In the face of promises from the new administration and its congressional allies to make abortion and other reproductive health care less accessible, state and local officials are moving forward with proactive measures to protect and expand access to vital services.
Gloria Totten, founder and president of the Public Leadership Institute (PLI) -- a nonprofit, nonpartisan policy and leadership center that crafts progressive model legislation -- told Truthout that despite the air of pessimism following the election, now is the time to push proactive measures. She and the other advocates and legislators who spoke with Truthout aren't letting conservative control of 69 of the 99 state legislative bodies stop them from working toward reproductive health equity.
"People who focus on Washington forget that [for] those of us who are working in the states, this is not a new environment," said Totten. "The reason that it's important now [to introduce proactive legislation] -- and hopefully it'll be taken up as a bigger part of a progressive strategy -- is that Trump's election symbolizes in a really bad way what voters have been trying to tell us for several election cycles: They want change, they do not want politics as usual, they want people to fight."
The lesson Totten takes from the loss of 1,000 state legislative seats and 27 legislative chambers since 2010 is that it's time to do things differently: to end the practice of simply opposing harmful legislation and to go on offense. Last month on the Roe v. Wade anniversary, PLI announced that elected officials from 18 states -- Arizona, California, Colorado, Connecticut, Georgia, Hawaii, Iowa, Kentucky, Maryland, Michigan, Minnesota, Missouri, New Mexico, Ohio, Oregon, Texas, Virginia and Wisconsin -- as well as Austin and Travis County, Texas, were all introducing legislation to protect or expand access to abortion.
"Lawmakers and activists in the states are fighting back for abortion rights," Totten said last month. "Donald Trump may think he can steamroll anti-abortion policy at the federal level but legislators, councilmembers and commissioners -- standing beside local activists -- are going to fight him every step of the way."
Many of the bills being introduced around the country are from PLI's "Playbook for Abortion Rights," which includes 29 model policies for protecting and/or expanding access to abortion care. Totten says their proactive legislation wasn't penned just so that individual municipalities could shield constituents from the erosion of their rights; she and her colleagues are looking to build a broader progressive coalition and voter base by giving people something to fight for.
"When you're putting something proactive out there, you're giving people something tangible to do in addition to all the other acts of resistance we're seeing," she said. "If we don't tie the resistance to a fight for real, tangible policy change for people, then we're going to lose them."
Proactive Steps From the Illinois State Legislature
With a Republican governor, Illinois seems at first glance to be an unlikely place for a proactive push, but advocates are drawing on the Chicago Women's March turnout -- the march drew an estimated 250,000 people -- to bolster support for State Rep. Sara Feigenholtz's House Bill (HB) 40. The bill would repeal the "trigger" provision in state law -- which re-criminalizes abortion should Roe v. Wade be overturned or overridden -- and extend abortion access to state employees and Medicaid recipients.
"The new Washington establishment has made it clear that they oppose a woman's right to choose and that abortion will be illegal in some states," Feigenholtz explained in a press release on HB 40. "We want Illinois women moving forward -- not backward."
Lorie Chaiten, director of the Women's and Reproductive Rights Project at the ACLU of Illinois, told Truthout that advocates and allies in the state legislature decided to take action on removing the trigger provision even before Trump was inaugurated.
"As soon as Trump was elected and he continued spewing things about overturning Roe and putting people on the Supreme Court who would do that, our sponsor was very clear that she didn't want Illinois to have the risk," said Chaiten. "We all agreed that we needed to take steps to ensure that regardless of what happens in Washington, abortion will remain legal and accessible in Illinois."
Illinois is one of the handful of states that passed trigger provisions in the wake of Roe v. Wade in order to automatically re-criminalize abortion should Roe be overturned or overridden. Because they don't go into effect unless decades-old precedent is overturned (a rare occurrence in the judiciary), most legislatures never went through the process of removing them from the books. The effort seemed like a waste of time until now.
"We basically are repealing all of the language that says that we would go back to the pre-Roe days. We're repealing language that says that the general assembly believes that the rights of the unborn child begin at conception," said Chaiten.
While Gov. Bruce Rauner has not commented on HB 40 directly, he campaigned as a supporter of legal abortion, so advocates are hopeful that he would sign it if the legislature sends it to him.
Freeing Doctors From Anti-Abortion Dictates in Minnesota
In the purple state of Minnesota, newly elected State Sen. Matt Klein (D) is wielding his background as a doctor to push to rescind a policy that has been enacted in several states since the Tea Party wave of 2010. The policy dictates that medical practitioners read inaccurate "information" written by the legislature to patients seeking abortion care.
Klein told Truthout, "The language [in SF 281, the revised policy] says that physicians in the exam room will give their patients information that's based in medical studies and medical evidence and based on that patient's own unique circumstances. And that they won't give them information that's provided by legislators or that's politically motivated."
"That was the biggest thing for me: trying to protect the sanctity of that physician-patient relationship and get legislators out of the exam room," He added.
Klein said that the misinformation that physicians are required to read includes myths about abortion leading to breast cancer and infertility. Additionally, he pointed to the intrusive nature of the mandate, calling his bill a "small-government initiative" that puts health care back into the hands of doctors and patients.
"It's surprising that the party of small government is suggesting to us that we mandate certain statements within the exam room, which is considered a fairly private place to be," he said.
While the bill doesn't mention reproductive health or abortion specifically, requiring physicians to deliver information based on medical studies and the circumstances of the patient will have a meaningful effect on abortion care.
Klein is optimistic about passing proactive legislation, telling Truthout that over 100 people showed up to his first town hall; he was expecting a handful of constituents, but had to turn people away when there was nowhere left to stand. He's spent his medical career at a "safety net" hospital, admitting people who are often quite sick, and ran for office to implement policies like SF 281 that have a direct impact on their lives.
"I really do see on a first-hand basis every day the people in the margins of our society, the people in the shadows of Minnesota, and I am inspired to believe that we can do better by those people -- and by all people, really," Klein said. "You see people who are really burdened with poverty, or with chemical dependence, or mental illness that are left out in the cold. And I also see working families -- people who are, by all rights, 'following the rules' of the modern capitalist society, working and raising children and still not fully insured or can't afford their deductibles, can't afford their copays. And I firmly and strongly believe that we're a better society than that."
Fighting Reproductive Health Care Gaps in Oregon
Legislators in Oregon are also working to do better for those residents who, despite recent expansions of access to reproductive health needs like contraception, still fall into coverage gaps. A coalition of racial and gender justice groups together with allies in the legislature introduced the Reproductive Health Equity Act (House Bill 2232) last month to protect Oregonians, should there be federal rollbacks to the Affordable Care Act birth control benefit. The bill also seeks to eliminate barriers to coverage based on income and immigration status. It would extend contraception coverage to those methods available for over-the-counter sale, as well as to voluntary sterilization procedures.
Amy Casso is the director of the Gender Justice Program at the Western States Center, a coalition-building organization aimed at bolstering progressive movements in the northwestern US. Casso told Truthout that HB 2232 came about through a collective effort to identify areas where people are still facing challenges in accessing care.
"Oregon has been a leader on many health care fronts, but there were still a lot of gaps and a lot of people left behind due to citizenship status, discrimination and the insurance they have," said Casso. "The ability to actually create policy where we can put an emphasis on having access to a full range of reproductive health care is really important and vital. No one should have to go bankrupt or deep in debt because they can't afford reproductive health care."
Ensuring that immigration status would no longer be a barrier was particularly important in the crafting of the legislation, which the coalition says would make Oregon "the first state in the nation to ensure reproductive health equity." Despite Republican claims to the contrary, undocumented people are not able to access benefits like welfare and health insurance. Casso was emphatic that they should no longer be shut out from access to care.
"Immigrants are our neighbors ... they're our children and they go to our schools," said Casso, who is optimistic about the chances that HB 2232 could pass.
"We do have friends in the legislature, both in the House and the Senate, and we're actively -- every week -- adding new cosponsors," Casso said. "We're definitely excited about the promise of what could happen with HB 2232; it will probably take the full year [session]. We're all very excited that Oregon, once again, could be at the forefront of moving really progressive, proactive health policy."
The Time to Act Is Now
Even those measures that will not eventually become law play an important part in the long-term struggle for equal access to reproductive health care. Totten shrugged at the notion that advocates should wait to pursue their goals until a friendlier administration is in place. She pointed out that political conditions are never ideal.
"Every time we put something forward -- even if it dies -- it's an organizing and communications opportunity," Totten said. "When you don't get the hearing, it's an opportunity to organize. Every one of these steps is about building a base of support."
All the advocates who spoke with Truthout expressed similar sentiments. They are harnessing local power in the face of federal uncertainty and threats to care -- and they don't seem fazed by the fight ahead.
"Even in a time where there's a lot of sadness and despair, there's still a lot of fight," said Casso. "We want to be able to demonstrate that even within that context, people are moving strong pieces of legislation proactively."