Interested Parties Memo: Biden-⁠Harris Administration Expands Coverage of Contraception Under the Affordable Care Act as Republican Elected Officials Continue Attacks on Reproductive Freedom

Jennifer Klein, Director, White House Gender Policy Council

Under President Biden and Vice President Harris’s leadership, the Administration is taking bold action to expand coverage of contraception for the 52 million women of reproductive age with private health insurance, marking the most significant expansion of contraception benefits under the Affordable Care Act in more than a decade. Today’s announcement builds on the Biden-Harris Administration’s strong record of defending access to reproductive health care and commitment to ensuring that women have the freedom to make deeply personal health care decisions, including if and when to start or grow their family.

Meanwhile, Republican elected officials continue to threaten women’s health, lives, and freedom through extreme abortion bans, some with no exceptions for rape or incest. Women are being denied essential medical care while doctors and nurses are threatened with jail time. Abortion, contraception, and IVF are under attack, while Republicans in Congress refuse to protect nationwide access to this vital reproductive health care. This extreme agenda is out-of-touch with the American people—which is why voters have overwhelmingly chosen to protect reproductive freedom in every state where abortion has been on the ballot.
President Biden and Vice President Harris stand with the vast majority of Americans in supporting a woman’s right to choose, and they will continue the fight against a national abortion ban and call on Congress to restore the protections of Roe v. Wade in federal law once and for all.

Women’s Health and Lives at Risk
From day one, President Biden and Vice President Harris knew that state abortion bans would have devastating consequences for women’s health and lives. Since Roe was overturned, more than 1 in 3 women of reproductive age live in the more than 20 states with dangerous and extreme abortion bans in effect.

• Abortion bans are leaving women without emergency care. Courageous women and their families have shared harrowing stories about being denied urgently needed care because of state abortion bans. Women have died because they did not get the care they needed—or women only received care after developing sepsis or losing more than half of their blood. Some women are suing their states so other women with severe and dangerous pregnancy complications will not be similarly forced to the brink of death before they can receive an abortion.
  
• Abortion bans are worsening maternal mortality. States with abortion bans have higher rates of maternal mortality than states where abortion remains legal. For instance, after a dangerous Texas abortion ban went into effect in 2021, maternal mortality increased by 56% (compared to 11% nationwide). One year after Dobbs, two-thirds of OBGYNs reported that the Court’s decision worsened pregnancy-related mortality and their ability to manage pregnancy-related emergencies. And criminal and civil penalties under state abortion bans are causing doctors to flee abortion ban states, exacerbating the maternal health crisis and creating maternity care deserts that impact entire communities. 
  
• Abortion bans are making it even harder to access contraception and other essential care. Since Roe was overturned, abortion bans have caused dozens of reproductive health care clinics to shutter, jeopardizing access to abortion, contraception, and preventive care that women rely on. In states with abortion bans, there were over 4% fewer filled prescriptions for oral contraception in the first year after Roe was overturned. Some states had far greater declines: Texas, for instance, had a 28% decline in filled prescriptions for oral contraception.
  
• Abortion bans are forcing women to travel hundreds of miles for care. State abortion bans are forcing many women to travel to another state to obtain care that would have been available in their state if Roe were still the law of the land. Women in nearly a quarter of counties in America—especially in the South—have been forced to travel more than 200 miles to get the essential care they need.
  
• Abortion bans are jeopardizing our ability to train the next generation of medical providers. States with abortion bans continue to see a decrease in medical and residency student applications, especially among prospective OBGYNs. Nearly 60% of third- and fourth-year medical students said they were unlikely or very unlikely to apply to a single residency program in a state with abortion restrictions, while nearly 80% said that access to abortion care would influence where they would pursue their residency. And about 1 in 5 OBGYN residents said that the overturning of Roe changed where they had planned to practice medicine, and those who had planned to practice in a state with abortion bans were eight times more likely to change their intended practice location.

Republican Officials’ Extreme Agenda

Despite the devastating impact of state abortion bans, Republican officials continue to push for a nationwide abortion ban to restrict the rights of women in every state, deny access to emergency medical care, and eliminate access to safe and effective, FDA-approved medication abortion.

• Republicans in Congress have proposed four national abortion bans that would deny every woman in America the right to choose, regardless of where she lives. This includes a nationwide abortion ban with no exceptions for rape or incest that puts IVF treatment squarely at risk. House Republicans have also attacked contraception access nationwide by repeatedly proposing to defund the Title X Family Planning Program. And Senate Republicans continue to block federal legislation that would safeguard nationwide access to abortion, contraception, and IVF.
  
• Republican elected officials have enacted or enforced abortion bans in more than 20 states. Republican attorneys general have made clear they seek to access women’s medical records—even for out-of-state care—and have tried to discourage women from traveling out-of-state to receive lawful abortion care by threatening those who help them with criminal charges.
  
• Republican elected officials filed more than 350 bills restricting abortion during the 2024 legislative session. In Louisiana, Republican officials classified medications used in abortion and miscarriage management as controlled substances, making it even harder to access these critical medications during an emergency. In Florida, state officials are attempting to undermine support for a reproductive freedom ballot measure, including by threatening TV stations that run ads with criminal charges. And Republican state legislators are proposing legislation that would jeopardize access to IVF.
  
• Republican elected officials want to ban medication abortion nationwide, including in states where abortion remains lawful. They are also fighting to prevent women from receiving the emergency medical care they are entitled to under federal law— including abortion care when necessary to save a woman’s health or life.

No attempt to “rebrand” can change the fact that Republican elected officials have spent decades undermining reproductive freedom. Republican elected officials will not stop pursuing extreme policies until there is a national abortion ban in place.

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