The impact of the 2020 US elections on key reproductive health policies

GlobalData Healthcare 14 October 2020 (Last Updated October 16th, 2020 10:08)

The impact of the 2020 US elections on key reproductive health policies

In light of the fast-approaching 2020 US presidential elections, both the Republican and Democratic Parties’ stance on reproductive health policies are brought to the forefront of political debates. Reproductive health topics surrounding their policies are perhaps some of the most divisive in US politics, with President Donald J Trump, and his Democratic opponent, former Vice President Joe Biden, taking vastly different positions on the right for abortions, federal funding for abortions, and coverage of contraceptive methods.

On the abortions rights front of reproductive health policies, Trump and the Republican Party are ‘pro-life,’ whereas Biden and the Democratic Party are ‘pro-choice.’ The Republican Party’s ideology aims to overturn Roe v Wade. The 1973 landmark Supreme Court ruling legalised the right to an abortion on the national level and gave women the right to choose having an abortion until viability—the point at which a fetus is considered viable outside the womb. In certain states, positions, such as the “personhood” initiative in Mississippi, “heartbeat bills” in several states, or the Alabama near-total ban on abortion, have come close to taking effect, but ultimately been blocked or not enacted. A study of the recent acceleration of passing of anti-abortion laws by Republicans in a number of states is indicative that the issue remains a focal point of the Party’s agenda. Notably, GlobalData believes that Trump’s nomination of Amy Coney Barrett, a conservative judge, to the Supreme Court on September 26 further demonstrates his commitment to ‘protect unborn life through every means available.’ In light of these latest developments, GlobalData believes the fate of the Roe v Wade ruling becomes even more uncertain. If Republicans control both the Presidency and the Congress following the election, it is likely that each state’s freedom in regulating abortion will be restricted. A possible conservative-leaning Supreme Court will increase the likelihood of this scenario. If Barrett joins the Supreme Court, this would mean a conservative majority of 6–3. Barrett is aligned with Republicans on the issue of abortion and has been a vocal pro-life advocate, having a history of decisions critical of abortion rights during the time she served on the US Court of Appeals.

If the ruling is overturned, GlobalData expects the right to abortion would be a battle in several states. It is estimated that 25 million women would be at risk of losing access to abortion. A conservative-leaning Supreme Court would likely also favour the passing of laws restricting abortion, and limiting the funding and operation of Planned Parenthood. Currently, over 20 states are poised to ban abortion if Roe v Wade is reversed. Meanwhile, states such as Florida and Mississippi have set abortion limitations this year.

The Democratic Party strongly opposes the overturning of Roe v Wade and any state and federal laws that prohibit women’s access to abortion. New York recently passed a law that allows late-term abortions when the fetus is not viable or the abortion is medically necessary “to protect the patient’s life or health.” Virginia Governor Ralph Northam has openly supported late-term abortion under specific medical circumstances. If the Democrats control both the Presidency and the Congress following the election, it is likely that abortion rights will be supported and restrictions will be loosened around late-term abortions.

Furthermore, Trump supports the Hyde Amendment, a legislative provision barring the use of federal funds for abortion with exceptions being situations to save the life of the woman, or for pregnancy resulting from incest or rape. This impacts free access to abortion services for lower-income women on Medicaid. Biden reversed his long-standing position last year when he announced he no longer supported the Hyde Amendment. He also plans to expand federal family planning funds. GlobalData expects this to favourably affect mostly low-income women or those seeking abortions under Medicaid.

Lastly, the two parties hold completely opposite views on healthcare. The Republicans seek the Supreme Court’s support to abolish the Affordable Care Act (ACA), which provides free access to preventive care, including contraception, and replace it with a free-market–based model of private enterprise. Biden plans to expand on the ACA by creating a Medicare-like public option plan that would automatically cover people with low incomes in states that have not expanded Medicaid.

Currently, under the ACA, insurance companies are required to cover contraceptive methods without a copayment when provided by an in-network provider. GlobalData foresees that whether the ACA is abolished and access to contraceptive coverage is changed or eliminated will depend on what happens in the Supreme Court. Biden has stated his intentions to build on the progress made by the ACA and proposes, “the public option will cover contraception.” If the ACA is abolished, coverage of contraceptives will fall onto the states and low-income women will face additional barriers accessing contraceptives at no out-of-pocket cost. At this time, 28 states require insurance plans to cover contraceptives.