stateline reported.

When Planned Parenthood’s Texas affiliates were removed from Medicaid eligibility, Linton said the Gulf Coast staff tried to connect their Medicaid patients to other health care providers.

“Unfortunately, what our patients told us is that sometimes it took them three months or more calling around the 20 or 30 practices to find someone who would even take them. Many times they didn’t provide the birth control method that that patient had been accustomed to receiving,” Linton said.

Bursch and other Alliance Defending Freedom attorneys argue that if Planned Parenthood stopped providing abortions in South Carolina, Medicaid funding could be restored.

Planned Parenthood Federation of America attorney Catherine Peyton Humphreville said that South Carolina does allow some abortions to be provided in the state.

“At no point has anyone asserted that Planned Parenthood South Atlantic is not complying with South Carolina law,” Humphreville said.

No one has questioned the quality of care that the organization provides, they said, and the idea that Planned Parenthood can be punished for simply advocating abortion “has serious First Amendment issues.”

On Capitol Hill

Anti-abortion Republicans in Congress are pushing bills to “defund Planned Parenthood” and other abortion providers, including independent clinics, nationwide. Unlike previous sessions when Congress faced gridlock, legislation could advance this year given the GOP trifecta of power in Washington, D.C.

U.S. Missouri Sen. Josh Hawley filed legislation on Jan. 16 that would prohibit federal funding from going to organizations that provide abortions, referrals and the like, with the stated intention of cutting funds from “Planned Parenthood and abortion providers across the nation.” A 2019 rule passed by the Trump administration blocked $60 million in federal funds from flowing to the organization, Hawley said, before the rule was rescinded under Biden.

The Hyde Amendment, a provision approved annually by Congress since 1977, already prevents federal funds from covering the costs of abortion unless the pregnancy stemmed from rape or incest, or the patient could die in child birth.

Planned Parenthood Federation of America President and CEO Alexis McGill Johnson said the organization is prepared to defend itself from both state-level and national attacks.

“The most immediate focus is going to be on the Medicaid defund [bills] in Congress, and that has a direct tie to the Supreme Court case,” McGill Johnson said. “That fight looks like doing everything we can to defeat, delay, to litigate, to mitigate every effort that is trying to put sexual and reproductive health care out of reach.” 

Jayanta Bhattacharya, President Donald Trump's nominee to be director of the National Institutes of Health, speaks at his confirmation hearing before the Senate Committee on Health, Education, Labor and Pensions on Capitol Hill on March 5, 2025 in Washington, D.C. (Photo by Andrew Harnik/Getty Images)

This report was updated at 7:59 p.m. EDT.

WASHINGTON — The U.S. Senate confirmed President Donald Trump’s nominees to lead the Food and Drug Administration and the National Institutes of Health.

Senators voted 53-47 along party lines Tuesday evening to confirm Jayanta Bhattacharya as director of the NIH before voting 56-44 to approve Martin Makary as FDA commissioner.

Democratic Sens. Dick Durbin of Illinois as well as Maggie Hassan and Jeanne Shaheen of New Hampshire were the only three members of their party to vote for Makary.

Shaheen said during an interview Wednesday that while she has reservations about how the Trump administration might try to change access to medication abortion, she felt Makary was qualified to lead the FDA.

“Well, I’m very concerned about what this administration might do about mifepristone,” Shaheen said. “But, I thought it was important to have someone in that role who has the scientific background and ability to run the agency.”

Hassan declined to answer questions about her vote when asked about it Wednesday afternoon by States Newsroom. Her office declined to send a written statement from the senator, offering only a response from a spokesperson. 

“The opioid epidemic has devasted communities across New Hampshire, and the FDA has made mistakes over the years that fueled this epidemic,” the spokesperson wrote in an email. “Senator Hassan voted for Dr. Makary as Commissioner of the FDA following his clear commitment to ensuring that the agency learns from its past mistakes and acts aggressively to tackle this crisis.”

Senate confirmation came just weeks after the Health, Education, Labor and Pensions, or HELP, Committee voted to advance Makary and Bhattacharya.

Sen. John Hickenlooper, D-Colo., voted in committee to send Makary’s nomination to the floor, but switched to opposing his confirmation on Tuesday.

Hickenlooper said during a brief interview with States Newsroom on Wednesday that he ultimately couldn’t support Makary over his comments about medication abortion. But he said nothing significant happened between his yes vote in committee and his no vote on the floor.

“I agonized over it. I could have easily gone back and voted yes,” Hickenlooper said. “You know, at some point when I see him, I’ll apologize and say, ‘You know, that was a hard vote for me. But I really wish you would have been more demonstrative about specifically mifepristone, because I think that’s a big issue that the FDA is going to take on.’”

Hickenlooper said he spoke with his staff and his wife over Makary’s comments about access to medication abortion before he cast his no vote on the Senate floor.

“I realized that he serves at the pleasure of the president, so what the president says he’s probably going to have to do,” Hickenlooper said. “But for me, I just became more and more uncomfortable that he wouldn’t make a few statements to say that, you know, this is not something that is a medical reinterpretation for political purposes. He should have said something.”

Abortion pill

Makary will have considerable authority at the FDA to determine if access to medication abortion remains as it is now, if the agency changes prescribing guidelines, or even pulls its approval.

During his confirmation hearing in early March, Makary testified he hadn’t yet decided how he would approach that aspect of the job.

“I have no preconceived plans on mifepristone policy except to take a solid, hard look at the data and to meet with the professional career scientists who have reviewed the data at the FDA,” Makary said at the time.

Medication abortion is a two-drug regimen consisting of mifepristone and misoprostol that accounts for about 63% of all pregnancy terminations within the United States, according to research from the Guttmacher Institute.

The FDA originally approved mifepristone in 2000 and changed its prescribing guidelines in 2016 and 2021. It is currently approved for use up to 10 weeks gestation and can be prescribed via telehealth and shipped to patients.

Sixteen major medical organizations — including the American College of Obstetricians and Gynecologists, the American Medical Association and the Society for Maternal-Fetal Medicine — affirmed to the U.S. Supreme Court last year that mifepristone is safe and effective.

“The scientific evidence is overwhelming: major adverse events occur in less than 0.32% of patients,” the medical organizations wrote in a 45-page brief. “The risk of death is almost non-existent.”

Goals for NIH

Bhattacharya testified during his confirmation hearing that he has five goals for the NIH, including focusing the agency’s research on chronic diseases and funding the “most innovative biomedical research agenda possible.”

“The NIH is the crown jewel of American biomedical sciences, with a long and illustrious history of supporting breakthroughs in biology and medicine,” Bhattacharya said at the time. “I have the utmost respect for the NIH scientists and staff over the decades who have contributed to this success.”

But, he said, “American biomedical sciences are at a crossroads” following the coronavirus pandemic.

Bhattacharya said during his hearing he would ensure NIH’s scientific research is replicable, that it has a culture that respects “free speech in science and scientific dissent” and that it regulates “risky research that has the possibility of causing a pandemic.”

“While the vast majority of biomedical research poses no risk of harm to research subjects or the public, the NIH must ensure that it never supports work that might cause harm.”

An expectant mom waits at a health clinic with her 1-year-old daughter. Republicans in multiple states are introducing bills to grant embryos and fetuses the same rights as children. (Angel Valentin/Getty Images)

As state legislative sessions grind on, conservative lawmakers have filed a new batch of bills that would grant legal rights to fetuses and fertilized embryos.

Lawmakers in at least eight states — Georgia, Idaho, Indiana, Kentucky, North Dakota, Oklahoma, South Carolina and Texas — have considered bills to go even further, to punish women who seek abortions.

Most of these states have already banned abortion. But new criminalization bills would allow women to face homicide charges for obtaining abortions. The bills would classify an embryo or fetus as an “unborn” or “preborn child” who can be a victim of homicide. Many of the bills would repeal parts of state laws that explicitly exempt women from being punished for seeking abortions.

“If we truly believe in the equal humanity of the preborn, then our laws must uphold that truth in practice,” Idaho state Sen. Brandon Shippy, a Republican, told fellow lawmakers while introducing his bill in February. The bill would allow women who seek abortions to be prosecuted under the state’s homicide laws.

“Justice requires accountability for intentional actions,” Shippy said. “To exempt any group from accountability actually undermines the law’s integrity and diminishes the value of the life being protected.”

Shippy did not answer requests for comment.

Most lawmakers, including Shippy, admit this type of legislation is a long shot. His bill is sitting in an Idaho Senate committee, although the chamber’s Republican leaders have indicated they wouldn’t move it forward. But similar bills are still pending in five other states — Georgia, Indiana, Kentucky, South Carolina and Texas.

Meanwhile, conservative lawmakers in several states are introducing less punitive bills that are structured around the same legal concept: fetal personhood.

A longtime cornerstone of the anti-abortion movement, fetal personhood is the idea that a fetus, embryo or fertilized egg has the same legal rights as a newborn. If the law considers fetuses to be people, then abortion should legally be considered murder.

But experts and reproductive rights advocates have long warned of the legal chaos that could result from fetal personhood laws, with potential implications extending far beyond abortion.

“In some ways it’s a hornet’s nest,” said Rebecca Kluchin, a history professor at California State University, Sacramento, whose research has focused on fetal personhood efforts. “If you establish fetal personhood, it raises all of these questions. Do you recognize a fetus on your taxes? How do you calculate the census? What do you do about miscarriages? What about alimony? It is really messy.”

And this year, less than two months after voters approved a state constitutional amendment guaranteeing the right to abortion, a Republican legislator introduced a fetal personhood bill that would put the question on the ballot again in 2026.

If the bill is approved by two-thirds of the state legislature, the question would ask Montanans whether they support amending the state constitution to grant full rights to all people “at any stage of development, beginning at the state of fertilization or conception.”

The measure passed out of committee last month along party lines.

At a legislative hearing, Montana residents expressed concern that a personhood ballot measure would not only outlaw abortion but also eliminate access to in vitro fertilization and expose women who miscarry to possible criminal prosecution. An estimated 10% to 20% of known pregnancies end in miscarriage, though the percentage is likely higher for all pregnancies, since many losses happen before a woman knows she’s pregnant.

Defenders of such legislation have downplayed its impact on IVF and insist that states have a duty to protect all life.

“For those of you who believe that a human life begins at conception and deserves legal protection, because the right to life is the foremost of unalienable rights, I don’t see how any of us could be satisfied with having a law on the books that does not actually protect human life beginning with the biological beginnings of human life, which is fertilization,” South Carolina Republican state Sen. Richard Cash told fellow legislators in February while introducing his bill.

Critics also worry criminalization bills could drive medical providers out of state and cause women to delay seeking medical care over fear of being punished for pregnancy complications. They say personhood language could even threaten individuals’ end-of-life decisions, such as “do not resuscitate” directives, which are often used by people with terminal illnesses.

Child support and tax credits

Many personhood bills are not, at face value, about banning abortion. Yet they ultimately could have the same effect. Some experts say that any attempt to weave fetal personhood language into state law could set the stage for stricter abortion laws.

A new Ohio bill would let taxpayers claim “conceived children” as dependents on their taxes. And Republican lawmakers in Kansas introduced a bill to guarantee child support payments to mothers from the moment of conception.

“These bills often look, on their face, like they’re trying to be helpful to pregnant people,” said Carmel Shachar, faculty director of the Health Law and Policy Clinic at Harvard Law School’s Center for Health Law and Policy Innovation. “But oftentimes the way they’re drafted, they’re almost impossible to take advantage of.”

For instance, Georgia’s Department of Revenue has interpreted the state’s anti-abortion law as allowing residents to claim a fetus with a detectable heartbeat as a state tax deduction. But the maximum tax savings is only about $150, according to the Urban-Brookings Tax Policy Center. And because it’s a deduction, rather than a refundable tax credit, it’s not available to many families with low incomes.

At least 19 states — either through state law, criminal statutes or case law — have declared fetuses at some state of pregnancy to be people, according to a 2023 report from Pregnancy Justice, a nonprofit that conducts research and advocates for the rights of pregnant people, including the right to abortion.

Fetal personhood language in state law has allowed prosecutors to press murder charges for the killing of a fetus after the killing of a pregnant woman in multiple states, including New Hampshire and Oklahoma. Laws also have allowed women in several states to be prosecuted for child endangerment for substance use while pregnant.

Anti-abortion discord

Historically, anti-abortion laws that carry criminal and civil penalties have targeted abortion care providers, such as physicians. Yet bills that would allow broader criminal prosecution of abortion are not unheard of; they’ve popped up over the years in conservative-led states, such as North Dakota.

But they aren’t widely popular, even within the anti-abortion movement.

In February, a representative from the North Dakota Catholic Conference spoke against a Republican-sponsored fetal personhood bill that would add “unborn child” to state laws relating to murder, assault and wrongful death lawsuits. The conference’s co-director told lawmakers that while his group opposes abortion, it doesn’t support punishing women who seek one. The bill made it to the House floor, where it eventually failed.

“There’s a real division in the pro-life movement,” said Kluchin, the history professor. “To some folks, abortion is murder, so anyone who commits abortion, whether a provider or pregnant person, should be accused. But most of the pro-life movement doesn’t go that way. Their thought is, how can you be compassionate if you accuse a woman of murder? That’s not going to get the general public on your side.”

Many lawmakers proposing the homicide bills acknowledge they’re unlikely to garner widespread support, even among their fellow conservatives.

“But it’s a way to say, ‘Here are my pro-life bona fides,’” Kluchin said. “I’m not sure it matters that it isn’t going to get out of committee.”

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org.

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Brad Schimel, the conservative candidate in Wisconsin’s April 1 Supreme Court election, has supported Wisconsin’s 1849 abortion law but also says voters should decide abortion questions.

The liberal candidate, Susan Crawford, claimed Schimel “wants to bring back” the law, which bans abortion except to protect the mother’s life.

Wisconsin abortions were halted, due to uncertainty over the 1849 law, after the U.S. Supreme Court reversed Roe v. Wade in 2022, but resumed in 2023 after a judge’s ruling. 

The Wisconsin Supreme Court is deciding whether the 1849 law became valid with Roe’s reversal, said Marquette University law professor Chad Oldfather.

Schimel has campaigned supporting the law, asking “what is flawed” about it. He recalled in 2012 supporting an argument to maintain the law, to make abortion illegal if Roe were overturned.

Schimel said Feb. 18 Wisconsinites should decide “by referendum or through their elected legislature on what they want the law to say” on abortion.

This fact brief is responsive to conversations such as this one.

Sources

• Judge Crawford for Wisconsin: Laurel
• Wisconsin Watch: Does Wisconsin’s 1849 abortion law allow abortion only for women who are in danger of dying?
• Marquette University law professor Chad Oldfather: Email
• New York Times: One of 2025’s Biggest Battles Over Abortion Rights Has Already Begun
• Milwaukee Journal Sentinel: Susan Crawford and Brad Schimel bring opposing views on abortion to the Wisconsin Supreme Court race
• Milwaukee Journal Sentinel: Democrats blast Schimel for signing onto anti-abortion legal paper
• Partial transcript: Brad Schimel remarks
• Team Schimel: Will of the People

Has Wisconsin Supreme Court candidate Brad Schimel supported Wisconsin’s 1849 abortion law? is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

President Donald Trump signed the orders at the end of a week where he was mostly silent on abortion. But after lobbying by anti-abortion movement leaders, Trump on Thursday pardoned nearly two dozen activists for blockading abortion clinics and earlier Friday gave a video speech at the anti-abortion March for Life. (Photo by Anna Moneymaker/Getty Images)

In a move that global health workers say will likely have devastating consequences for women and girls throughout the world, President Donald Trump has reinstated a policy that bans foreign aid workers from offering information about abortion, and doubled down on an existing domestic policy that bans federal funding for abortion.

The so-called Mexico City Policy, which Trump reinstated Friday night with an executive order, was first introduced in 1984 under Republican President Ronald Reagan, and bans foreign non-governmental organizations (NGOs) that receive U.S. family planning funds from promoting abortion as a method of family planning and from abortion-related counseling and referrals. It is known by reproductive rights advocates as the “global gag rule,” and it has been rescinded and reinstated as presidential administrations have changed parties for many years.

“We saw the devastating impact of the global gag rule during the last Trump administration when contraception and vital reproductive services were cut off. There was a spike in pregnancy-related deaths, reproductive coercion, and gender inequality worldwide,” said Rachana Desai Martin, chief government and external relations officer at the Center for Reproductive Rights, in a statement. “Many clinics and health programs shuttered, leaving vulnerable populations with nowhere to get birth control, pregnancy care and other vital health services.”

Reinstatement of the policy was prescribed in Project 2025, a nearly 1,000-page blueprint document authored by the Heritage Foundation and many other organizations, including several anti-abortion groups.

“To stop U.S. foreign aid from supporting the global abortion industry, the next conservative administration should issue an executive order that, at a minimum, reinstates [the policy] and … closes loopholes by applying the policy to all foreign assistance, including humanitarian aid, and improving its enforcement,” page 261 of the document reads. “The executive order … should be drafted broadly to apply to all foreign assistance.”

The executive order includes the statement, “I direct the Secretary of State, in coordination with the Secretary of Health and Human Services, to the extent allowable by law, to implement a plan to extend the requirements of the reinstated memorandum to global health assistance furnished by all departments or agencies.”

Advocates within foreign assistance organizations said the change will affect not only abortion access, but comprehensive reproductive health services, including HIV prevention and treatment, contraception access, screening for sexually transmitted diseases and cancers, and treatments for other infectious diseases.

“An expanded Mexico City Policy will have wide-reaching impacts on women and girls’ access to life-saving healthcare,” Janeen Madan Keller, policy fellow and deputy director of global health policy at the Center for Global Development, said in a statement. “As research shows, the Mexico City Policy reduces access to contraception which — counter to the policy’s intended goal — leads to more unplanned pregnancies and higher abortion rates.”

Madan Keller added that when Trump reinstated the rule during his first term in 2017, other donors were able to bolster the United Nations Population Fund’s budget and blunt any negative effects.

“However, with many donors now slashing aid budgets, it’s unclear whether they would cover the shortfall,” she said.

On the same day as the executive orders, the Trump administration rejoined the so-called Geneva Consensus Declaration, a global agreement launched by the U.S. and five other countries in 2020, which states that there is no international right to abortion and countries are not obligated to finance or facilitate it, according to a document obtained by Politico. The pact also includes Brazil, Egypt, Hungary, Indonesia and Uganda.

Hyde Amendment

Trump issued another executive order on Friday titled, “Enforcing the Hyde Amendment,” referring to a federal provision prohibiting the use of federal funds such as Medicaid to pay for abortions. Hyde does, however, allow funding in cases of rape, incest or to save a patient’s life. The order said the prior Democratic administration of President Joe Biden “embedded forced taxpayer funding of elective abortions” in a variety of federal programs, and rescinded two of Biden’s executive orders from 2022 that aimed to increase access to abortion.

Trump signed the orders at the end of a week where he was mostly silent on abortion. But after days of lobbying by anti-abortion movement leaders, Trump on Thursday pardoned convicted abortion-clinic blockaders and earlier Friday gave a last-minute video speech at the anti-abortion March for Life.

Project 2025 references the Hyde Amendment several times, citing Biden’s 2022 executive order that allowed the U.S. Health and Human Services secretary to find ways to assist pregnant people traveling across state lines to receive abortion care. The Biden administration subsequently interpreted Hyde to only apply to the abortion procedure itself.

Page 471 of the document calls for HHS to withdraw that guidance and for the U.S. Department of Justice to withdraw and disavow its interpretation of the amendment that was issued in September 2022. It also says HHS should complete a full audit to determine compliance with the amendment and permanently codify the Hyde Amendment in law rather than approving it as part of an appropriations process every year.

Republican U.S. Sens. John Kennedy of Louisiana and Roger Wicker of Mississippi introduced a bill in early January to codify the amendment and establish “a single, government-wide standard that bars federal tax dollars from financing abortions.” It’s unclear if that bill is an attempt to fully cut Medicaid funding for Planned Parenthood, which relies heavily on those funds to provide sexual and reproductive health services like contraception and screenings, including in states with abortion bans. Cutting that funding is a directive from Project 2025, as well.

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People attending the annual March for Life rally watch a pre-taped video recording of President Donald Trump on the National Mall during the annual March For Life. (Kent Nishimura/Getty Images)

WASHINGTON — President Donald Trump delivered his Day One promise to the anti-abortion movement four days into his second term: He pardoned nearly two dozen anti-abortion activists convicted of federal offenses that included using physical force to block access to and invade abortion clinics, as well as for threats to clinic staff and patients. And after months of Trump distancing himself from the abortion issue and a week of lobbying by anti-abortion leaders, the president and Vice President J.D. Vance spoke at the movement’s annual March for Life rally on Friday.

“I am proud to be the first president ever to have joined you in person,” Trump said in a video recorded in the Oval Office, referring to his 2020 appearance, to the cheers of an estimated tens of thousands of activists and students gathered on the National Mall.

But the president failed to offer specific federal policy plans to further the movement’s goal of banning abortion nationally and gave what appeared to be a scripted speech that evoked religious language, referring to every child as “a beautiful gift from the hand of our creator.” He touted the controversial Dobbs v. Jackson Women’s Health Organization decision that ended federal abortion rights and the pardons he issued Thursday. Trump insisted, as he did throughout his campaign, that the abortion issue has returned “to the state legislatures and to the people, where it belongs.”

“In my second term, we will again stand proudly for families and for life. … We will work to offer a loving hand to new mothers and young families, and we will support adoption and foster care,” Trump said, but did not offer specific plans. As during his campaign, he accused Democrats of supporting abortion until “after birth,” a falsehood.

Vice President J.D. Vance, who spoke on stage after Trump, to raucous applause, referred to the anti-abortion movement as “our movement” and emphasized the need for government to make it easier for people to afford kids. Vance also did not name any policy plans the administration would pursue, beyond potentially raising the child tax credit. Vance said he and the president support the recent abortion bill that passed the U.S. House this week, which would have created penalties for health care professionals who don’t provide medical care for babies born after an attempted abortion. U.S. Senate Democrats blocked the bill arguing it was unnecessary and could have prevented parents from making decisions.

Vance, who was criticized during the presidential campaign for his comment about “childless cat ladies,” doubled down on the idea that a “culture of radical individualism” has taken root in this country and called for more Americans to reproduce.

“Our society has failed to recognize the obligation that one generation has to another is a core part of living in a society to begin with,” Vance said. “So, let me say very simply: I want more babies in the United States of America.”

Concerns about Trump’s anti-abortion commitment 

Many activists at the march celebrated the return of a presidential administration friendlier to the anti-abortion cause than the Biden administration. Several sported red Make America Great Again hats, while others expressed reservation about Trump, following his shifted abortion language during his presidential campaign.

“When Trump went kind of more pro-choice, really, for a lot of us, we felt abandoned,” said Bryan Gebhart, a parent helping to chaperone about 45 students bussed from St. Francis DeSales High School in Columbus, Ohio. He told States Newsroom he didn’t vote for Trump, but for the American Solidarity Party, a minor political party based on Catholic teachings.

“I would like to see an end of abortion at the federal level,” Gebhart said, noting that banning abortion nationally is a long-term effort and unlikely to be realized during Trump’s second term.

Already, Trump has received praise from anti-abortion leaders. In its first week, his administration scrubbed information from its national health site about reproductive rights and abortion access and withdrew the U.S. from the World Health Organization, which anti-abortion news outlet LifeNews referred to on X to as the “Pro-Abortion World Health Organization.”

But some anti-abortion leaders are also concerned that the new administration is not fully committed to their cause. For the first time since federal abortion rights were overturned in 2022, Republicans control the White House, Congress and the U.S. Supreme Court. But unlike his major policy pronouncements in other areas, Trump has not signaled any major federal actions to limit abortion. In fact, he has repeatedly said he would veto a federal abortion ban, would not prohibit the mailing of medication abortion via the Comstock Act of 1873 and says he supports in vitro fertilization, something many in the anti-abortion movement oppose. Trump continues to take credit for overturning Roe v. Wade, despite the decision’s unpopularity, but campaigned as a moderate on abortion, which he says is a state issue.

“This is not just a states’ rights issue; this is a federal issue that must be remedied by this court or by a constitutional amendment,” said Mark Harrington, who runs the Ohio-based Created Equal group, on Wednesday at an event in front of the Supreme Court to commemorate the 52nd anniversary of the Roe decision. Several leaders said they were disappointed by the lack of a statement from the White House on the anniversary.

Harrington later told States Newsroom he plans to speak out if Trump does not deliver on some of the movement’s major asks, such as eliminating family-planning federal funding to reproductive health organizations and reinstating regulations to abortion drugs.

“We have to be a witness, calling truth to power and reminding him that we helped him get elected, and he better come through for us and the unborn or else — obviously, he’s not getting reelected, but his successor is not going to get our support,” Harrington said. “We’re not going to lay down and play dead, I hope. But a lot of people have been lured to sleep because of Trump’s popularity.”

Terrisa Bukovinac’s Progressive Anti-Abortion Uprising group is affiliated with several of the activists who were serving prison sentences for blockading abortion clinics until the Trump pardons. Bukovinac told States Newsroom that while she is grateful for Trump’s action, she no longer considers Trump and Vance to be “pro-life.”

“Trump has come out in favor of the abortion pill, and so has Vance,” Bukovinac told States Newsroom. “Trump has been clear, and I believe him when he says that he has no intention of setting any kind of federal abortion restrictions. I mean, that’s what we’re fighting for. That’s what the movement is trying to do, and Trump is like, no. So it’s not ideal, but I am optimistic about the things that we can get, … like get FACE repealed.”

The U.S. Department of Justice said Friday it would scale back on prosecuting abortion-clinic protest cases under the Freedom of Access to Clinic Entrances Act, according to the Washington Post.

Bukovinac said her group will continue to fight for full repeal of the law, which Democratic President Bill Clinton signed into law in 1994 after a spate of deadly abortion protests. The Biden administration cracked down on a resurgence of these tactics of physically blocking reproductive health clinics and then resisting arrest and prosecuted dozens under the federal law, including attacks on anti-abortion pregnancy centers, which the law also protects. Anti-abortion activists have claimed the Biden administration disproportionately prosecuted those who oppose abortion.

The Chicago-based nonprofit legal group the Thomas More Society filed petitions on behalf of 21 of the 23 pardoned individuals, arguing Biden’s Justice Department weaponized the law, which is also how Trump has justified his more than 1,500 day-one pardons and commutations of individuals who invaded the U.S. Capitol on Jan. 6, 2021, some of whom violently attacked police officers.

Brittany Fonteno, the CEO and president of the National Abortion Federation, which tracks violence and harassment at abortion clinics, told States Newsroom she is concerned the Trump administration is going to turn a blind eye to dangerous events at abortion clinics.

“What we’ve seen is that over the years, and in particular after the Dobbs decision, there has been a stark increase in violence and disruption from anti-abortion activists and advocates,” Fonteno said. “We’ve seen an increase in burglaries and arson and threats to abortion providers, and we anticipate that that will only increase with this new administration, as anti-abortion extremists are empowered and emboldened to try to create a culture of fear around abortion care.”

‘Personhood’ advocates seize on ‘conception’ language in executive order on gender

Aside from the anti-abortion pardons, none of Trump’s many executive orders issued during his first week in office concerned abortion.

Thus many in the anti-abortion movement are far from confident that Trump will make abortion more difficult to access, let alone get closer to their larger goal of enshrining fetal personhood rights in the U.S. Constitution.

But some leaders were reassured by a different executive order Trump signed, related to another Christian-right issue: gender. He issued an order on his first day in office that says the U.S. will only recognize two genders, declares that “‘Female’ means a person belonging, at conception, to the sex that produces the large reproductive cell,” and “‘Male’ means a person belonging, at conception, to the sex that produces the small reproductive cell.”

Anti-abortion groups, such as Students for Life of America, viewed the order as a win for the so-called fetal personhood doctrine.

Other leaders have praised some of Trump’s appointees for their anti-abortion positions such as Attorney General appointee Pam Bondi and Secretary of State appointee Marco Rubio.

Though many were disappointed that Trump’s Health and Human Services appointee Robert F. Kennedy Jr. has supported abortion rights, they are still working to wield influence in this critical agency.

Students for Life of America president Kristan Hawkins posted this week on X that an alum from her group “will be serving in a key role at HHS! This is a great sign for life saving measures to come!” She also posted a picture of herself holding a “Defund Planned Parenthood” sign alongside Republican Speaker of the House Mike Johnson, who also spoke at the March for Life. Hawkins wrote in the post, “Speaker Mike Johnson is on board! Planned Parenthood, we’re coming for you next.”

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Reproductive rights supporters marched in Phoenix to mark Roe v. Wade’s anniversary in January 2024. Arizona voters approved an amendment restoring abortion access up to fetal viability in the fall. (Photo by Gloria Rebecca Gomez/Arizona Mirror)

Erika Christensen decided to become a patient advocate for abortion later in pregnancy after she had to travel from New York to Colorado to get a third-trimester abortion.

Christensen found out her wanted pregnancy wasn’t viable around 30 weeks. At that time in 2016, New York banned abortion after 24 weeks of pregnancy, and only allowed abortions after that limit to save a patient’s life.

She and her husband were able to borrow thousands of dollars from her mother and put last-minute travel funds on a credit card to access abortion care across the country, Christensen told States Newsroom.

“At every stage, I realized how many pieces had to be in the perfect place for me to be able to do that, to be able to get this urgent health care that I desperately needed,” she said.

When she and her husband returned home to New York, a lawyer at the state American Civil Liberties Union affiliate reached out and asked if they wanted to be advocates. They led a grassroots effort to get legislation passed in 2019 that protected abortions after 24 weeks for fetal abnormalities and to preserve a patient’s health.

The Reproductive Health Act also decriminalized abortion later in pregnancy and allowed health care providers besides physicians to perform abortions. Former Democratic Gov. Andrew Cuomo signed the bill into law on Jan. 22, 2019, the anniversary of the U.S. Supreme Court’s Roe v. Wade ruling that protected the right to an abortion nationally.

This year would have marked the 52nd anniversary of Roe, which ensured abortion rights until fetal viability, when a fetus can survive outside the womb — generally thought to be around 24 weeks. Only about 1% of all abortions in the United States happen after that point, typically for medical reasons, research shows.

But a conservative-majority bench overturned Roe nearly three years ago, upending abortion access across the nation with the Dobbs v. Jackson Women’s Health Organization decision. States rolled out a patchwork of varied health care restrictions.

Twelve states ban most abortions today, while voters in 10 approved ballot measures enshrining the right into state constitutions. Most of the states with constitutional protections have fetal viability limits.

“Advocates, activists and folks in the movement have different opinions about how we reach the ideal policy on reproductive rights and justice, and initiatives and laws may vary from state to state depending on the political realities that we see,” said Ashley All, president of Kansas Coalition for Common Sense, who has worked on several successful abortion-rights initiatives.

Some within the reproductive rights movement argue that gestational bans on abortion later in pregnancy cause patients harm, and say that the protections of Roe — the 1973 Supreme Court said abortion is a privacy right based on the due process clause of the 14th Amendment — are insufficient.

Renee Bracey Sherman is the founder of the nonprofit WeTestify, a nonprofit devoted to evaluating and shifting the narrative around abortion.

“Allowing the public to vote on personal medical decisions is wrong and completely ridiculous,” she said. “But somehow it’s acceptable with abortion, and then doubly acceptable when it comes to later abortion. We have a population that does not understand how anatomy works, how pregnancy works, how abortions happen, and why people need later abortions.”

In pregnancy, “viability” isn’t straightforward and can be used in more than one way. The word can reference whether a pregnancy is expected to develop normally or if it could lead to a miscarriage, according to the American College of Obstetrics and Gynecology. And fetal viability is the point in pregnancy when a fetus is able to survive outside of the womb. Premature babies have a 42% to 59% chance of survival at 24 weeks, according to ACOG and the Society for Maternal-Fetal Medicine.

Many states only allow abortion after 24 weeks in cases of fetal anomalies or if the patient’s life or health is at risk. Alaska, Colorado, New Jersey, New Mexico, Oregon, Vermont and Washington, D.C., have no fetal viability limits on abortion.

ACOG, the national OB-GYN organization, “strongly opposes policy makers defining viability or using viability as a basis to limit access to evidence-based care” and said the decision to terminate a pregnancy should be between patients and medical providers.

Viability language in policymaking stemmed from the Roe decision in 1973, according to Adrienne Ramcharan, assistant director of state policy at Physicians for Reproductive Health and MiQuel Davies, the former public policy director at the organization.

“While this framing was built into the law, researchers and medical providers who care for pregnant people recognize that viability is not a set point in time,” Ramcharan and Davies wrote in August 2024. “Instead, it occurs along a continuum shaped by an individual’s medical history, access to medical care, and demographic characteristics among other things.”

Later abortion care is criminalized and stigmatized, Christensen said, causing the cost of care to go up. Plus, abortion providers willing to offer the procedure later in pregnancy are scarce.

“I have the benefit of having directly experienced a viability ban and knowing in my core how unjust it was, how my humanity was erased, my dignity was erased,” Christensen said.

She is the co-author of a memo published last year titled Abortion Justice Now. The authors wrote that they reject efforts to restore Roe-era limits into abortion policy.

“Gestational and viability limits will disproportionately impact the most marginalized among us, either denying them critical care or pulling families toward financial instability,” they wrote. “These limits will result in an inequitable ability to exercise rights, allow for criminalization in pregnancy, and ultimately reinforce the dangerous assertion that the government has any role in regulating a pregnant person’s body.”

Abortion opponents, including doctors, sometimes hinge their argument on the concept of fetal viability.

“I think, certainly, beyond the point where a child can survive outside of his or her mother, there would never be a reason you would need to intentionally end that child’s life,” Dr. Christina Francis, chief executive officer at the American Association of Pro-Life Obstetricians and Gynecologists, told lawmakers on a U.S. Senate committee in June, States Newsroom reported.

“You would simply deliver that baby,” Francis said. “You’d take care of mom and you’d take care of baby in an appropriate way.

Patients may seek abortion after fetal viability for several reasons: They receive a fetal fatal diagnosis later in pregnancy, giving birth could risk their life or health, they couldn’t access or afford an abortion earlier, or they didn’t know they were pregnant, according to ACOG.

Polling shows that Americans support abortion in most cases, but not necessarily after fetal viability. A June 2023 poll from Gallup found that 69% of respondents said abortion should be legal in the first three months of pregnancy, while 37% said it should be legal in the second trimester and 22% in the third.

But the nonpartisan public opinion research firm PerryUndem found last year that most public polling on abortion later in pregnancy lacks context. Of those who heard stories about women with complications later in pregnancy who needed to travel out-of-state for abortions, 69% said abortion should be legal in all cases.

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Wisconsin taxpayers paid $1.6 million to Planned Parenthood and others who sued over a 2013 state law that was ruled an unconstitutional restriction on abortion access.

In a new attack, the Wisconsin Democratic Party blamed conservative Brad Schimel for the costs, but he didn’t become state attorney general until 2015. 

Schimel faces liberal Susan Crawford in the April 1 state Supreme Court election.

The law would have required doctors who perform abortions to have admitting privileges at a hospital within 30 miles of where an abortion was done. 

After Planned Parenthood sued, federal judge William Conley in Madison temporarily blocked the law, then in 2015 ruled it unconstitutional.

Schimel appealed, arguing the restriction was reasonable. A three-judge federal appeals court in Chicago upheld Conley. Schimel asked the U.S. Supreme Court to take the case, but it refused.

Conley ordered the $1.6 million payment.

Federal law enables plaintiffs to sue for legal fees in successful civil rights cases.

This fact brief is responsive to conversations such as this one.

Sources

• Wisconsin Democratic Party: BradSchimel.org
• Wisconsin Legislative Council: 2013 Wisconsin Act 37
• U.S. District Court: Planned Parenthood of Wisconsin v. J.B. Van Hollen — Complaint
• U.S. District Court: Planned Parenthood of Wisconsin v. J.B. Van Hollen — Opinion
• U.S. District Court: Planned Parenthood of Wisconsin v. J.B. Van Hollen — Judgment
• U.S. Court of Appeals: Planned Parenthood of Wisconsin v. Brad Schimel — Appeal
• U.S. Court of Appeals: Planned Parenthood of Wisconsin v. Brad Schimel — Decision
• U.S. Supreme Court: Planned Parenthood of Wisconsin v. Brad Schimel — Petition
• U.S. Supreme Court: Order List
• U.S. District Court: Planned Parenthood of Wisconsin v. J.B. Van Hollen — Amended Judgment
• Wisconsin Blue Book: Brad Schimel attorney general tenure
• Mother Jones: Red States Are Paying Planned Parenthood Millions for Suing Them

Did Wisconsin taxpayers pay $1.6 million over an abortion restriction law that was ruled unconstitutional? is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.