GOP Bill Would End ACA Abortion Coverage—Even in Pro-Choice States

10.15.25

Click to skip ahead: Normalizing Extremism looks at an interview with the South Carolina lawmaker trying to ban abortion and birth control. In the States, news from Missouri, Florida, Utah, Alaska, and Kansas. In the Nation, Sen. Josh Hawley targets abortion coverage (even in pro-choice states), and RFK is mucking up science on pregnant women. Anti-Abortion Glossary looks at the rise of ‘drug dealers’. And Clinic Watch checks in on California, Wisconsin, and Texas.

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Normalizing Extremism

The man behind one of the most extreme anti-abortion bills in the country gave an interview yesterday to explain himself. It…did not go well.

South Carolina Sen. Richard Cash admitted he wants to ban contraception and jail not just abortion providers and patients, but anyone who so much as shares a clinic’s website. (As Abortion, Every Day reported last week, this is the same guy who once wrote a pamphlet claiming all birth control pills are murder.)

And while I know it’s tempting to dismiss his comments as the ramblings of a lone extremist, remember that it’s the ‘fringe’ who increasingly sets the anti-abortion agenda. And Cash’s bill, SB 323, is modeled on legislation from a major national group. So interviews like this help provide a roadmap for what the movement wants for women in every state.

It’s good for us when these guys say the quiet part out loud.

Cash told WYFF there’s been “misinformation” and “fearmongering” about SB 323—but the longer he spoke, the clearer it was that voters probably aren’t worried enough.

When asked why his bill redefines contraception, Cash admitted he believes certain forms of birth control are “an early abortion.” When pressed about allowing homicide charges against abortion patients—which could mean the death penalty in South Carolina—he shrugged it off: “It’s wrong to kill an innocent person.”

And when asked about whether someone could be criminally charged for calling an abortion clinic, or sharing a clinic website with a friend, Cash compared it to “sharing a website to find a killer to rub your wife out.”

“If you’re aiding and abetting the killing of an innocent person,” he said, “you’re going to be held accountable.”

Again—Cash is echoing rhetoric we’ve heard across the country. When Oklahoma Republicans introduced an ‘anti-trafficking’ bill to criminalize helping a minor get an abortion, for example, Sen. Nathan Dahm said giving a teen gas money to travel out of state was “no different than if you gave somebody gas money to be the getaway driver for another crime.”

These are the men shaping our laws, and they’re gaining more legislative and cultural power by the day. The fact that SB 323 is even up for debate says it all.

We have to share one last gem from Cash—maybe the most telling moment of all. When WYFF asked if he’d consider allocating resources for women and families into his bill, he said:

“I am not trying to add all that other stuff to the code. Anytime you write a bill, you have to focus on certain things. You can’t do everything.”

It’s like they’re trying to be unlikeable.

In the States

Some good news in Missouri, which is not something we get to say especially often: The Western District Court of Appeals just rejected Attorney General Andrew Bailey’s latest request to reinstate TRAP laws that would shut down the state’s few abortion clinics.

Bailey had the nerve to argue that TRAP laws weren’t causing “irreparable harm” because abortion seekers could simply travel out of state to Kansas or Illinois. Rightly, Judge Jerri Zhang called this argument “disingenuous.”

The decision—which comes as Republicans try to codify an abortion ban using a 2026 ballot measure—means that abortion should remain available in the state. That said, just as last year’s abortion rights ballot measure didn’t sweepingly fix Missouri’s abortion access crisis, this ruling doesn’t either.

To learn more about what access has actually been like on the ground, read this guest column from Missouri Abortion Fund:

Voters Thought They Were Overturning An Abortion Ban. They Got This Headache Instead.

Because a six-week abortion ban apparently isn’t enough, Florida Republicans have filed a terrifying fetal personhood bill for a third year in a row. SB 164 would update the state’s wrongful death statute to include embryos and allow people to seek civil damages for the wrongful death of a fetus or “unborn child.”

And though the legislation claims to include exceptions for IVF and other reproductive technology, that doesn’t mean the potential threat of lawsuits won’t stop clinics from possibly pausing services anyway. (Abortion bans across the country include ‘exceptions’ for medical emergencies or rape—yet providers turn people away out of fear regardless.)

Legal experts and abortion rights advocates have also warned that wrongful death bills for embryos and fetuses could allow men to retaliate against ex-partners for having abortions. After all, we’ve already seen how abusive men have weaponized state bans.

The real goal of SB 164, however, is to enshrine fetal personhood: it defines an “unborn child” as a “member of the species Homo sapiens, at any stage of development, who is carried in the womb.”

You all know how dangerous fetal personhood is—but if you want a deeper look at how it shapes nearly everything Republicans do on abortion, check out AED’s conversation with law professor and author Mary Ziegler:

Everything You Need to Know About Fetal Personhood

Over in Utah, Gov. Brian Cox just nominated conservative Judge John Nielsen to fill a state Supreme Court vacancy. Utah Republicans, who have been critical of some of the high court’s abortion-related rulings for not going far enough, are pleased. Which is pretty scary.

Here’s what state Sen. Todd Weiler told Fox 13:

“I suspect this one would be the easiest vote of some of my Republican colleagues. He’s an excellent choice. He’s very smart and I think he checks all the boxes my colleagues are looking for.”

To be clear, what Weiler’s GOP colleagues are looking for is someone who shares their extreme anti-abortion agenda. And though abortion remains legal in Utah until 18 weeks, severe restrictions on access are constantly working their way through the legislature and court system. So this seat matters.

Meanwhile, Alaska’s Supreme Court is set to hear arguments on whether nurse practitioners and physician assistants can provide abortions—or if a state law restricting who can offer care should remain in place.

A lower court blocked that law last year after the regional Planned Parenthood pointed out the obvious: those same providers are already allowed to deliver nearly identical care and medications for miscarriage treatment.

This comes at a time when Planned Parenthood’s two Alaska clinics are struggling to retain enough staff to meet patient need—so expanding who can legally provide abortions could make all the difference.

Definitely a case to keep an eye on, especially as other states like Kansas fight similar battles over expanding the provider pool to meet rising abortion demand.

Speaking of Kansas: Keep your eyes peeled for updates this Friday, when a court is expected to rule on whether a handful of medically unnecessary requirements placed on abortion clinics are constitutional.

As a reminder, in 2019, the Kansas Supreme Court ruled that the state’s constitution protects the right to abortion. Republicans are arguing that restrictions like a 24-hour waiting period—and bizarre rules for font size and text color for abortion clinic documents—don’t infringe on that right.

“Ohio’s Republican overlords openly defy the state constitution on redistricting and abortion rights to get their way no matter what a majority of folks in their state wants. Question is, will voters cede self-governance for team loyalty at the ballot box, or will they demand due respect from the elected representatives who work for them and loyalty to the rule of law over party?”

- Marilou Johanek, Ohio Capital Journal

In the Nation

U.S. Sen. Josh Hawley—one of the most smarmy and vile anti-abortion extremists in Congress—somehow continues to outdo himself. While the GOP drags out the government shutdown, Hawley has introduced a bill that would bar any Affordable Care Act plan from covering abortion—even those funded by pro-choice states.

Hawley’s press release doesn’t admit that, of course; he just says the legislation would close “loopholes” on abortion and gender-affirming care for minors.

As you know, the Hyde Amendment already blocks federal dollars from being used for abortion except in cases of rape, incest, or life-threatening pregnancy. But some ACA marketplace plans still offer abortion coverage because certain states use their own funding to pay for it—and 12 states even require marketplace plans to cover abortion. (KFF has a helpful map if you want to learn more.)

Hawley’s bill would end all of that. Under this legislation, any plan offered on the health exchange would be prohibited from covering abortion unless the pregnancy threatens the patient’s life or results from rape or incest.

Anti-abortion groups are already applauding Hawley for trying to eliminate what they call “state-level workarounds and separate billing schemes.”

Is this what Republicans meant by “leaving abortion to the states”?

Meanwhile, Politico has a piece on why we should all disregard RFK’s advice about what medications pregnant women should or shouldn’t use. The truth is, clinical trials involving pregnant people are so rare that we have little data to interpret. And thanks to abortion bans, that gap is only getting worse: scientists and prospective pregnant participants now fear that any harm to a fetus could land them in legal trouble.

PRESTO—a federally funded online database where people trying to conceive share data with researchers—has seen more than a 27% drop in participation in banned states. Which makes sense: of course fewer people are reporting information about their pregnancies to the government at a time when more and more people are being jailed for miscarriages.

In the absence of data, it’s exponentially harder for the government and medical groups to evaluate the safety of different medications and vaccines for pregnant people.

All while confidently spewing their ableist, anti-Tylenol bullshit, Trump and RFK Jr. are rapidly creating a scientific knowledge deficit that will have long-term consequences for pregnant women’s safety.

Quick hits:

• Rewire on how RICO could be weaponized against abortion providers and funds

• Common Dreams on what the weird ads about ‘good genes’ and anti-abortion policies have in common;

• MSNBC has an op-ed from law professor and author Mary Ziegler unpacking the attacks on abortion pills—and the current danger to shield laws;

• Ms. magazine with “Five Things to Know About Missed Period Pills.”

Anti-Abortion Glossary

I’ll give the anti-abortion movement this much—they sure know how to stay on message.

In the lead-up to the 2024 election, it was all about ‘consensus’ and ‘minimum national standards’—language to make voters think Republicans didn’t really support abortion bans. Now the anti-abortion buzzwords are ‘coercion’, ‘abuse’, ‘trafficking’ and ‘drug dealers’—talking points designed to make providers who prescribe abortion medication sound shady or criminal.

AED has been tracking the explosion of ‘coercion’ since 2023, when anti-abortion strategists identified it as the GOP’s most promising talking point because “no one is openly in favor of coerced abortions.” That soon gave way to the message that abortion medication is a common tool of domestic abusers and sex traffickers.

Now the focus has shifted from the medication to blasting providers themselves. ‘Drug dealer’, in particular, has taken serious hold—especially as Republican attorneys general move to challenge shield laws.

Louisiana AG Liz Murrill drops the term constantly. When moving to extradite New York abortion provider Dr. Maggie Carpenter, Murrill called her a “drug dealer who victimized a child.” She used the same language when bringing a suit against the FDA over mifepristone, calling the shipping of abortion pills “flat-out drug dealing,” and providers, “out-of-state abortion drug peddlers.”

The same rhetoric shows up in the mifepristone lawsuit brought by the AGs of Idaho, Missouri, and Kansas, who argued “the FDA fostered the creation of out-of-state abortion drug markets” and “created a 50-state abortion drug mailing economy.” And when Louisiana Gov. Jeff Landry signed a bill expanding civil liability around abortion, he said it was to “protect…victims of abortion drug dealers.”

You get the gist!

For Republicans, ‘drug dealers’ serves a dual purpose: If they can codify the message, it expands how they can punish providers. There’s a reason some states are trying to reclassify abortion medication as a ‘controlled substance’, and why anti-abortion bills try to invoke the RICO Act. They want to literally charge people as drug traffickers.

But what’s even more important is the cultural message: Republicans know abortion rights are popular, and arresting people for abortion is not. (Especially when so many of the folks packing pills into envelopes look like your old art teacher.)

Conservatives certainly can’t admit that women across the country want pills, and that they’re desperate to seek out safe care because their own states won’t allow it. So they’ve created an imaginary network of seedy doctors who ‘coerce’ unsuspecting women into taking ‘dangerous’ abortion pills.

They need it to sound sinister. That’s why it’s more important than ever to tell the truth: abortion providers and funds are lifelines for the women devastated by Republican policies. And the work they do isn’t shameful or criminal—it’s care.

Clinic Watch

Ever since Republicans’ “Big, Beautiful Bill,” reproductive health clinics across the country are suffering from devastating losses of funding. AED is tracking the impact on clinics—update us about the latest in your state by emailing tips@abortioneveryday.com.

California 🔴

We’re sorry to report that Planned Parenthood of Orange and San Bernardino Counties (PPOSBC) is being forced to scale back its services: the group will shutter its Melody Health program, which provides primary care for 13,000 patients in the area. PPOSBC president Krista Hollinger said that because the program is a Medicaid-managed health contract, “All of those patients are now going to have to find new providers.”

Wisconsin 🟡

Wisconsin Planned Parenthood recently stopped providing abortion services in order to continue its other health services for Medicaid patients. It’s terrible news, but Democrats in the state are trying to help a bit: legislators have introduced a bill to repeal all medically unnecessary abortion restrictions, in the hopes of making it easier for patients to get out-of-state or telehealth care. We’ll keep you updated on this one.

Texas 🟠

It may surprise some people to learn that Texas Planned Parenthood clinics are still operating. They’ve taken devastating blows, yes, but The Texas Tribune explains how the organization is surviving post-Roe America—and Trump. (None of this changes the fact that Texas women have been irrevocably harmed, but it’s helpful to get an inside look at how some clinics are managing.)