Biden and Harris frame 2024 against ‘extremist’ GOP plans to ban abortion nationwide

The president’s campaign targets Trump’s anti-abortion agenda while patients and providers face devastating impacts 18 months after the end of Roe v Wade

Another January 22 has come and gone without Americans’ constitutional right to abortion care affirmed by the US Supreme Court.

The dissolution of Roe v Wade’s decades-long precedent 18 months ago unleashed a wave of anti-abortion laws across the US, including more than a dozen states where abortion is effectively outlawed in all cases – stranding millions of women without adequate healthcare and exposing the scale of legal and medical minefields for patients and their providers.

President Joe Biden’s administration intends to frame the fight for abortion rights in unflinching terms as he campaigns for his re-election. Vice President Kamala Harris, speaking to supporters in the battleground state of Wisconsin on Monday, made it clear who was responsible: Donald Trump.

“As we face this crisis and as we are clear-eyed about the harm, let us also understand who is responsible, shall we?” she said in her remarks on what would be the 51st anniversary of the Supreme Court’s landmark decision in Roe v Wade.

“The former president handpicked three Supreme Court justices because he intended for them to overturn Roe,” she said. “He intended for them to take away your freedoms. And it is a decision he brags about.”

Mr Trump has routinely taken credit for the reversal of Roe v Wade, with his appointment of conservative justices Neil Gorsuch, Brett Kavanaugh and Amy Coney Barrett, who joined Chief Justice John Roberts and Justice Samuel Alito and Clarence Thomas in the Dobbs v Jackson Women’s Health Organization decision in June 2022.

“Proud that women across our nation are suffering?” Ms Harris said. “Proud that women have been robbed of a fundamental freedom? Proud that doctors could be thrown in prison for caring for their patients, that young women today have fewer rights than their mothers and grandmothers? How dare he.”

The seismic impacts from the Dobbs decision have spawned a burst of new legal battles – including a forthcoming Supreme Court case to determine the fate of a widely used drug for medication abortion, the most common form of abortion care in the US – and reshaped the landscape for reproductive healthcare across the country.

Powerful anti-abortion groups are far from done, while Mr Trump and Republican lawmakers are forced to confront a post-Roe reality in step with an American public that is overwhelmingly against the GOP’s long-held vision for political control of their voters’ bodies and healthcare.

Mr Trump, likely the GOP’s nominee to face Mr Biden in November, is open to banning abortions nationally at a certain gestational threshold. The Biden administration is underscoring that any federal abortion ban would undermine abortion rights even in states that have ensured those protections.

“Even if you live in a state where the extremist Republicans are not running the show, your right to choose, your right to privacy would still be at risk,” Mr Biden said in remarks from the White House on Monday.

“Folks, this is what it looks like when the right to privacy is under attack,” he said. “These extreme laws have no place, no place, in the United States of America.”

Last year, in the first full year without Roe’s protections, stories of patients who were forced to flee their states to seek emergency care or who suffered life-threatening consequences after they were denied care for nonviable pregnancies have rocked communities and courtrooms across the country. They’ve also caught the attention of Democratic campaigns, warning that those devastating medical nightmares are a direct result of the GOP’s anti-abortion agenda.

Dr Austin Dennard – an obstetrician-gynaecologist in Texas who was forced to leave her state to seek her own care to terminate a pregnancy – is among the plaintiffs in a landmark lawsuit targeting the rules for emergency abortion care in Texas. She told her story in a new minute-long ad for the Biden-Harris campaign.

“At a routine ultrasound, I learned that the fetus would have a fatal condition and that there was absolutely no chance of survival,” she says in the ad. “In Texas, you are forced to carry that pregnancy, and that is because of Donald Trump overturning Roe v Wade … We need leaders that will protect our rights and not take them away and that’s Joe Biden and Kamala Harris.”

The White House has offered support to state and local lawmakers and health providers, with Ms Harris serving as the administration’s face for its reproductive healthcare agenda in roundtables, conferences, speeches and other meetings across the country. But the administration has largely met the limits of the president’s executive authority on abortion care, facing a Republican-controlled House and a nearly deadlocked Senate that won’t be able to codify Roe’s protections into law.

On Monday, the US Department of Health and Human Services announced new guidance for patients under the federal Emergency Medical Treatment and Labor Act, or EMTALA, which requires hospitals to provide necessary care, including abortions, in urgent circumstances.

Jennifer Klein, director of the White House Gender Policy Council, told reporters on Monday that “ultimately, the only way” to address the “legal chaos and the medical chaos” under state-level bans is through congressional action.

Republican lawmakers – once describing the end of Roe v Wade as a victory for “states’ rights” – have pushed through dozens of new restrictions, including plans for a national abortion ban, and have swatted down measures that would allow voters to weigh directly on the future of their right to such care.

But in states “where abortion has been on the ballot, the American people have overwhelmingly voted to protect reproductive freedom,” Ms Klein told reporters last week.

Eighteen months after Roe was overturned, more than a dozen states – mostly across the entire US South – have effectively outlawed most or all abortions. Eleven states make no exceptions for pregnancies from rape or incest. Six states ban abortions after a specific gestational period, from roughly six weeks of pregnancy to 20 weeks.

Most of those states have moved to ban abortion in nearly all cases with limited or no exceptions, making abortion care out of reach entirely for millions of Americans who are forced to travel hundreds or thousands of miles for access to legal care.

For those patients, “the consequences can be devastating,” according to Dr Didi Saint Louis, a member of the Committee to Protect Healthcare’s Reproductive Freedom Taskforce and an obstetrician-gynaecologist in Georgia, where abortion is effectively banned at six weeks of pregnancy.

“When politicians interfere with women’s personal health care decisions, women’s lives are put at risk,” she told reporters on Monday. “A national abortion ban like Donald Trump supports would put lives at risk nationwide.”

A national ban “would mean worse reproductive health care – from miscarriage management to the infertility treatment that helps people start their families to caring for people with complicated pregnancies – [and] worse reproductive health care for all of us,” according to Dr Kristin Lyerly, a Wisconsin obstetrician-gynaecologist.

“It would also mean that anti-abortion extremists like Donald Trump would continue to be able to dictate your personal medical decisions,” she told reporters on Monday.