Trump’s first term led to the fall of Roe v. Wade — so I decided to dig deeper into Project 2025 and find out exactly what the plan has to say about contraception and abortion. Here’s what I found.

So, while the plan isn’t Trump’s “official” platform as a candidate, it’s not far-fetched to think that a second Trump administration would likely draw on the policies laid out in Project 2025. Since Trump’s first term led to the fall of Roe v. Wade, I decided to dig deeper into Project 2025 and find out exactly what the plan has to say about contraception and abortion. Here’s what I found:

1. Under the Affordable Care Act, most health insurance plans are currently required to offer hormonal birth control methods at no cost to patients. This is great for folks who use these medications to prevent pregnancy and for people who use them to treat other medical conditions like PCOS and endometriosis. Project 2025 would like to see Trump’s previous religious and moral exemptions reinstated to allow employers to choose not to cover these important medications for employees and dependents covered on their health plans. This change would make it harder and more burdensome for some patients to get the medications that they and their doctors agree they should have.

“Restore Trump religious and moral exemptions to the contraceptive mandate (also a CMS rule). HHS should rescind, if finalized, the regulation titled “Coverage of Certain Preventive Services Under the Affordable Care Act,” proposed jointly by HHS, Treasury, and Labor.70 This rule proposes to amend Trump-era final rules regarding religious and moral exemptions and accommodations for coverage of certain preventive services under the ACA. Preventive services include contraception, and it appears the proposed rule would change the existing regulations for religious and moral exemptions to the ACA’s contraception mandate.”

2. Project 2025 also proposes removing one specific form of emergency contraception from the ACA’s mandate, calling it a “potential abortifacient” (it isn’t).

“Eliminate the week-after-pill from the contraceptive mandate as a potential abortifacient. One of the emergency contraceptives covered under the HRSA preventive services guidelines is Ella (ulipristal acetate). Like its close cousin, the abortion pill mifepristone, Ella is a progesterone blocker and can prevent a recently fertilized embryo from implanting in a woman’s uterus. HRSA should eliminate this potential abortifacient from the contraceptive mandate.”

3. There is one type of contraception that Project 2025 would like to see expanded, however — fertility awareness-based methods. Think “the rhythm method.” According to Planned Parenthood, these types of family planning measures are less effective than hormonal birth control, and even perfect use can still result in unplanned pregnancies.

“HHS [Health and Human Services] should more thoroughly ensure that fertility awareness-based methods of family planning are part of women’s preventive services under the ACA. FABMs often involve costs for materials and supplies, and HHS should make clear that coverage of those items is also required. FABMs are highly effective and allow women to make family planning choices in a manner that meets their needs and reflects their values.”

4. Project 2025 urges the FDA to reverse its approval of the abortion drug mifepristone, citing 26 deaths of pregnant people taking the drug in over 20 years since it was first approved.

“Now that the Supreme Court has acknowledged that the Constitution contains no right to an abortion, the FDA is ethically and legally obliged to revisit and withdraw its initial approval, which was premised on pregnancy being an ‘illness’ and abortion being ‘therapeutically’ effective at treating this ‘illness.’ The FDA is statutorily charged with guaranteeing the safety and efficacy of drugs and therefore should withdraw this drug that is proven to be dangerous to women and by definition fatally unsafe for unborn children.”

5. Project 2025 would also put a stop to abortion drugs being sent through the mail by relying on a “zombie law” from over a hundred years ago that hasn’t been enforced since the mid-20th century.

“Stop promoting or approving mail-order abortions in violation of long-standing federal laws that prohibit the mailing and interstate carriage of abortion drugs.”

A footnote on this proposal leads to the Comstock Act, a law passed in 1873 that criminalized sending “obscene, lewd, lascivious, indecent, filthy or vile” materials through the mail. However, the Comstock Act has not been enforced in decades at this point.

6. Project 2025 calls for changes to EMTALA that would no longer require hospitals and emergency rooms to provide abortion in the event of a medical emergency. EMTALA stands for Emergency Medical Treatment and Labor Act. This federal law requires hospitals that get Medicare funding to treat emergency patients “until the emergency medical condition is resolved or stabilized.” In response to state-level abortion bans in 2022, the Supreme Court ruled that under EMTALA, abortion cannot be denied in cases where a pregnant person’s health is in danger.

“In July 2022, HHS/CMS released guidance mandating that EMTALA-covered hospitals and the physicians who work there must perform abortions, to include completing chemical abortions even when the child might still be alive. The guidance also declared that EMTALA would protect physicians and hospitals that perform abortions in violation of state law if they deem those abortions necessary to stabilize the women’s health. This novel interpretation of EMTALA is baseless. EMTALA requires no abortions, preempts no pro-life state laws, and explicitly requires stabilization of the unborn child.”

7. The plan would also ban the use of taxpayer funds to help patients travel out-of-state for abortions.

“Prohibit abortion travel funding. Providing funding for abortions increases the number of abortions and violates the conscience and religious freedom rights of Americans who object to subsidizing the taking of life. The Hyde Amendment has long prohibited the use of HHS funds for elective abortions, but an August 2022 Biden executive order pressed the HHS Secretary to use his authority under Section 1115 demonstrations to waive certain provisions of the law in order to use taxpayer funds to achieve the Administration’s goal of helping women to travel out of state to obtain abortions. Moreover, the Department of Justice Office of Legal Counsel (DOJ OLC) issued a politicized legal opinion declaring, for the first time in the history of Hyde, that this action did not violate the Hyde Amendment and that Hyde applies only to the performance of the abortion itself in violation of the plainly broad language that Congress used. 

Two of the first actions of a pro-life Administration should be for HHS to withdraw the Medicaid guidance (and any Section 1115 waivers issued thereunder) and for DOJ OLC to withdraw and disavow its interpretation of the Hyde Amendment.”

“The CDC’s abortion surveillance and maternity mortality reporting systems are woefully inadequate. CDC abortion data are reported by states on a voluntary basis, and California, Maryland, and New Hampshire do not submit abortion data at all. Accurate and reliable statistical data about abortion, abortion survivors, and abortion-related maternal deaths are essential to timely, reliable public health and policy analysis. 

Because liberal states have now become sanctuaries for abortion tourism, HHS should use every available tool, including the cutting of funds, to ensure that every state reports exactly how many abortions take place within its borders, at what gestational age of the child, for what reason, the mother’s state of residence, and by what method. It should also ensure that statistics are separated by category: spontaneous miscarriage; treatments that incidentally result in the death of a child (such as chemotherapy); stillbirths; and induced abortion.”

And that’s just the tip of the 900+ page iceberg. Project 2025 would also shut down the Department of Education, limit civil protections for LGBTQ+ people, end climate change and renewable energy programs at the Department of Agriculture, and so much more.

9.

WASHINGTON, DC – MARCH 01: Government watchdog Accountable.US launches its “Expose Project 2025” campaign on the streets of Washington on March 01, 2024 in Washington, DC. (Photo by Paul Morigi/Getty Images for Accountable.US)