Over the past decade, there has been an unprecedented number of laws enacted, regulations promulgated, and policies adopted that undermine access to sexual and reproductive health care services in the U.S. and globally. The COVID-19 pandemic has further disrupted access to reproductive health services and exacerbated inequalities in access to care. Furthermore, the Supreme Court’s decisions in three reproductive health care cases this term could both impact the right to abortion and have a chilling effect on the provision of other essential reproductive health services. In light of these challenges, the U.S. Department of Health and Human Services (HHS) has taken several meaningful actions under the Biden-Harris administration to protect and bolster reproductive health, rights, and justice.
More must be done to protect and bolster sexual and reproductive health. To that end, Secretary Becerra has launched an HHS-wide Task Force to address these critical priorities. The Task Force on Reproductive Healthcare Access (Task Force) is composed of senior-level HHS officials who have been designated by their respective agencies to identify and coordinate activities across the Department to protect and bolster access to essential sexual and reproductive health care, including implementation of activities identified in the White House National Strategy on Gender Equity and Equality. The working group activities are focused on advancing quality, access, and equity for reproductive health, rights, and justice and include coordinating federal interagency policymaking, program development, and outreach efforts to address barriers impacting individuals and communities seeking reproductive health care.
The Secretary has directed each agency to prepare a plan outlining measurable actions the agency is considering or will take to protect and bolster access to sexual and reproductive health care. Actions could include:
- Identifying and eliminating any existing policies or barriers within Federal programs and services;
- Expanding relevant data collection and research;
- Identifying and advancing policies that improve reproductive healthcare access within Federal programs and services, eliminate health disparities and expand access to culturally competent health care services for underserved communities, including people of color, people with disabilities, young people, LGBTQI+ people, and others;
- Partnering with bilateral and multilateral partners to support evidence-based guidance and policy that bolster access to sexual and reproductive healthcare globally; and
- Supporting efforts to mitigate the persistent stigmatization of reproductive health care as separate and distinct from other essential primary care services.
Domestically, more state abortion restrictions were passed in 2021 than any other year since Roe v. Wade was decided. Furthermore, a record number of states have taken action to prevent many qualified family planning providers from participating in their Medicaid programs, undercutting access to a broad range of reproductive health care services — including contraceptives and preventive care such as cancer screenings — for low-income people. In addition, at least one state has attempted to deny Medicaid coverage for certain methods of contraception. Such barriers have had implications for access to reproductive health care and can have far-ranging consequences. For instance:
- Restricted access to abortion is associated negative consequences for pregnant individuals and adverse birth outcomes such as preterm births and low-birthweight infants.
- State-level restrictions such as mandatory parental involvement, mandatory counseling, mandatory waiting period, two-visit laws, and gestational age limit laws are associated with an increased risk for infant mortality.
- Restrictive abortion policies compound existing racial/ethnic and socioeconomic perinatal and infant health inequities.
- Policies that restrict the ability of U.S. funding to support global NGOs that provide or counsel clients on abortion also disrupt access to contraception and HIV testing and counseling, and are associated with worse child health outcomes.
- Access to health care affects the ability to effectively manage comorbid conditions during pregnancy that may contribute to overall higher costs of pregnancy.
- Women denied abortion due to laws setting gestational age limits are more likely to have worsened economic hardship and insecurity that can last for years.