One year after the Supreme Court overturned Roe v. Wade, Democrats and reproductive rights advocates are ramping up efforts to protect access to contraception, looking to emphasize daylight with Republicans on the issue ahead of the 2024 elections.
Health advocates say there have been concerns over access to birth control well before the Supreme Court's decision in Dobbs v. Jackson Women's Health Organization.
But while the ruling last summer gave a jolt of energy to the reproductive rights movement, it also has made it harder to separate the issue of contraception from the politics of abortion.
In a direct response to the Dobbs decision last year, the then-Democratic-majority House passed legislation to codify access to contraceptives on the federal level, allowing individuals to obtain and use birth control and safeguarding a health care provider’s ability to supply such products. Only eight Republicans joined every Democrat to pass the bill.
A companion measure was blocked in the evenly divided Senate.
Last week, Senate Democrats tried to force consideration of the bill again as part of their efforts to bring attention to post-Roe America and force Republicans to object on the record to broadly popular legislation.
Sen. Mike Braun (R-Ind.) objected to the unanimous consent request.
"This bill is not about contraception, it’s about abortion,” Braun said, adding the legislation uses "intentionally vague language to hide its ulterior motive of protecting access to abortion drugs."
He also objected to a provision that would guarantee funding for Planned Parenthood.
Sen. Edward Markey (D-Mass.), who introduced the measure, said that by blocking it, the GOP showed they are the party of extremists.
"Each and every Republican who refused to protect the right to contraception told Americans loud and clear that they’re willing to risk the health of millions of Americans for politics," Markey said.
Polling consistently shows there is broad bipartisan support for birth control, and most Republicans argue the people opposed to it are in a small minority. They say the bills solve problems that don't exist and are attempts to score political points.
Sen. Mike Lee (R-Utah) in floor remarks last week said Democrats have an "obsession" with abortion.
According to the annual Gallup values and beliefs poll released earlier this month, 88 percent of Americans said birth control was morally acceptable.
Still, advocacy groups say they are not taking chances, pointing to Justice Clarence Thomas writing that the Supreme Court should reconsider Griswold v. Connecticut, the 1965 decision that established a right to use contraception.
"I think perhaps prior to Dobbs, people might have been more complacent about contraception," said Rachel Fey, vice president of strategic policy at Power to Decide, an organization that advocates for sexual and reproductive choice, including birth control and abortion.
Now that Roe v. Wade has been undone, "it has sort of woken people to the idea that these are not things we can take for granted. These rights are things we have to continue to fight for," Fey added.
According to KFF and the Guttmacher Institute, which tracks reproductive health measures, the Dobbs decision hasn't necessarily triggered a wave of attacks on birth control. Even some GOP-led states have passed measures to expand access.
In March, West Virginia Gov. Jim Justice (R) signed legislation that requires insurance plans to provide coverage for 12-month supplies of contraceptives from pharmacies. Montana Gov. Greg Gianforte (R) signed a similar bill in May.
Also in May, Indiana Gov. Eric Holcomb (R) signed legislation that allows pharmacists to prescribe hormonal contraceptive patches and oral contraceptives.
Still, other states are trying to limit access by conflating common birth control methods with abortion.
Usha Ranji, associate director for women’s health policy at KFF, said tying the issues together muddies the common scientific understanding and stigmatizes contraception.
"Broadly speaking, the public are very supportive of access to contraception as well as access to abortion. But there have been some very deliberate conflating and misinformation around contraception acting as abortifacients," Ranji said.
Earlier this month, Nevada Gov. Joe Lombardo (R) vetoed a bipartisan measure guaranteeing the right to contraception.
Last year, the Missouri Senate nearly banned Medicaid funding for emergency contraception and intrauterine devices (IUDs) until a bipartisan coalition beat back the amendment.
In Texas, state-funded women’s health care programs don’t provide emergency contraception, and the Medicaid program explicitly excludes Planned Parenthood from any coverage — a violation of federal law.
Florida Gov. Ron DeSantis (R), who is running for president, twice vetoed state funding for a program that would have provided long-acting reversible contraception to low-income women. The program was opposed by the state's Catholic bishops; the Catholic Church opposes all forms of artificial birth control.
And while the major anti-abortion groups say they are neutral on birth control, they also say that life begins at conception and argue that anything preventing a fertilized egg from implanting in a woman’s uterus is an "abortifacient."
For example, Students for Life lists common contraceptives such as IUDs, Plan B and other emergency contraception, birth control pills, hormonal patches, implants and shots as abortifacients.
The American College of Obstetricians and Gynecologists said an IUD doesn't prevent implantation; it prevents the initial fertilization, and birth control pills prevent ovulation. Last year, the Food and Drug Administration updated the labeling attached to emergency contraceptive pills to clarify that they are not abortion drugs.
The issue of contraception has taken on more urgency for the White House in the past year.
Ahead of the one-year anniversary of the Dobbs ruling, President Biden last week signed an executive order directing agencies to find ways to expand access to birth control.
“While contraception cannot replace the need for abortion services or fill the gap left by the loss of a constitutional right to choose, it’s an important part of helping ensure that women can make decisions about their own health, lives and families,” said Jen Klein, director of the White House’s Gender Policy Council.
Yet the order contained no specific timeline for action or concrete calls to action.
Clare Coleman, president and CEO of the National Family Planning & Reproductive Health Association, said she was disappointed, and urged the administration to go further.
"The threat to the legality and legitimacy of contraception is real, and it is growing," Coleman said in a statement. "We are in a health care crisis moment, and our nation’s leaders need to take bold action to protect and expand access to contraception. Once again, we urge the White House to do all it can to confront the growing threats to contraception.”
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