Let’s Get to Work: Five Priorities for the Start of the Biden Administration

Four important starting points, among many:

• As the pandemic has raged, Trump’s administration has defended and then fought to reinstate a policy that subjects patients to COVID-19 risks in order to access safe and legal medication abortion — disproportionately harming people of color and people with low incomes. Mifepristone (one of the drugs used for medication abortion) is safe, effective, and has been used by more than 4 million people since the FDA approved it 20 years ago. Requiring patients to obtain mifepristone directly from a doctor’s office, hospital, or other health center — rather than at a pharmacy or in the mail, as they can for other equally safe medications — is unnecessary and indefensible. The Biden administration should ask the FDA to reevaluate this requirement and other restrictions on the availability of mifepristone. 

• President Trump made the Global Gag Rule more restrictive than ever, banning overseas groups from receiving U.S. health funding if they refer, provide, or even mention abortion or abortion-related services. Trump’s policy affected members of economically disadvantaged and hard-to-reach communities around the world, including in sub-Saharan Africa, South Asia, Latin America, and the Caribbean. President-elect Biden must junk the global gag rule on day one of his presidency.

• The Title X Gag Rule decimated Title X — the federal program that gives grants to health care providers so that people who are uninsured or underinsured can access free and low-cost birth control, contraception education, STD tests, breast and cervical cancer screenings, and other preventive reproductive health care. This unethical Trump administration policy stops health care providers from talking with their patients about how to access abortion, keeping 4 million people who rely on Title X from being able to get full and accurate information. The gag rule forced Planned Parenthood health centers — which had served 40% of Title X patients — and many other providers out of the program, undermining access to these services as a result. The rollback of this dangerous rule should begin on the Biden administration’s first day.

• The Trump administration issued rules designed to undermine the Affordable Care Act’s (ACA) contraception mandate, which guarantees no-copay birth control coverage in insurance plans. Over 62 million women now have access to birth control without copayments thanks to the ACA’s birth control mandate. As Trump leaves office, these regulations — which make it harder for people to get the care they need — remain in place. They must be rolled back.

Who Can Make This Happen: The Biden administration

• The Hyde Amendment is a discriminatory policy that blocks people with Medicaid and other government funded programs from using their federal health insurance to access safe, legal abortion. Due to legacies of systemic racism, homophobia, and transphobia, people who use Medicaid are disproportionately Black, Latino, and members of the LGBTQ+ community. The Biden administration should eliminate the Hyde Amendment from its budget proposal, and work with Congress to stop the harm done by the Hyde Amendment once and for all.

• The Helms Amendment is a harmful policy that has created significant barriers to accessing vital, lifesaving health care in some of the most economically disadvantaged countries in the world. The policy restricts people’s ability to make their own personal medical decisions and denies access to comprehensive reproductive health care — purporting to merely prohibit funding for “abortion as a method of family planning.” When aggressively applied in practice, however, the rule amounts to a complete ban on U.S. funding for all abortion services, even in cases of rape, incest, or a life-threatening pregnancy. Congress should send legislation repealing this cruel policy to President Biden’s desk.

Who Can Make This Happen: The Biden administration, in conjunction with Congress

Senate Republican leadership spent months refusing to pass relief for people hard-hit by the coronavirus pandemic, which has claimed over 300,000 lives in this country. This delay was inexcusable — and deadly for the Black, Indigenous, and Latino communities where COVID-19 has made its deepest impact. 

Planned Parenthood Action Fund and its partners in the We Demand More coalition know that people who are disproportionately impacted by the COVID-19 pandemic can’t wait — they need comprehensive COVID-19 relief now. We look forward to a Biden administration that, from Day One, works with Congress to pass additional relief that includes:

• no restrictions on accessing safe, legal abortion or any other essential sexual and reproducive health care;

• support for state and local governments;

• free COVID-19 tests and treatment, and vaccines — distributed equitably and efficiently — for all; 

• personal protective equipment for all health care providers and other frontline workers; and

• support for and collaboration with international partners addressing global health.

Who Can Make This Happen: Congress, with President Biden’s signature

The Trump-Pence administration’s appointees have sought to undermine the programs they oversee. Seema Verma, for instance — the administrator of the Centers for Medicare & Medicaid Services (CMS) — authorized restrictions, such as work requirements, that blocked people with low incomes from accessing Medicaid while providing no benefit to public health. Diane Foley, who oversaw Title X — the nation’s only dedicated federal program for birth control and reproductive health care — previously ran so-called “crisis pregnancy centers” and had a history of opposing sex education and access to abortion. As these appointees leave office, Planned Parenthood Action Fund and its supporters are counting on President-elect Biden to appoint leaders who:

• fight to support and improve the health programs they oversee, not dismantle them;

• reflect ethnic and geographic diversity at all levels;

• support sexual and reproductive health and rights; and

• have a demonstrated commitment to racial equality, LGBTQ+ equality, and economic justice.

In vote after vote, even as the coronavirus pandemic took the lives of more than 300,000 people and left millions of people in the U.S. unemployed, Senate Republicans prioritized confirming over 230 of Trump's nominees to lifetime positions as federal judges instead of passing comprehensive relief. Most of these confirmed judges are white and male; many hold views that are hostile to sexual and reproductive health and rights. In the courts, they could make rulings that affect our rights and access to health care for generations to come.

Biden has signaled that he wants his judicial nominees to reflect the true diversity of the country — and pledged that his nominees would “support the right of privacy, on which the entire notion of a woman's right to choose is based.” People across America whose access to health care — including abortion — is already tenuous need him to keep his word.

Who Can Make This Happen: President Biden, in conjunction with the Senate

The Trump-Pence administration encouraged states to block access to birth control and other preventive care at Planned Parenthood health centers. In 2018, it rescinded guidance that had made clear to states that blocking patients’ access to their sexual and reproductive care providers of choice violates federal law. Two years later, the Trump administration went a step further — letting Texas use federal Medicaid dollars for a state program that bars its patients from accessing preventive care at Planned Parenthood and other health centers that provide abortion.

Since Texas ended its previous Medicaid family planning program, replacing it with an entirely state-run program, nearly 45,000 Texans have lost access to care. Many of those had no other providers in their communities that could accommodate all of the patients served by Planned Parenthood health centers. Another 39,000 have lost access to birth control. 

Barriers to health care such as those imposed in Texas particularly hurt people of color, people with low incomes, and LGBTQ+ people, who rely on Medicaid in disproportionate numbers, due to legacies of systemic racism and discrimination. During a public health crisis, members of those communities — and all communities — need access to preventive care more than ever. Upon taking office, the Biden administration should move swiftly to reinstate guidance and take other steps to protect Medicaid patients’ access to care at Planned Parenthood health centers or other providers of their choice.

Who Can Make This Happen: The Biden administration