Access to Contraception and Abortion Under Trump: I’m Worried

Paula England, New York University

Abortion is already hard to get for poor women—federal healthcare funds can’t be used for abortion (e.g., under Medicaid) because of the Hyde Amendment. And abortions are expensive; usually at least $500. But Trump is promising to appoint a Supreme Court justice likely to favor overturning Roe v Wade. If it is overturned, in many red states, abortion would again be prohibited. This would mean that, in addition to coming up with the price of an abortion, poor women would have to travel to another state to get a legal abortion.birthcontrol

What about contraception? I am in print several places saying that cost is not much of a barrier to poor women getting contraception, such as the birth control pill. I still believe that, yet there are two reasons I believe it to be true, each of which is threatened by Trump, Pence, and Congressional Republicans. First, poor women use the sliding-scale services of Planned Parenthood. I’ve done two qualitative interview studies about contraception, and Planned Parenthood is all over the transcripts of both of them. In the Republican primaries, candidates competed with each other as to how fast they would defund Planned Parenthood (which uses private contributions, payments for services, and some federal funds to provide services to those who couldn’t otherwise afford them). Second, the Affordable Care Act (aka “Obamacare”) requires insurance plans to cover contraception and even prohibits copays from applying to contraception. While Trump has recently mused that he wants to replace rather than merely repeal Obamacare, and that he would favor retaining certain features now present, I cannot imagine that this feature will survive in whatever the now-Republican-dominated Congress will pass.

There are hundreds of reasons I am concerned about the Trump presidency. If you favor access to abortion and contraception for poor women, add this one to your list. Poor women in the United States already have disproportionately high levels of unplanned pregnancy. Under present structural arrangements, scholars have argued that this is largely from a combination of low opportunity costs of pregnancy, lack of sources of meaning (other than children), and low efficacy and self-regulation. But they have had access, if not to abortion, to cheap contraception. The access they now have to contraception through Planned Parenthood’s sliding scale, or their subsidized health insurance is likely to be in jeopardy soon.

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