Tag Archives: abortion rights

Nebraska is the only state with two abortion measures on the ballot. Confusion is the point.

Originally published in Vox on October 15, 2024.
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Voters in 10 states will weigh in on abortion-rights ballot measures this November, but only Nebraskans will cast ballots on two competing initiatives. Initiative 439 would establish a state constitutional right to abortion up to fetal viability or when necessary to protect the “health or life” of the pregnant patient. Initiative 434, however, would ban abortion in the second and third trimesters, with exceptions for sexual assault, incest, or medical emergencies.

“We hear all the time how confusing the two measures are and folks are very afraid of accidentally checking the wrong one,” said Shelley Mann, the executive director of Nebraska Abortion Resources (NEAR), the only statewide abortion fund in Nebraska.

Much of the confusion surrounding the competing proposals is intentional, and likely a preview of new tactics in the evolving anti-abortion playbook.

Since May 2023, abortion in Nebraska has been banned past the first trimester, and last fall reproductive choice advocates launched a ballot measure campaign to restore and expand access. Anti-abortion leaders introduced a competing measure four months later. (The proposed anti-abortion ballot measure wouldn’t expand current restrictions, but it would embed existing second- and third-trimester bans into Nebraska’s state constitution. This would make it significantly more difficult for the legislature or courts to roll back those restrictions later.)

While collecting signatures, some canvassers from the Protect Women and Children campaign misrepresented themselves as being in favor of expanding abortion access, leading hundreds of Nebraskans to erroneously sign their petition.

Upon realizing their mistake, more than 300 of those voters signed affidavits to have their names removed from the anti-abortion petition, marking the highest number of removal requests in the state’s history. (Over 205,000 people signed the anti-abortion petition in total.)

More recently, Catherine Brooks — a neonatal pediatrician who filed legal objections to block the pro-abortion rights measure from appearing on Nebraska’s ballot — appeared in a TV ad in which she portrayed herself as an advocate for reproductive freedom fighting against government intrusion in medicine.

“As a doctor, I want compassionate, clear, scientific standards of care,” Brooks said in the ad. “As a mom, I want to keep the government out of the relationship between a woman and her physician. Initiative 439 pretends to protect our rights but it does the opposite. It lets government officials interfere in medical decisions and takes care out of the hands of licensed physicians, when women in crisis need them most.”

There’s little doubt that Republicans in Nebraska hope to restrict abortion beyond the existing 12-week ban, which was passed shortly after lawmakers narrowly failed to impose a six-week limit. Nebraska’s Republican Gov. Jim Pillen has publicly pledged to continue fighting until abortion is fully banned in his state.

The outcome of these dueling ballot proposals could affect not just those in Nebraska but pregnant people nationwide. Abortion rights activists have been sounding the alarm, warning that if Initiative 434 succeeds in November, anti-abortion leaders will export their winning strategy elsewhere — using the language of reproductive freedom to advance seemingly moderate measures that obscure long-term goals of deeper bans.

Nebraska’s 12-week abortion ban is already causing harm

The 12-week abortion ban Nebraska lawmakers passed in May 2023 included exceptions for pregnancies caused by rape or incest, or to save the life of the mother.

As in other states, these exceptions have proved ambiguous for doctors on the ground, and many patients who need abortion care have been unable to get it.

Kim Paseka, a 34-year-old woman based in Lincoln, Nebraska, was one of those patients. Paseka lives with her husband and their 3-year-old son, and though they wanted at least two children, they were unsure about pursuing that in Nebraska after Roe was overturned.

“We knew it was probably inevitable that our state government was going to work on banning reproductive health care in some capacity and it definitely gave us pause, like should we move, do we stay and fight? Those were our dinner table conversations,” she told Vox. In the summer of 2023, just after Nebraska lawmakers passed their 12-week ban, Paseka learned she was pregnant again.

Initial blood tests looked fine, but following a routine ultrasound, Paseka was informed that her baby’s heartbeat was slower than expected. In subsequent appointments, the doctors determined the heartbeat was diminishing and that Paseka was carrying a nonviable pregnancy.

Because of the new ban and the fact that Paseka’s life was not immediately threatened, her doctors weren’t comfortable ending the pregnancy. They sent her home with instructions for “expectant management” — meaning to wait until she’d bleed out eventually with a miscarriage.

“I had to go back to the hospital for three more scans, where I had to see the heartbeat weaken further week by week, and during this whole time I’m so nauseous, I’m tired, I’m experiencing all the regular pregnancy symptoms, but I was carrying a nonviable pregnancy,” she said. It took roughly a month for Paseka to finally bleed out the pregnancy at home.

“In Nebraska, we have these exceptions, but in my situation it wasn’t assault, it wasn’t incest, and my life wasn’t in immediate danger, so I automatically just lose health care,” she said. “They’re forgetting how detrimental that can be to mental health, that it’s not just about physical endangerment. … I felt like a walking coffin.”

Mann, the executive director of Nebraska’s statewide abortion fund, emphasized that the 12-week ban has had far-reaching consequences that most people underestimate.

“Not only are folks now restricted in how and when they can get the care they need, but it’s additionally problematic that these rules are designed to be confusing and were brought about during a time when confusion was at an all-time high,” she told Vox. “We talk to callers and members of the community all the time who have no idea when and if abortion is even legal here in Nebraska.”

There are two remaining abortion clinics in the state, though both only perform abortions part-time, meaning there sometimes are not enough appointments to go around, including for patients traveling in from states with near-total bans like Iowa and South Dakota.

“This means that not only are patients who are past the 12-week mark forced to flee the state for care, but even patients under that ban restriction are sometimes having to travel just to get an appointment in a timely manner,” Mann explained. “These patients are going to places like Minneapolis, Chicago, and Denver … this travel is often expensive, inconvenient, and overall an enormous burden on pregnant people.”

Anti-abortion leaders plan to push for further restrictions in Nebraska

Initiative 434, also known as the Prohibit Abortions After the First Trimester Amendment, sounds almost like a measure to protect abortion access in the first 12 weeks of a pregnancy. The proposal, which is being primarily funded by Nebraska billionaire and US Sen. Pete Ricketts, does not in fact do that.

On top of codifying the state’s existing ban on abortion past 12 weeks into Nebraska’s constitution, the measure allows lawmakers to pass further legislative bans on top. Put differently, it strengthens abortion bans but provides no meaningful increase in abortion access.

Marion Miner, the associate director for “pro-life and family policy” at the Nebraska Catholic Conference, emphasized in a video posted over the summer that he does not see Initiative 434 as “an acceptable final resolution” because it does “not protect all unborn children” including those born from sexual assault or incest.

“It is an imperfect proposal … an incremental pro-life initiative that takes a small step to protect unborn life without restraining us from doing more,” Miner said, stressing Initiative 434 would “allow for additional protections to be passed in the future.”

Over a century ago, Nebraska lawmakers enacted a law stating that if two conflicting state constitutional ballot measures pass, the measure with the most votes will be adopted. According to Nebraska Secretary of State Bob Evnen, if both Initiative 439 and Initiative 434 pass, it would mark the first time this 1912 law could be used.

“It’s possible that one of the proposals could get approved and not be adopted,” Evnen told NPR in May. “It’ll come down to, whichever one receives the most votes is the one that would go into Nebraska’s constitution.”

Even the existing 12-week ban, often described by conservatives as a moderate compromise, appears out of step with what Nebraskans want. The ACLU of Nebraska found in late 2022 that 59 percent of respondents opposed lawmakers enacting abortion bans, with opposition in both rural and urban areas and every congressional district.

In the more than two years since the Supreme Court overturned Roe v. Wade, abortion rights ballot measures have succeeded in all seven states in which they’ve appeared, including red and purple states like Kentucky, Ohio, Kansas, Michigan, and Montana. This year, high-profile abortion rights measures are on the ballot in states like Florida, Arizona, and Missouri. Nebraska’s contests, relative to these other states, have received less attention.

“They know public opinion is on our side so they’re doing everything they can to muddy the waters,” said Allie Berry, the manager for the Protect Our Rights campaign, which is leading Nebraska’s ballot measure to expand abortion rights. While Berry feels cautiously optimistic, she understands her opponents are striving to trip up voters. “If they succeed here,” Berry predicts, “they’ll try this in every other state.”

Abortion groups are raising more money than ever. Where exactly is it going? 

Originally published in Vox on September 30, 2024.
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In some ways, there have never been more dollars flowing into abortion rights organizing, with philanthropies finally stepping up and more Americans activated over freedoms they previously doubted were really at stake. With hundreds of candidates vying for office and abortion rights on the ballot in 10 states, advocates have been busy raising money to spend through November. In June, the ACLU pledged more than $25 million to protect abortion rights; this was followed by $40 million weeks later from Planned Parenthood, then another $100 million from a new coalition of national groups.

But even as money flows toward protecting abortion rights, the financial burden of accessing abortion services has grown more severe, as bans force people to travel further and delay procedures until they are riskier and more expensive.

This strain is overwhelming the nation’s 100 abortion funds, which are mostly volunteer-led organizations that help people end unwanted pregnancies by paying for their abortions as well as practical support like travel costs — and the tab for this kind of aid quickly adds up.

Though cheaper methods to safely end a pregnancy have emerged over the past two years, many abortion seekers lack knowledge of these new, more affordable options. Funds and clinics also don’t always provide clear guidance on alternatives, driven by a mix of financial and legal self-interest, as well as a belief that in-person abortion care should be prioritized.

“What we’re seeing is patients are very comfortable embracing telemedicine as an option, but people within our movement have not been as flexible,” said Julie Kay, the co-founder of the Abortion Coalition for Telemedicine, which formed in 2022 after the Supreme Court overturned Roe v. Wade.

This past year, abortion funds say they’re fighting for their lives, unable to raise enough money to meet demand. A few are fundraising with new state-level partners, but increasingly, funds have had to tell callers they’ve run out of resources, leaving people to scramble for other options or carry unwanted pregnancies to term.

In general, all the money flowing to the 2024 election in the name of reproductive rights feels very siloed from their work paying for abortions, said Alisha Dingus, the development director at the DC Abortion Fund.

“There is an alarming disconnect between abortion funds … and large national organizations that are advocating for access,” a group of over 30 funds wrote collectively in the Nation in early August. “The national organizations … fundraise endlessly, siphon support from institutional funders and grassroots donors, capitalize on the Dobbs rage donations, and funnel that money into campaign bank accounts.”

Another challenge is messaging. Abortion funds have always positioned themselves as more radical and unapologetic when it comes to abortion care, priding themselves on avoiding stigmatizing language, whether that’s by using gender-neutral terms or elevating stories of people ending unwanted pregnancies for no traumatic, exceptional reason.

But given the increasingly desperate funding environment, these activists are being forced now to reconsider how they appeal to a public that is broadly supportive of reproductive rights but is still more moderate on abortion.

“In my experience on ballot campaigns, abortion funds have been incredibly challenging as partners in states that weren’t blue,” one leader involved with multiple post-Roe ballot measures, who requested anonymity to speak candidly, told Vox. “If you’re only communicating in very extreme messaging about abortion access, you’re not broadening your base of donors, you’re just talking to the 12 people who already agree with you. A lot of people who would love to donate to funds and probably don’t understand the need are turned off before they even get in the door by the language and behavior.”

These kinds of criticisms vex Dingus, who wrestles with whether abortion funds should be more “acceptable and digestible” to the public, as she put it.

“I came from a more traditional philanthropy space where you had to make sure you never hurt anyone’s feelings or made anyone angry because you might lose a dollar,” she said. “Abortion funds I’ve always found to be more liberated spaces where we can speak truth to power and push for change and not have to worry about one funder here or one funder there. But we are also seeing the reality of people not getting the care they need, people are going to be forced to give birth, so I think it’s tough.”

Tensions are rising within the movement as disagreements over a scarce resource — money — intensify. These battles among leaders reflect practical and ideological divisions about the future of abortion access and underscore the messy, unsettled questions that loom over activists more than two years after Americans lost their national right to end a pregnancy.

The 2024 election is dominating abortion-related donations

When it comes to donations this year, it’s mostly going to one place.

Despite earlier concern that abortion rights ballot measures would struggle to raise enough money, organizers say those fears have mostly not been realized, and tens of millions of dollars are flowing into the state contests as the election draws near.

These contests are “expensive and high-impact,” said Kelly Hall, the executive director of the Fairness Project, a national progressive group. “We are very grateful that organizations and in-state donors are seeing the opportunity with state ballot measures and are investing the resources that are needed to win.”

One newer member of the abortion rights political ecosystem is the House Majority PAC’s Reproductive Freedom Accountability Fund, a $100 million investment to mobilize voters in swing districts sympathetic to abortion rights. “In 2022, 42 percent of our ads mentioned abortion, and I think it will be that much again if not higher,” said C.J. Warnke, a spokesperson for the congressional PAC.

Still, making sense of the amount of abortion-rights money flowing into political campaigns can be difficult.

Some lower-profile elections, like two high court contests in Arizona, have struggled to raise money, despite their importance for reproductive rights. And in June Planned Parenthood, one of the largest abortion rights advocacy groups, announced it would be spending $40 million during the 2024 cycle, less than the group spent in either of the previous two election cycles. Their announcement came shortly after it announced it would also need to reduce its subsidies for abortion care through its Justice Fund program.

Planned Parenthood says it can spend less simply because other organizations are spending more and because candidates themselves are more emboldened on reproductive rights. But elections are more expensive now and there are more political contests to fund than during the midterms, so the explanation is puzzling. (The group also declined to share details of its Justice Fund or to direct patient assistance broadly, citing “disclosure policy” restrictions.)

In some ways, this is likely to be the last big year for spending on abortion rights ballot measures, simply because there aren’t many additional states that allow for such citizen initiatives. “It’s not an either-or” on funding, said Ashley All, who led the communications strategy for the winning Kansas abortion rights ballot measure in 2022. “We have to do these ballot campaigns because if we don’t then people will lose access to care.”

Still, while national activists and fundraisers are spinning things in a more positive light, emphasizing that more money will be available to fund direct services soon, many local abortion fund leaders are skeptical things will really improve financially when election season ends.

According to Lexis Dotson-Dufault, executive director of the Abortion Fund of Ohio, no new donors contributed to the organization following the passage of Issue 1, the abortion rights ballot measure that prevailed in Ohio last year by a 13-point margin.

“We have seen nothing but an increase in need and we got no new funders from Issue 1,” she told Vox. “In 2022, we saw about 1,200 folks, in 2023 we saw about 4,500, and this year so far between February and August we’ve seen almost 4,000 people.”

Dingus, of the DC Abortion Fund, said election season has made their financial challenges more difficult. “It’s tough to see, not just the ballot measures but the Zooms for Harris that raised millions of dollars in 30 minutes,” she said. “It can be really demoralizing to see that and then look at our budgets and know we continually have to cut back and maybe will have to get rid of staff.”

Cheryl Wolf, an organizer with Cascades Abortion Support Collective in Portland, Oregon, said it’s been hard to convince the public that donating to small local funds over large political campaigns is a more reliable way to ensure their money directly supports abortion care.

“When they make their donations to national organizations, so much of it goes to overhead, salary, campaigning, advertising,” she told Vox. “Rather than directly into the hands of abortion seekers.”

This pressure has all been exacerbated by recent national funding cuts; since July, the National Abortion Federation, along with Planned Parenthood, announced they’d only be able to subsidize up to 30 percent of abortion costs, down from their previous cap of 50 percent.

Wolf described these cuts from the National Abortion Federation as “detrimental,” particularly because most of the collective’s money comes from small one-time or monthly donations from individuals. “We are definitely not raising enough,” she added, noting they bring in about $500 every month and spend about $9,000. “We’re definitely looking at running out of money in the next couple months if we don’t have some kind of miracle.”

As travel costs rise, some abortion rights leaders say the movement has been too focused on elevating travel for those living in states with bans.

Kay, of the Abortion Coalition for Telemedicine, formed her more critical perspective while working in Ireland when abortion was criminalized. “The Irish solution to abortion bans was travel, but not everyone has the privilege or means to travel,” she said. “It’s alienating, stigmatizing, and expensive.” Prioritizing travel today, Kay thinks, reflects a movement that hasn’t “pivoted to the reality of what we’re living in now” with more options and more restrictions.

A difference of philosophy — and why it matters

Across the abortion rights movement, leaders are grappling with how best to engage voters and donors while also debating how much compromise is acceptable in the pursuit of broader support.

In 2023, when Ohio activists were pushing for an abortion rights ballot measure, leaders with the Abortion Fund of Ohio were frustrated by compromises these ballot measure activists were willing to make. “I’m not really ever into hearing things about trimester limits or viability standards, or hearing language that’s very trauma-focused,” said Dotson-Dufault. “Something I say is a lot of the reason you feel the need to use that type of language is because we haven’t been doing the deep community destigmatization work.”

In other states, abortion fund staff and volunteers are experiencing similar discomfort. In South Dakota, a local abortion fund has publicly criticized the abortion rights ballot measure citizens will be voting on this November, even as the red state has a near-total abortion ban. Other funds are wrestling with messaging choices. “A lot of campaigns like Yes on 4 [the Florida abortion rights ballot measure] use gendered language, while we always use ‘pregnant people’ or ‘people who are pregnant,’” said Bree Wallace, the director of case management at the Tampa Bay Abortion Fund.

When I asked Brittany Fonteno, the president and CEO of the National Abortion Federation, how her organization balances their more bold, progressive rhetoric with their recent funding cuts to local affiliates, she said it comes down to “investing time and energy in educating people, and helping them to evolve their own perspective.” Fonteno then cited her own journey growing up in a more conservative and religious environment, and her path to abandoning abortion stigma. “It took time for me to evolve and become someone who is not pro-choice but pro-abortion, pro-reproductive freedom,” she said.

Yet rejection of terms like “pro-choice” from activists like Fonteno stands in sharp contrast to how most Americans who support reproductive rights feel about it. Election pollsters have also found that some of the most effective abortion rights-related messages with voters are the same ones that activists argue are too gendered, stigmatizing, and patronizing (like that the decision to end a pregnancy should be “between a woman and her doctor” or that “victims of rape and incest would be forced to give birth.”)

In 2022, under pressure from activists, the House Pro-Choice Caucus circulated new talking points that warned “choice” is “harmful language” for reproductive rights, and should be replaced with the “helpful” alternative of “decision.” This generated some ridicule, but other aides and leaders were upset that activists would seek to ditch the well-known and popular “pro-choice” label at such a high-visibility moment, and without real survey research to support it.

There are no simple answers to the movement’s future direction, though progressive activists rightly note that public opinion is increasingly shifting in favor of abortion rights. Some activists are wary about prematurely abandoning the long-held goal of restoring accessible in-person clinic care nationwide, while others worry that leaders’ refusal to adapt to new realities will come at the expense of pregnant people.

Wallace, of the Tampa Bay Abortion Fund, said that after Roe v. Wade was overturned, her fund received 755,000 individual donations, but by 2023, that number fell to 272,000. “People are donating more toward the election and Yes on 4 right now, and we all want Yes on 4 to pass, but people don’t understand that even if it does, people still don’t have money for abortion, people still don’t have ways of traveling to their appointments,” she said. “Next year is going to be all about holding people to account.”

How IVF exposed fissures in the Republican coalition

Originally published in Vox on September 26, 2024.

Donald Trump is struggling with female voters and occasionally acts like he knows it.

With the November election fast approaching, Republican political consultants have been bemoaning the fact that their presidential candidate continues to publicly boast about overturning Roe v. Wade — something a majority of Americans oppose. Trump’s openly anti-abortion pick for vice president, JD Vance, also continues to attract attention for his deeply unpopular insults of women who don’t have biological children.

These dynamics are exacerbated by the fact that the economy — typically Republicans’ strongest issue — continues to improve; the Fed recently cut interest rates and inflation has fallen to its lowest point in three and a half years, with gas and grocery prices plunging.

To help improve his chances, Trump has been trying to dispel fears. At the September presidential debate, when asked if he would veto a national abortion ban, Trump repeatedly dodged the question, insisting it wouldn’t be necessary since abortion rights are now under state control. This is only half-true: Trump is right that he’s unlikely to face a national abortion ban from Congress in the next four years.

But most anti-abortion leaders weren’t counting on that, anyway. The anti-abortion movement has been banking on more appointments of friendly federal judges and taking control of key federal agencies that could use executive power to heavily restrict reproductive freedom.

“We don’t need a federal abortion ban when we have Comstock on the books,” Jonathan Mitchell, the legal architect behind a 2021 law in Texas that effectively banned abortion, told the New York Times earlier this year. Mitchell was referring to the Comstock Act, an 1873 federal law that could prohibit anything associated with abortion from being sent in the mail. Such a ban could mean not only restricting abortion medication, the most common method used to end a pregnancy in the US, but also any medical equipment used during surgical abortion, like speculums, suction catheters, and dilators.

The Comstock Act was rendered moot by Roe v. Wade in the 1970s but never formally repealed, and now, with Roe gone, some conservatives, including Mitchell and JD Vance, are pushing for its revival. “I hope [Trump] doesn’t know about the existence of Comstock, because I just don’t want him to shoot off his mouth,” Mitchell added, urging anti-abortion groups to also “keep their mouths shut as much as possible until the election.”

Things seemed to be mostly going according to Mitchell’s plan, with Trump avoiding answering reporters’ Comstock Act questions and publicly insisting abortion was now a state duty. That is, until August, when Trump — seemingly more nervous about his election chances — announced on Truth Social that his administration would be “great for women and their reproductive rights.” He also finally told the media he would not use the Comstock Act to ban mailing abortion drugs, and on top of that, announced his administration would mandate health insurance companies cover the hefty cost of in vitro fertilization (IVF).

Trump’s new stances have not been clarifying or convincing enough for most voters — indeed, on the heels of him promising free IVF, he said he thought Florida’s six-week ban was too strict, and then announced he’d be voting against Florida’s proposed abortion rights ballot measure in November. That measure would legalize abortion up to viability to protect the patient’s health, as decided by their provider, and polls show most Floridians back it.

Still, Trump’s new rhetoric of (somewhat, sometimes) embracing reproductive rights has antagonized parts of his conservative base, who feel he’s taking the anti-abortion movement for granted and that he’s having his “Sister Souljah moment” with the segment of the electorate that helped deliver his victory in 2016. The immediate question is whether these conservatives will sit out in protest in November, and if they do, whether Trump can make up for it by drawing in more voters elsewhere. The larger, more enduring question is whether this portends an emerging split in the Republican coalition on the question of abortion, just a couple of years removed from the anti-abortion faction’s greatest victory.

Why Trump’s IVF announcement is causing problems with parts of his religious base

While opposition to abortion has been a fragile part of the GOP coalition for years, IVF emerged this year as a new point of tension among conservatives.

After Trump announced in late August that he’d back free IVF, anti-abortion groups immediately urged him to retract his stance. At first glance, it may seem puzzling that a faction of voters who identify as “pro-life” would oppose technology that helps people with infertility become parents. About 2 percent of births in the US are done through IVF, which involves fertilizing eggs outside of the body and then transferring embryos to a womb.

But the opposition makes more sense when IVF is understood as conflicting with “fetal personhood” — a core goal of a faction within the anti-abortion movement that seeks to grant fetuses (and embryos) full human rights and legal protections.

“Human embryos are created and discarded or frozen by dozens in most IVF procedures,” Matthew Yonke, a spokesperson for the Pro-Life Action League, told me. “It’s no way to treat human beings, and the federal government should not subsidize it.”

(Louisiana remains the only state to outright prohibit the destruction of embryos, requiring patients to either pay forever to store their unused embryos, or donate them to a married couple. Most states allow patients to decide what to do with any excess genetic material.)

Some social conservatives also lament that contemporary IVF treats parenthood like an individual right instead of a responsibility or privilege for committed couples, and others object to the ethical implications of sex selection and optimizing for certain characteristics, such as eye color or intelligence.

Ever since February, when Alabama’s Supreme Court issued its unprecedented legal decision that invoked God to claim frozen embryos count as “children” under state law, policymakers and prospective parents have been realizing how vulnerable IVF is in the United States, even as politicians scramble to assure voters it’s not actually at risk.

For religious conservatives who oppose IVF, the last seven months have provided a fresh opportunity to make their case against the assisted reproductive technology. In some states they’ve made political gains: the North Carolina Republican Party adopted a platform in June that opposes the destruction of human embryos. Also in June, the Southern Baptist Convention, the largest Protestant denomination in the US, approved a resolution against IVF.

Anti-abortion leaders are prepared to fight for their long-term goal of fetal personhood, just as they did for decades to overturn Roe v. Wade. In many ways, these new IVF battles are just beginning: This past spring, a supermajority of justices on Florida’s Supreme Court signaled openness to a future fetal personhood challenge, suggesting that “pre-born children” are “persons” entitled to the right to life under the Florida Constitution. Regardless of whether Trump wins in November, these fights over reproductive technology will continue to embroil conservatives and the Republican Party.

Fiscal conservatives are getting ticked off, too

It’s not just the ethics of IVF that are causing fissures — Trump’s promise that the government would foot the bill has also sparked concern among conservative budget hawks.

The average out-of-pocket cost per IVF cycle stands at $24,000, according to a federal fact sheet, or $61,000 in total per successful live birth, since people often need multiple IVF cycles. While Trump’s team has refused to provide any financing details for his plan, some experts believe it would require significant new Congressional spending.

Ira Stoll, a prominent conservative columnist, tried to make the fiscally conservative case for Trump’s IVF policy in the Wall Street Journal. He argued the proposal would be less expensive than it seems since the costs of low birth rates “far outweigh the costs” of adding IVF to insurance companies. “The roughly $15,000 price of an IVF procedure is nothing compared with the priceless potential of an individual human being,” Stoll added, though existing research suggests IVF would not significantly increase the birth rate.

However, for most conservatives concerned with federal spending and rising deficits, the government mandating taxpayer-funded IVF treatment feels like a bad joke. National Review editor Philip Klein argued that the expensive Trump proposal would amount to a significant expansion of Obamacare and drive up health insurance premiums for all.

Vance Ginn, the chief economist at the Office of Management and Budget during the Trump administration, came out to blast the IVF proposal. “I’m for IVF, as we’ve used it for two of our beautiful kids, but nothing is ‘free,’” he wrote on X. “Can we stop handing out things to win votes like it’s candy when we’re running $2T[rillion] deficits and not abiding by the limited roles outlined in the US Constitution?”

Fiscal conservatives in Congress have also been concerned. Sen. Lindsey Graham (R-SC) rejected the free IVF proposal on ABC News, saying there would be “no end” to its cost. Sen. Thom Tillis (R-NC) was more restrained with NBC News. “I’m a little bit hesitant on an insurance mandate. Is there some other way that we could incent[ivize] these sort of coverages through the private sector?” he asked. “We got a lot of things we’ve got to pay for next year by extending the tax provisions.”

Sen. Rand Paul (R-KY) opted to be less diplomatic, calling the idea “ridiculous.” The “government has no money,” he said. “We’re $2 trillion in the hole, so I’m not for asking the taxpayer to pay for it.”

Even before his promises for free IVF, fiscal conservatives were growing increasingly frustrated with Trump, as he’s been virtually silent on the mounting federal debt, and issuing new campaign pledges like ending taxes on overtime pay and Social Security benefits, and exempting tips from taxes. Trump’s disregard for deficit spending could turn off some of these budget hawks in November, too.

Will social conservatives stick with Republicans in the future? And will that even matter?

Evangelical voters were a critical part of Trump’s path to victory in 2016, and his campaign in 2020, and most political strategists say he’ll need to earn at least 80 percent of white evangelicals nationally to win in November.

A recent Fox News poll showed him at 75 percent with this group, a number that could sink lower given his recent flip-flops. Al Mohler, president of Southern Baptist Theological Seminary in Louisville, Kentucky, has been warning — in recent op-eds, speeches, and podcast interviews — that the Republican Party is making a huge mistake by potentially motivating religious voters to stay home. Mohler has been urging Trump to clarify how he’ll restrict abortion in the Oval Office, just as Trump promised evangelicals before that he would work to overturn Roe v. Wade if elected.

Tony Perkins, president of the right-wing Family Research Council, has been making a similar argument that Trump needs to give religious voters something to be genuinely excited about. “It’s just on the margins, but it’s the difference in many elections,” Perkins argued in Politico.

For now there’s no clear survey evidence on whether Evangelicals really are planning to stay home in November, though Lila Rose, a prominent anti-abortion activist, has been urging her followers to withhold their votes unless Trump changes his tune. But Mohler, for his part, said he’s likely to stick with Trump in November because he trusts that Trump will ultimately stack his administration with anti-abortion leaders, regardless of what he says on the campaign trail.

“I have a high degree of confidence that a lot of people in crucial roles in a Trump administration would reflect that pro-life sentiment,” he told the New York Times. “I believe the opposite about a Kamala Harris administration … I have to look at a longer-term strategy. And I think the most responsible pro-life figures in the United States think similarly.”

IVF in particular is popular in the US, with 70 percent of adults supporting access to the treatment. Even among Christian and Republican voters, clear majorities believe IVF access is a good thing.

That’s why, even as Republican lawmakers continue to vote against federal bills to protect access to IVF, they have been publicly stressing their support for the technology. Pennsylvania’s Republican Senate candidate Dave McCormick is running on a $15,000 tax credit for fertility treatment, and in September, a conservative super PAC started funding a major ad campaign in support of IVF.

Public backing for abortion rights also continues to loom over Trump and the Republican Party; polls show voters have grown even more supportive of abortion rights than they were before the Supreme Court overturned Roe. Among women in particular, many say abortion rights are their top issue this November. A recent New York Times poll found that for women under 45, abortion is even more important to them than the economy. Another poll by Galvanize Action showed that 82 percent of white moderate women specifically plan to factor in a candidate’s stance on abortion when voting.

Whether this late-stage gamble by Trump to send mixed messages on reproductive rights pays off is anyone’s guess, but even if it does, the internal fights within the GOP coalition will likely remain — unresolved, festering, and ready to resurface after November.