Leaving Abortion to the States: A Broken Trump Campaign Promise – KFF Health News

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On the campaign trail, Donald Trump repeatedly said that restricting abortion access at the national level would not be a priority in a second term. “My view is, now that we have abortion where everybody wanted it from a legal standpoint, the states will determine by vote or legislation, or perhaps both, and whatever they decide must be the law of the land,” he said in a video posted last April. 

And indeed, abortion opponents held their breath when, during Trump’s first few days in office, his piles of executive orders did not include any on abortion. 

But he has more than made up for it since, having gone further in his first two weeks in office to restrict abortion than any president since Roe v. Wade was decided in 1973. 

As was widely expected, Trump has reinstated the “Mexico City Policy,” an order issued by every GOP president since it was adopted by former President Ronald Reagan in 1984. It bars funding to international aid organizations that “perform or actively promote” abortion. 

He also issued a similar-sounding order seeking to end “the forced use of Federal taxpayer dollars to fund or promote elective abortion” in domestic programs. It in fact goes further to restrict abortion than previous presidents in the modern era. 

Trump’s order, and a memo from the Department of Health and Human Services following up on it, says that the basis for this policy is the Hyde Amendment, which was named for the late GOP congressman and anti-abortion crusader Henry Hyde. That measure has barred federal funding of most abortions since Congress first passed it in the late 1970s. 

In its current iteration (it has changed several times over the years), the Hyde Amendment says that no HHS funding “shall be expended for health benefits coverage that includes coverage of abortion.” 

But Hyde bars only payment. Unlike the Mexico City Policy, it says nothing about “promoting” abortion. 

In fact, for decades, the Hyde Amendment existed side by side with a requirement in the federal family planning program, Title X, that grantee providers give patients with unintended pregnancies “nondirective” counseling about all their options, including abortion, and be referred for abortions if they request it. Former President Joe Biden reinstated that requirement in 2021 after Trump eliminated it during his first term. 

With Roe now in the rearview mirror, the Trump administration could take even more dramatic action to restrict abortion at the federal level, including by canceling FDA approval of the abortion pill mifepristone. His anti-abortion backers are expecting he will. So are those who support abortion rights. 

“We said they were coming for us,” said Clare Coleman, president and CEO of the National Family Planning & Reproductive Health Association. “And they are.” 

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