Here's What Abortion Would Look Like Under Kamala Harris

Democratic nominee Kamala Harris is known to be a staunch supporter of reproductive freedoms. But what exactly could she do to protect access to abortion if elected as president?

In one of her first campaign events, Harris promised to stop Donald Trump's "extreme abortion bans."

"When Congress passes the law to restore reproductive freedoms, as president of the United States, I will sign it into law," Harris announced to the cheering crowd.

However, it's easier said than done, as Republicans dominate the House, while the current Supreme Court has been called the most conservative-leaning in modern U.S. history.

For one in eight Americans, abortion is the most important issue in their 2024 vote, according to the KFF survey conducted earlier this year.

Harris' contender, Donald Trump, has said it should be up to individual states to decide their abortion laws but did not reject the idea of revoking access to mifepristone, the first drug in a two-dose medical abortion regimen.

Meanwhile, Project 2025, created by the Heritage Foundation, a conservative think tank, calls for revisiting the approval for mifepristone and eliminating government support for abortion. Trump has denied any associations with Project 2025; however, critics point out that the document was drafted by several former Trump administration officials.

What could Harris do about abortions?

Mike Schmidt, lawyer at Schmidt & Clark LLP, says Harris' presidency could mark a pivotal shift in the national conversation around reproductive health. She could work on proposing comprehensive federal legislation that reinstates the protections previously guaranteed by Roe v. Wade.

"Such a move would aim to ensure that access to abortion is a fundamental right, safeguarding it against state-level restrictions and potential bans. Given the current landscape, where several states have enacted stringent laws curbing abortion rights, this would not only reflect the majority view among Americans who support reproductive freedoms but would also provide a strong framework to uphold those rights across the nation," Schmidt says.

After Roe v. Wade was overturned in 2022, stripping federal protection for abortions, 14 states imposed full abortion bans with rare exceptions for rape and instances when a woman's life is in danger. However, these exceptions do not necessarily work in real life, leaving women denied medical care.

The support for abortion access is increasing. Sixty-one percent of American adults want their state to allow abortion for any reason, compared to 49% in 2021, a survey reveals.

Genevieve Scott, a senior fellow at the Yale Law School program for the Study of Reproductive Justice, says a law to restore reproductive freedoms could codify protections for reproductive autonomy to ensure meaningful access to patients across the country without discrimination.

Harris may ensure protections for mifepristone

Another significant area for Harris to focus on would be the protection of medical abortion, Schmidt says. While the Biden administration has already taken steps in this direction, the president could strengthen these efforts by directing federal agencies to prioritize access to mifepristone and similar medications.

"This would include ensuring that healthcare providers and pharmacies are supported in dispensing these medications without intimidation or harassment, thus safeguarding the rights of women in more conservative states," Schmidt tells Healthnews.

Medical abortion accounts for 63% of all abortions in the United States, according to 2023 data, and is approved for use up to 10 weeks of pregnancy.

This method of pregnancy termination has been proven overwhelmingly safe — only 0.3% of patients experience side effects requiring hospitalization, such as vaginal bleeding or infection.

A recent study suggests that medical abortion pills are safe and effective even when prescribed via telehealth: among 6,034 abortions, 97.7% resulted in a pregnancy termination without further intervention. Of those, nearly all (99.8%) did not cause serious adverse events.

The latest effort to ban medical abortion has been blocked by the Supreme Court when the nine justices unanimously ruled to preserve access to mifepristone. The challenge was brought by individual doctors and medical groups who argued that the drug was unsafe and that the process that the Food and Drug Administration used to approve mifepristone was flawed.

Medical abortion regulations are likely to remain the key frontier in the battle over reproductive rights in the U.S. Trump critics fear that Republicans may enforce the now-defunct Comstock Act. The federal law passed in 1873 prohibits mailing anything that can produce an abortion, including pills and instruments.

"If they can't be mailed, then there's no way abortion clinics or abortion doctors can get those pills or supplies. It would be really hard for anyone to have an abortion," David Cohen, a professor of law at Drexel University, has recently told Healthnews.

All eyes on the Hyde Amendment

During the 2019 presidential race, Harris called out Joe Biden for his previous support of the 1977 Hyde Amendment, which bans the use of federal funds for abortion. The law prevents people enrolled in Medicaid and other public programs in 34 states and the District of Columbia from using their health insurance to cover abortion care.

Scrapping the Hyde Amendment could improve access to abortion, especially for vulnerable populations: research shows that among women with Medicaid coverage subject to the law, one in four who seek an abortion are forced to continue the pregnancy. 

The American Civil Liberties Union has already urged a potential Harris administration to ensure all hospitals satisfy their obligations under the Emergency Medical Treatment and Labor Act. The law requires hospitals that receive Medicare funds to provide emergency stabilizing treatment, including abortion, to any patient in need.

Abortion is one of the most divisive issues in American politics. Even if a pro-choice candidate is elected as the next president of the U.S., expanding reproductive rights may not be an easy task.