Introduction

Despite vowing to leave abortion to the states, the Trump administration has cut off abortion options in states that protect those rights. The results sweep beyond abortion, with huge impacts on pregnancy care, primary care, and more.

Veterans’ health care

Veterans’ health care

After placing abortion opponent Doug Collins in charge of the Department of Veterans Affairs (VA), the VA proposed a rule to reinstate a ban on all abortion care and counseling, including in instances of rape, incest, or where the health of a pregnant veteran is in danger. As the rule was still pending, Josh Craddock, a staunchly anti-abortion lawyer in the Department of Justice (DOJ), wrote a legal opinion disavowing all abortion care for veterans. On December 22, 2025, instead of following the formal process to finalize such a rule, the VA relied on the DOJ opinion to quietly announce in an internal memo that the new policy was now in effect. The rule was officially finalized on December 31, 2025, and technically goes into effect at the end of January 2026, but it’s clear the VA has already stopped providing this care.

While veterans were previously allowed to access abortion care in specific circumstances, this policy bans all abortion care with only a narrow exception to save the life of a pregnant patient. It reverts to one of the strictest abortion bans in the country–and it applies to all VA health centers across the U.S., even in the 14 states with constitutional protections for abortion.

In addition to eliminating one of the only abortion access points for veterans in states that are hostile to abortion, this rule significantly impacts states that protect reproductive rights –the 364,800 women veterans who live in states that support abortion access, constituting 51% of all women veterans of reproductive age, are now unable to get previously available abortion care at their local, in-state VA facility.

The Center led a public comment campaign in response to the rule, driving approximately 10% of the total comments submitted (1,999 out of 20,980). Comments provide agencies with information about how a proposed rule affects the public in practical, tangible ways. Agencies are required to review, consider and respond to each argument made in the comments submitted prior to finalizing a rule, and submission of a large number and wide variety of unsupportive comments demonstrates broad opposition to the regulation.

Medicaid health coverage

Medicaid health coverage

On July 4, 2025, President Trump signed the One Big Beautiful Bill Act (OBBBA) into law, eliminating health coverage for at least 10 million people. The law defunds essential community providers like Maine Family Planning (MFP) and Planned Parenthood (PP), adding $52 million dollars to the federal budget deficit. The law also adds mandatory work requirements and slashes state budgets for reproductive health care, targeting states that expanded Medicaid coverage.

Given that almost half of all births in the U.S. are covered by Medicaid, the new law will put the health and lives of pregnant people at risk by stripping them of vital insurance coverage. Although OBBBA tries to exempt pregnant people from work requirements, the exemption can’t make up for coverage losses experienced before or after pregnancy. This means that more pregnant people may start their pregnancies with untreated health problems, or experience postpartum health complications that go unaddressed. The exemption also can’t make up for the loss of providers, health centers, and hospitals, which will impact rural, low-income, and marginalized communities the most. Research consistently demonstrates that exemptions don’t work, just like abortion ban exceptions don’t work.

In order to compensate for the defunding, PP has been covering the costs of care provided for most of its Medicaid patients, an estimated $700 million annually. The defunding provision also took about $2 million from MFP, cutting off its ability to offer primary care services. Primary care represented 13% of MFP’s visits in 2024.

The Center sued the Trump administration on MFP’s behalf over the Medicaid defunding. Unfortunately, a federal court ruled that the administration can continue to deny MFP’s Medicaid reimbursement. This defeat led to nearly 1,000 primary care patients in Maine losing their provider, and threatens MFP’s ability to continue providing other essential services.

Title X family planning programs

Title X family planning programs

The Trump administration froze millions of dollars for nearly 1 in 5 grantees of Title X, the country’s only federal grant program solely dedicated to funding birth control and related reproductive health services. Shortly after appointing abortion opponent Natalie Dodson to advise the Office of Population Affairs, the agency that administers Title X, the administration announced plans to continue targeting health centers like MFP and PP through new Title X rules.

The previous Trump administration’s Title X rules resulted in more than 1,000 health centers withdrawing from the program, including MFP and PP. The rules also left six states with no Title X-funded health centers, five of which were in states that protect abortion (Hawaii, Maine, Oregon, Vermont, and Washington). Title X still has not recovered. In 2023 it supplied essential care like birth control, cancer screenings, and STI testing to a million fewer clients than before the Trump Administration regulations went into effect.

Attacks on Title X, combined with Medicaid cuts, are a one-two punch for many health centers. Since the beginning of 2025, nearly 50 PP health centers have been forced to close following the loss of Title X funds and Medicaid reimbursements, including in protective states like California, New Jersey, and Ohio.

Hours after the administration’s Title X freeze, the Center filed a Freedom of Information Act (FOIA) request to demand answers—including key documents, communications, and records—about the administration’s motivations and strategies for attacking such a vital community resource. The administration has yet to respond, risking future litigation.

What’s next?

What’s next? More defunding.

A new Title X rule will go out of its way to target abortion providers and supporters, and require costly changes for all clinics able to remain in the program.

Far from leaving reproductive rights to states, the current administration has cut off reproductive options nationwide, especially in states that protect abortion. The Center is building an administrative record and advocating for providers in court to defend the country’s reproductive health infrastructure.