All of the Ways Trump Could Impact Abortion Policy From Day One

In August, Trump said he would not enforce Comstock. But others in his orbit, including contributors to the conservative policy blueprint known as Project 2025, have endorsed that approach.

Planned Parenthood and Title X

During his last presidency, Trump worked to boot clinics, including Planned Parenthood — the nation’s largest provider of reproductive health care — from a federal program that supports family planning clinics for low-income people.

The program, Title X, does not directly fund abortion; the money supports health care services such as contraception, cancer screenings and testing for sexually transmitted infections. But the reproductive health clinics supported through the program sometimes may refer patients for abortion. Planned Parenthood, a frequent target of abortion opponents, operates the bulk of clinics that qualify for Title X funds.

Trump’s previous administration forbade Title X clinics from telling patients about abortion options, even if they did not provide the service themselves. The rule resulted in more than 400 Planned Parenthood clinics losing federal funding, along with more than 600 clinics outside of the organization. The Guttmacher Institute, which tracks reproductive health policy, estimates that the change cut the Title X program’s capacity in half, affecting about 1.6 million patients. The Biden administration reversed that policy.

Trump’s first administration also moved to let anti-abortion centers — mostly non-medical facilities that focus on discouraging people from getting abortions — apply for and receive Title X funds, another policy the Biden administration undid.

On the 2024 campaign trail, Vice President-elect JD Vance said that once in office, Trump would support “defunding Planned Parenthood” — suggesting he might bring back the rule upon returning to the White House.

Medicaid

By law, Medicaid, the public insurance program for low-income Americans, is not allowed to discriminate against qualified family planning providers, meaning beneficiaries should be allowed to use that coverage at Planned Parenthood clinics. Medicaid is jointly funded and run by the federal government and individual states, so it can only cover abortion when the state government has specifically put money toward doing so.

During Trump’s previous presidency, HHS authorized states to have “greater flexibility” in determining which providers could participate in the program, a move that some interpreted as easing the way for states to bar Planned Parenthood from Medicaid. In 2024, the Biden administration issued guidance remaining states that they were required to let Medicaid-covered patients choose their family planning provider, and that they could not prohibit a qualified clinic from participating in the program.

Currently, two states — Arkansas and Missouri — have actively enforced laws that prevent local Planned Parenthood clinics from participating in Medicaid. Similar laws in other states have been blocked by courts.

The Supreme Court has agreed to hear a case weighing whether states can in fact kick Planned Parenthood out of their Medicaid programs, even when the insurance plan is not being used to cover abortion. The case concerns a 2018 executive order issued by South Carolina Gov. Henry McMaster, who sought to stop Medicaid funds from going to Planned Parenthood.