During his first few weeks in office, President Trump has moved towards imposing a ‘domestic gag rule’ on abortion access. This past Friday, Jan. 31, he signed an Executive Order “to end the use of federal taxpayer dollars to fund or promote elective abortion.” The order primarily aims to reinforce the Hyde Amendment, a policy that has been prohibiting federal funds from covering abortion services since 1976.
The amendment essentially prevents programs within Labor, Health and Human Services, Education and Related Agencies (LHHS) from covering abortion. Because these restrictions primarily apply to those in the Medicaid health insurance program, low-income individuals are critically impacted by this amendment. With these restrictions, one in four low income women seeking an abortion are forced to go through with an unwanted pregnancy.
According to recent data, 58% of women of reproductive age who are enrolled in Medicaid or CHIP (Children’s Health Insurance Program) live in states that ban Medicaid coverage for abortion. Additionally, 51% of these enrollees are women of color, meaning that the Hyde Amendment disproportionately impacts the reproductive health of marginalized women. “The Hyde Amendment,” Supreme Court Justice Thurgood Marshall (1980) claimed, “is designed to deprive poor and minority women of the constitutional right to choose abortion.”
During his term, Biden passed two executive orders in support of abortion access, Executive Order 14076 and Executive Order 14079. However, both have now been rescinded, with Trump claiming they violate the Hyde Amendment. Executive Order 14076 imposed a whole-of-government effort to promote and fund abortion while also politicizing the enforcement of the Freedom of Access to Clinic Entrances (FACE) Act, which protects access to reproductive health care facilities and places of worship. Executive Order 14079 recategorized abortion as healthcare, which allowed for tax-payer money to go towards funding elective abortions, including Medicaid money to pay for travel costs. Trump has now nullified these two policies that were essential in providing support for equitable abortion access.
This is not the first time Trump has enforced sweeping abortion restriction policies. During his first term in office, he instated a similar domestic gag rule which gutted Title X’s capacity to serve patients and their reproductive health. Title X was passed in 1970, as part of the Public Health Service Act. The program expressly aimed to help reduce reproductive health inequity and ultimately help patients exercise their right to make their own reproductive decisions. Trump’s past domestic gag rule and its restrictions reduced Title X networks’ capacity by 46% nationwide, affecting potentially 1.6 million patients. The Biden-Harris administration made efforts to rebuild from the devastating effects of this gag-rule, but the process was slow-going.
Instead, many Title X programs had to accommodate and find independent solutions, such as allowing payments on a sliding scale, prioritizing free and/or low cost services for young people, and helping patients connect to private or public insurance. These strategies may need to be put to action again with Trump’s recent Executive Order.
Ultimately, Trump’s Executive Order represents a larger motion to return the issue of abortion to the states, as already seen with the 2022 Dobbs decision, in which three of the judges were Trump appointees. This order poses an immense threat to millions of women and child-bearing individuals, pulling out from under critical support needed for their reproductive health, safety, and freedom.
