The anti-abortion plan ready for Trump on Day One

Many of the policies they advocate are ones Trump implemented in his first term and President Joe Biden rescinded — rules that would have a far greater impact in a post-Roe landscape. Other items on the wish list are new, ranging from efforts to undo state and federal programs promoting access to abortion to a de facto national ban. But all have one thing in common: They don’t require congressional approval.

“The conversations we’re having with the presidential candidates and their campaigns have been very clear: We expect them to act swiftly,” Kristan Hawkins, the president of Students for Life, told POLITICO. “Due to not having 60 votes in the Senate and not having a firm pro-life majority in the House, I think administrative action is where we’re going to see the most action after 2024 if President Trump or another pro-life president is elected.”

The groups have had, at times, a fraught relationship with Trump, who appointed the Supreme Court justices who helped overturn Roe v. Wade but who has blamed the anti-abortion movement for electoral losses, criticized Florida’s six-week ban and favors exemptions for rape, incest and life of the mother. Yet the sweeping plans indicate how much conservative activists see a potential Trump administration as an opportunity to restrict abortion nationwide — including in states that have voted to protect access over the last two years.

The Heritage Foundation’s 2025 Presidential Transition Project — a coalition that includes Students for Life, Susan B. Anthony Pro-Life America and other anti-abortion organizations — is drafting executive orders to roll back Biden-era policies that have expanded abortion access, such as making abortions available in some circumstances at VA hospitals. They are also collecting resumes from conservative activists interested in becoming political appointees or career civil servants and training them to use overlooked levers of agency power to curb abortion access.

“We’re trying to do as much, now, of the future president’s work that we can,” Spencer Chretien, a former special assistant to Trump who now runs Project 2025, recently told a packed room at Students for Life’s annual DC conference. “We need our people, our pro-life conservative people across America, to get fired up and to know that help is on the way and that they have something to look forward to.”

The Biden campaign hopes its own voters are similarly fired up, and is highlighting the right’s policy plans as they draw a contrast between Trump and Biden and make abortion rights a leading issue in the presidential election.

“We’ve made such great progress here in the state of Michigan, and yet, it is precarious in the event that Donald Trump comes back to the White House because all that work could be undone,” Biden campaign co-chair and Michigan Gov. Gretchen Whitmer told POLITICO — referencing her state’s vote in 2022 to overturn a 1931 ban and enshrine abortion rights in the state constitution. “We cannot afford to have someone in the White House who is going to rip these rights away that we’ve been fighting so hard to protect.”

In a call with reporters earlier this month, campaign manager Julie Chávez Rodriguez pointed to Project 2025 as a particular threat — arguing that Biden’s policies to advance abortion rights would be in jeopardy if he loses in November and vowing to hammer the message until “every single voter knows it.”

“They have laid out an 887-page blueprint that includes, in painstaking detail, exactly how they plan to leverage virtually every arm, tool and agency of the federal government to attack abortion access,” she said. “Trump’s close advisers have actual plans to block access to abortion in every single state without any help from Congress or the courts.”

The Trump campaign did not respond to questions about its second-term plans for abortion.

But Project 2025, led by Trump administration alumni, along with other conservative activists close to the campaign, said they’re confident Trump would at the very least revive his first-term policies that Biden has since scrapped. That includes reimposing restrictions on domestic and international clinics that provide contraception and STD testing and rolling back access to abortion pills.

Rewriting the rules

The Title X family planning program provides free and subsidized contraception, STD screenings, prenatal care and other services to millions of low-income people around the country.

The Trump administration, in 2019, barred clinics that receive Title X funds from counseling patients about abortion or providing a referral for one, and required clinics that provided both abortion and family planning to construct physically separate facilities and maintain separate staff and finances.

Approximately one-quarter of Title X providers quit the network in protest of the rules, leaving the program with 1,000 fewer sites and 22 percent fewer patients served, according to HHS. Six states lost all Title X providers, while another six lost the vast majority, which the agency estimated led to as many as 181,477 unintended pregnancies.

The Trump rules also allowed faith-based centers that don’t provide or inform patients about their full range of contraceptive options and try to dissuade them from having an abortion to participate in the program and receive federal funding.

Should these policies return with abortion banned or restricted in nearly half the country, the effect could be far greater.

“You are talking about a population that by definition is very low-income and you’d be cutting them off from very basic health care services,” said Usha Ranji, the associate director for women’s health policy at KFF. “The risk of unplanned pregnancies is also completely different post-Dobbs. Title X funds have never been used for abortion services. But providers could once again be prevented from offering comprehensive counseling on all their options, including options that may not be available for great distances.”

Anti-abortion activists are also preparing for a future Trump administration to rescind all the policies Biden enacted that expanded access to both abortion pills and surgical abortions — including funding for military members who must travel across state lines for an abortion, the provision of abortions at VA clinics, the expansion of HIPAA privacy rules to cover abortions, and the availability of abortion pills by mail and at retail pharmacies.

“We need to undo all of those,” said Roger Severino, the Heritage Foundation’s vice president of domestic policy who drafted part of the Project 2025 playbook. Speaking at the Students for Life conference, he added the group is “working on those sorts of executive orders and regulations” that will roll back Biden policies and “institutionalize the post-Dobbs environment.”

Undoing many Biden actions would take several months, because the Trump administration would have to propose a new agency rule and allow for public comment before implementation. Several other items on anti-abortion groups’ policy wish list for a Trump administration would also require rulemaking.

Students for Life is pushing for the EPA to classify the chemicals in the abortion pill mifepristone as “forever chemicals” subject to stricter regulations, and to require any doctor who prescribes the pill to be responsible for collecting and disposing of the aborted fetus.

They also want the Federal Trade Commission to penalize and prosecute virtual clinics that prescribe abortion pills to people in states where they are banned.

Susan B. Anthony, an anti-abortion group spending tens of millions of dollars to elect conservative candidates this fall, wants the FDA to reimpose the requirement — lifted by the Biden administration — that abortion pills only be dispensed in-person by a doctor, and investigate non-fatal complications reported by patients who take the drugs. Others want the agency to go further and strip the two-decade-old approval of the pill, banning its sale nationwide.

These regulatory changes would likely face legal challenges. Many rules the Trump administration tried to enact were blocked in court because officials did not follow administrative procedure. But given that experience, the prep work being done by Project 2025 and other groups, and the additional judges appointed by Trump, they would likely have a better success rate in a second term.

“I would anticipate both the very aggressive use of executive authority to undermine access to abortion and a reliance on conservative-leaning courts to lock those executive actions in place,” said Chris Jennings, a health policy expert who worked in both the Clinton and Obama administrations. “Even people who think they’re safe because they live in blue states would lose access should that happen.”

Lawmaking by memo

A second Trump administration could make swifter and more sweeping changes by issuing guidance and interpretations of existing laws.

The Comstock Act, passed in the 1870s and named for an official who campaigned against everything from masturbation to women’s suffrage, bans mail delivery of any “lewd or lascivious material,” including any “instrument, substance, drug, medicine, or thing” that could be used for an abortion. The law remains on the books, though its scope has been narrowed by Congress and the courts — for example, it no longer can be used to stop mail delivery of contraception. Project 2025 is preparing for Trump to bring it back into force, cutting off access not only to the pills used in the majority of abortions but also to medical equipment used for abortions and other procedures, and allowing criminal prosecutions of both providers sending the drugs and patients receiving them.

“We believe the Comstock Act should be followed and abortion pills should not be sent through the mail — certainly that should be enforced,” Carol Tobias, the president of the National Right to Life Committee told POLITICO.

The Biden administration’s Justice Department issued a legal memo in December, 2022 arguing that the Comstock Act does not bar mail delivery of abortion medication unless the sender intends for it to be used illegally. But judges appointed by Trump have, since then, ruled the opposite, and GOP state attorneys general have cited Comstock to pressure major pharmacies not to carry the pills in their states.

Groups are also planning for a Trump administration to rescind Biden administration guidance requiring hospitals to offer abortions to patients experiencing medical emergencies regardless of state bans on the procedure — an issue the Supreme Court is set to consider this year.

“The Biden administration has reiterated that stabilizing care includes abortion services and providers need to provide it,” Ranji said. “That could be something the Trump administration could decide not to enforce and they would not even have to go through a rule-making process. They could just do it.”