Women's rights advocates are already sounding the alarm about Republican control of the House of Representatives. National Organization of Women President Terri O'Neill fired off a press release warning that "under the new Republican leadership, women's issues will be compromised" while an e-mail from Planned Parenthood described a "'Stupak on steroids' abortion ban" agenda. Perhaps comedian Etta Devine articulated it best on Twitter: "Hold on to your vaginas for the next two years or government will try and do it for you."
Even more worrisome, Republicans swept many state houses, flipping 11 legislatures and eight governorships from blue to red. That gives Republicans power to enact anti-abortion measures across the country -- a significant blow to abortion rights considering the more than 600 anti-choice state bills already proposed this year.
But at the federal level, the buck still stops with the president. Republicans may grandstand and write anti-choice legislation in largely symbolic gestures for their base. The real threat, though, especially in the long term, is that the Obama administration might not stand firm in its commitment to women's reproductive rights.
With the president in control of the executive branch, which oversees myriad programs and directs millions of dollars toward women's health services, the majority of federal-level reproductive-health decisions are in his hands. Most simply, the administration can allow the departments under its purview to do their jobs. Under George W. Bush, Health and Human Services suggested redefining several forms of birth control as abortion. Likewise, the Food and Drug Administration stalled approval of over-the-counter status for emergency contraception for three years under pressure from the Bush administration, despite a scientific determination backed by Food and Drug Administration staff to grant it over-the-counter status. Under the Obama administration, the FDA quickly approved Ella, an emergency contraception pill that works up to five days after conception, which The New York Times hailed as a return of science-based decision-making at the FDA.
On the programmatic level, the administration and HHS have significant control over sex education, and the Obama administration is responsible for renewed support of evidence-based, comprehensive curricula -- proved to reduce sexually transmitted diseases and unwanted pregnancy and essential to ensuring sexual health. Though Bill Clinton and George W. Bush together funneled more than $1.5 billion into abstinence-only education, in just the last two years, the Obama administration has made a significant effort to redirect federal funding of sex education to science-based programs.
For example, President Barack Obama's 2010 budget breathed new life into the Office of Adolescent Health. Created in 1992 as a department within HHS, but never before funded, in 2010, OAH oversaw $114.5 million in spending on programs to prevent teen pregnancy, support teens who do become pregnant, and further research prevention programs. According to James Wagoner, president of the Advocates for Youth, "vigorous presidential leadership" could stave off GOP attacks on these new programs, which enjoy overwhelming popular support.
Perhaps most important, health-care reform gives the administration an unprecedented chance to improve women's reproductive health: HHS has the power to define contraception as a preventative service that insurance programs must provide to women free of charge. Next week, the Institute of Medicine will begin this process by drawing up recommendations for which services should be considered preventative, and therefore cost-free, under the women's health amendment in the new health-care law. The stage is already set for a battle, with religious organizations, including the Catholic Bishops, who have vigorously opposed the classification of contraception as preventive care, while Planned Parenthood has launched a campaign, Birth Control Matters, to raise awareness of the issue. "This is huge," emphasizes Nancy Northup, president of the Center for Reproductive Rights, who sees the potential for free birth control as the most important development of the next few years. For Northrup, cost-free contraception would be the culmination of years of advocacy and the most important improvement Obama could make for reproductive choice.
Not only is providing affordable contraception key to protecting women's reproductive choices, it is also an issue that could rally female voters around the Democratic Party. Looking at the diminished gender gap in the midterms, Wagoner sees the issue of cost-free contraception as "the ultimate line-in-the-sand for the administration." Unmarried women supported Democrats over Republicans by 20 points last week, but many stayed home, and a majority felt their issues were not addressed. As the party that enjoys the support of women voters, particularly young, single women, "if they let [cost-free contraception] go, they're toast."
Despite the importance of reproductive-health issues to the Democratic base, "signals from the administration remain mixed," says Wagoner. He points to a minimum $25 million within the OAH budget that the administration earmarked for abstinence-based curricula. In a country where 70 percent of adolescents have sex by the age of 19, and research showing that teens who don't learn about contraception don't use it, that's $25 million less that goes toward proven, effective sex ed.
His support of reproductive rights not withstanding, Obama has earned the ire of progressives by stalling or seemingly abandoning causes like "don't ask, don't tell" and health care's public option. Despite enormous public support for comprehensive sex ed, government support of family planning, and affordable access to contraception, there’s no guarantee that reproductive rights won't become the administration's next broken promise. In March 2009, the courts ordered the FDA to reopen the question of allowing over-the-counter Plan B to 17-year-olds, saying the current rules were the result of Bush administration politics rather than scientific evidence. The FDA has not heeded the judge's order under Obama's watch, nor has the Department of Justice stepped in to enforce it.
Though states will continue to chip away at abortion access, the administration controls the most effect ways to reduce unwanted pregnancies and support women's health. Obama's defense of -- or retreat from -- women's health over the next two years will reflect how he interpreted the midterm results and how he's shaping his overall electoral strategy leading up to 2012. Ceding ground will mean Obama is moving to the center. But if Obama uses the executive branch to counter the forthcoming attacks on women's reproductive rights, he will reaffirm his party's commitment to those who elected him.