Biden Administration Expected to Pursue a Pro-Choice Agenda

WASHINGTON — Once he is inaugurated, President-elect Joe Biden is expected to adhere to a pro-choice agenda and reverse many of the anti-abortion policies implemented by the Trump administration — a prospect that pro-choice groups are looking forward to seeing and pro-life groups are dreading.

On his campaign website, Biden listed a number of goals and promises in this area:

• Repeal the Hyde Amendment. The Hyde Amendment bars federal — but not state — Medicaid funds from being spent on abortion, except to safeguard the life or health of the mother. “Healthcare is a right that should not be dependent on one’s Zip code or income,” the website says. This move would require action from Congress — something that’s highly unlikely any time soon given the current divide in the Senate between Democrats and Republicans

• Stop state laws violating Roe v. Wade. The website says that “Biden will work to codify” Roe v. Wade, the 1973 Supreme Court decision that legalized abortion nationwide, “and his Justice Department will do everything in its power to stop the rash of state laws that so blatantly violate Roe v. Wade“

• Restore federal funding for Planned Parenthood. “As President, Biden will reissue guidance specifying that states cannot refuse Medicaid funding for Planned Parenthood and other providers and reverse the Trump Administration’s rule preventing these organizations from obtaining Title X funds,” the website says. Title X is a federal program that provides family planning services to low-income patients

• Rescind the Mexico City Policy (also referred to as the global gag rule) that President Trump reinstated and expanded. “This rule currently bars the federal government from supporting important global health efforts — including for malaria and HIV/AIDS — in developing countries simply because the organizations providing that aid also offer information on abortion services,” the site says

• Restore the Affordable Care Act’s contraception mandate in place before the Supreme Court’s Hobby Lobby decision. That decision “attempted to carve out broad exemptions to the Affordable Care Act’s (ACA’s) commitment to giving all women free access to recommended contraception,” the website notes. “Biden will restore the Obama-Biden policy that existed before the Hobby Lobby ruling: providing an exemption for houses of worship and an accommodation for nonprofit organizations with religious missions. The accommodation will allow women at these organizations to access contraceptive coverage, not through their employer-provided plan, but instead through their insurance company or a third-party administrator”

Biden’s agenda in this area is of great concern to the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG). “AAPLOG advocates for the rights of our members to practice medicine according to Hippocratic principles,” Christina Francis, MD, chair of AAPLOG’s board of directors, said in a statement emailed to MedPage Today. “Hippocratic medical practice means that we do not intentionally hurt or kill our patients. Any administration that opposes the right of physicians to practice according to Hippocratic principles will only worsen this situation.”

Francis also criticized Biden’s support for repealing the Mexico City Policy, adding that “the Trump administration reinstated the Mexico City Policy — which prevented the promotion of abortion as a family planning method — promoting true healthcare for women.”

Francis also said that “the recent Geneva Consensus Declaration, which declared that there is no international right to abortion and that the West has no right to attempt to ideologically colonize other countries, is fully supported by the current administration” but likely would not be by Biden. “We do not support taxpayers being forced to fund a practice that kills innocent preborn children and harms women.”

Physicians for Reproductive Health (PRH), a pro-choice organization, had a different take on the Biden agenda. “The COVID-19 pandemic has worsened existing health inequities, making it even harder for individuals to access the healthcare they need, including sexual and reproductive healthcare,” PRH president and CEO Jamila Perritt, MD, an ob/gyn here, said in a statement sent to MedPage Today. “Clinic closures, loss of insurance coverage, and decreased resources have limited the capacity of providers to meet their patients’ health needs.”

“The Biden-Harris administration must protect the patient-provider relationship and promote evidence-based medicine by reversing harmful Trump era policies like the Title X domestic and global gag rules, the religious refusals rule which allows virtually any healthcare entity to deny essential healthcare based on a religious or moral belief, and the public charge rule which discourages immigrants from accessing basic health coverage,” Perritt said. “All people deserve comprehensive access to healthcare, and at PRH we will continue to push Congress and the new administration to protect and expand access to the healthcare our communities deserve.” The domestic gag rule prohibits Title X providers from referring pregnant patients for abortions.

The Guttmacher Institute, a pro-choice reproductive health research and advocacy organization, agreed. “Throughout the pandemic, and well before, sexual and reproductive health and rights were neglected — or outright targeted — by the Trump administration and their anti-reproductive rights allies at all levels of government,” Zara Ahmed, DrPH, the institute’s associate director of federal issues, said in an email. “We must hold the incoming administration and congressional lawmakers accountable to undo the harms of the last 4 years, push for progressive and equitable policies, and make 2021 a turning point for sexual and reproductive health, rights, and justice. And we must be vigilant for any harmful or restrictive policies that may be enacted in the period between the election and inauguration.”

In particular, the institute supports closing “loopholes” in the ACA’s guarantee of contraceptive coverage, and “repairing the Title X program by reversing the ‘domestic gag rule’ and rebuilding the network by allowing long-standing providers back into the program,” according to an email sent to MedPage Today.