President Trump has changed his mind or failed to follow through on many campaign promises in his first 100 days in office, but there's at least one pledge he's kept: to limit access to abortion.
Early on in his campaign, Trump often switched on his stance on abortion and appeared uneducated about the issue. He seemed not to know the difference between "pro-life" and "pro-choice," and later suggested that abortion "laws are set" and can't be changed. But by September 2016, Trump had solidified his anti-abortion bona fides. He announced the creation of a "pro-life coalition" and promised to gut federal funding for abortion providers, among other sweeping federal changes.
Now, anti-abortion advocates — already thrilled with the support they've seen so far from Trump's administration — are eager for what's to come.
"He has got the weight of the world on him and yet he is keeping his promises to the pro-life movement," said Jim Sedlak, executive director of the American Life League, which describes itself as a Catholic pro-life education organization. "I think after eight years we're going to look back at the Trump presidency and say, 'Thank you, God. You gave us what we needed.'"
On Jan. 27, Vice President Mike Pence became the first sitting U.S. vice president to attend the March for Life, an annual gathering for anti-abortion activists in D.C., where he assured the thousands of attendees, "Over there at 1600 Pennsylvania Avenue, we're in the promise-keeping business."
The crowd went wild. They had good reason to: Trump had already signed an executive order rolling back the so-called "Mexico City policy" barring the United States from providing aid to nonprofits that promote abortion access abroad. A few weeks later, Trump slashed funding to the United Nations Population Fund, a family planning agency that operates in more than 150 countries around the world, claiming that the agency supports coercive abortion policies in China. (The agency denies this.)
Limiting foreign aid to groups that support abortion rights has been standard procedure for Republican presidents since Reagan, but Trump went further than past administrations. Historically, the Mexico City policy — which abortion rights advocates dub the "global gag rule" — cut off only family planning funds. But Trump's rule slashed all aid for U.S. global health assistance, including funding for HIV programs and maternal and child health programs. So while the previous policy cut off about $575 million in aid, the new version could affect up to $9.5 billion, according to one estimate.
Ilyse Hogue, the president of NARAL Pro-Choice America, said this move was devastating for abortion rights groups. But, she said, it fits right in with the Trump brand.
"It's Trump, right? He's got to do everything 'bigly,'" Hogue explained. "You look at that first executive order in this arena, and you've seen that consistency in his approach all along the way."
That consistency includes limiting abortion domestically. Trump signed a bill in April repealing an Obama-era rule banning states from withholding federal Title X family planning grants from abortion providers — a controversial piece of legislation that only made it past Congress after Pence cast the tie-breaking vote in its favor.
Kristi Hamrick, a spokeswoman for Americans United for Life, called the bill "a huge victory" in the movement to "[disentangle] the American taxpayer from supporting the abortion industry." Since 2011, at least 13 states have drafted restrictions that could lead to abortion providers losing Title X funding. Those restrictions may now go into effect.
"We have massively expanded the culture of abortion providers in America just by virtue of the fact that we pay a lot of money to keep their lights on, to pay for their personnel," Hamrick said. By taking away that federal money and instead giving it to "full-service medical care" centers, she said, the national abortion rate will drop. (The rate is already the lowest ever recorded — it has fallen 14 percent since 2011, according to the Guttmacher Institute, which attributes the drop to both rising use of contraception and a surge of state-level abortion restrictions.)
It is already illegal for federal Medicaid dollars to pay for abortion services, with rare exceptions, thanks to a legislative provision called the Hyde Amendment. Planned Parenthood contends that the amendment penalizes marginalized groups like low-income women and people of color — who are more likely to rely on Medicaid — and restricts their access to abortion.
Hyde must be extended annually, and Congress has renewed it every year for the past four decades. Making it technically permanent is at the top of anti-abortion advocates' legislative wish list, and the president has promised to make it happen.
But Trump has faltered when his anti-abortion promises have run up against bigger, more complicated legislation. His effort to repeal and replace the Affordable Care Act, complete with a mandate to federally "defund" Planned Parenthood, failed.
Hamrick said that doesn't mean her organization is giving up hope that a health care overhaul will eliminate the "large numbers of anti-life mandates intertwined throughout the law," such as the requirement that health care plans cover specific types of contraception.
"Everybody believes Obamacare's going to come back" for revision, Hamrick said. "The question just becomes, how much can you do in any given timeframe?"
Because it's not just what Trump has done in his first 100 days, Hamrick explained — it's the groundwork he's laid for what he'll do next. "He has put in his administration the kind of people who are actually pro-life and actually committed to the life issue, as opposed to lip service to get elected," she said.
Hogue, the abortion-rights advocate, called these people "true believers," who will "take a scorched-earth approach to abortion."
Besides Pence, who as governor of Indiana signed legislation that caused half the state's abortion clinics to close — leaving Indiana with just six open clinics — there is Health and Human Services Secretary Tom Price, who has co-sponsored bills to give zygotes full legal protection, a move that would outlaw not only abortion but also emergency contraception. Hogue also pointed to Roger Severino, who heads HHS' Office for Civil Rights. In a 2016 column for the conservative website the Daily Signal, Severino urged Congress to cut Planned Parenthood's federal funding.
We don't yet know whether Neil Gorsuch is one of these true believers. But in the eyes of both supporters and opponents of abortion access, Trump's Supreme Court pick fulfills one of the president's most fervent campaign promises: to nominate justices who would help overturn Roe v. Wade.
Although Gorsuch lacks a substantial record on abortion, his dedication to interpreting the Constitution exactly how it was originally written marks him as a justice who "will fail to find in the Constitution any provision that denies a self-governing people the right to fashion laws that recognize the humanity of unborn members of the human family," according to a letter sent by the National Right to Life Committee urging senators to confirm Gorsuch.
Sedlak, of the American Life League, also applauded a book Gorsuch wrote condemning physician-assisted suicide, an issue that anti-abortion activists often see as going hand in hand with opposition to abortion. For him, this is proof that Trump "has given us the kind of Supreme Court nominee that he promised he would."
Much of the abortion battle in recent years has been fought at the state level, and states introduced nearly 50 anti-abortion bills at the start of this year. Yet both pro- and anti-abortion rights camps dismiss the idea that some sort of "Trump effect" trickled down to the states and led to a rash of legislation. They attribute it instead to years of successful grassroots organizing by anti-abortion advocates.
Hogue said Trump owes those anti-abortion organizers for their support during the election. For example, the president of the massive anti-abortion advocacy group Susan B. Anthony List, Marjorie Dannenfelser, gave Trump's pro-life coalition some much-needed legitimacy when she agreed to spearhead it during the campaign. In the coming months, Trump will be expected to double down on his federal attacks on abortion, Hogue explained.
"Do I think he's going to repay his debts? I mean, I could cross my fingers and hope not, given the number of contractors who've come forward and said he never paid them. But this is an easier debt for him to pay because it doesn't include cash money," she said. "So I'm guessing that he intends to keep it."
Yet even if Trump never keeps another anti-abortion campaign promise, his presidency is still a success for abortion opponents, given the alternative.
"All of this has to be put in the context of the fact that most people believed Hillary Clinton was going to be president," Hamrick said. "And so we were already ahead of the game the day Donald Trump won."
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