Inside the MAGA Plan to Attack Birth Control, Surveil Women and Ban the Abortion Pill

Tessa Stuart
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The Supreme Court announced last week that it would take up a case considering restrictions on the most widely-used method of abortion in the United States: the abortion pill. Under a worst-case scenario for American women, that case could have triggered a full reversal of the Food and Drug Administration’s approval of mifepristone, cutting off access to the medication across the country. That didn’t happen. The Supreme Court said it would only consider a more narrow set of questions about regulatory changes that have made the abortion pill more accessible in recent years. It could significantly limit access to mifepristone, but won’t end it altogether.

But it may not matter how the high court rules if Republicans win the presidency next November. That’s because GOP operatives have already crafted an expansive blueprint, 887 pages long, laying out in painstaking detail how they intend to govern, including plans to leverage virtually every arm, tool and agency of the federal government to attack abortion access. The document explicitly names their intention not just to rescind FDA approval for the abortion pill if they regain control of the White House in 2024, but to revive a 150-year-old law that criminalizes sending or receiving through the mail any “article, instrument, substance, drug, medicine or thing” that could be used to facilitate an abortion. That law, the Comstock Act, is viewed as a de facto federal abortion ban by reproductive rights advocates and anti-abortion activists alike.

Those plans — and many more, including proposals to attack contraception access, use the Centers for Disease Control and Prevention to increase “abortion surveillance” and data collection, rescind a Department of Defense policy to “prohibit abortion travel funding,” punish states that require health insurance plans to cover abortion, and retool a law that is currently protecting pregnant women with life-threatening conditions — are outlined in Project 2025’s “Mandate for Leadership.”

Project 2025 is an initiative of the Heritage Foundation, a rightwing think tank that has helped staff and set the agenda for every Republican administration since Ronald Reagan. It describes Project 2025 as “the conservative movement’s unified effort to be ready for the next conservative administration to govern at 12:00 noon, January 20, 2025.”

For the last 40 years, Heritage has released a similarly detailed list of policy recommendations before every presidential contest. The organization has a strong track record of exerting influence: Reagan enacted roughly half of the recommendations his first year in office. But Donald Trump bearhugged Heritage’s agenda: In 2018, just one year into his administration, Heritage boasted that Trump had already implemented two-thirds of their policy recommendations, the most of any president since the organization’s founding.

There is good reason to believe that Trump, if nominated and elected, would find this new set of recommendations even more compelling than he did in his first term. That’s because it was drafted with extensive input from many of his allies, advisers and appointees. Among the groups that contributed are America First Legal (led by high-ranking Trump administration officials Stephen Miller and Gene Hamilton), the Conservative Partnership Institute (where Mark Meadows, Trump’s last chief of staff, is a senior partner) and the Center for Renewing America (helmed by Russell Vought, the director of the Office of Management and Budget under Trump). High-ranking Trump administration officials even authored individual chapters of the report, including its recommendations to dramatically restrict abortion access.

The chapter that envisions reshaping the Department of Health and Human Services was authored by the Heritage Foundation’s vice president for domestic policy, Roger Severino, who served as the head of HHS’ Office of Civil Rights under Trump. “Now that the Supreme Court has acknowledged that the Constitution contains no right to an abortion, the FDA is ethically and legally obliged to revisit and withdraw its initial approval” of mifepristone, Severino writes. (Incidentally, Severino’s wife, Carrie, is the president of the Judicial Crisis Network, the dark money group that spent tens of millions of dollars on advocacy campaigns that helped cement the Supreme Court’s 6-3 conservative supermajority responsible for ending the federal right to abortion.)

Writing for Project 2025, Severino calls abortion pills “the single greatest threat to unborn children” now that Roe v. Wade has been overturned. He proposes that, as an “interim step,” the next HHS secretary immediately reimpose old regulations that required the pill be dispensed in-person, under a doctor’s supervision, a requirement researchers have long argued is unnecessary. His proposal would also shorten the period in which mifepristone could be prescribed to terminate pregnancies: 7 weeks gestation or less, compared to 10 weeks today.

Severino suggests that reimposing the old rules as a stop-gap measure while the HHS secretary works to revoke mifepristone’s FDA approval, which he declares, in language echoing the anti-abortion activists who brought the lawsuit challenging the drug’s approval, was the result of a “politicized approval process” and “illegal from the start.” (More than 100 studies conducted over a 30-year span have found that in 99 percent of instances, mifepristone works with no complications at all, making it safer than many common drugs, including Tylenol and Viagra.)

Elsewhere, Severino complains that the CDC’s “abortion surveillance” system is “woefully inadequate,” and proposes turning the agency into a kind of snitch network that would collect data about who had abortions and where — and punish any states that refuse to share that information. “Because liberal states have now become sanctuaries for abortion tourism, HHS should use every available tool, including the cutting of funds, to ensure that every state reports exactly how many abortions take place within its borders, at what gestational age of the child, for what reason, the mother’s state of residence, and by what method,” Severino writes.

Severino declined an interview request, and did not respond to emailed questions about his proposals.

Read together with the proposals to begin enforcing the Comstock Act, Mary Ziegler, a professor at UC Davis School of Law and one of the preeminent historians of abortion in America, says the data collection plan “is essentially setting the table for investigations to take place later.”

Discussion of reviving the Comstock Act — a 150-year old vice law that criminalized the circulation of “obscene, lewd or lascivious” publications — appears among the policy proposals for the Department of Justice. That section was drafted by Gene Hamilton, who worked in Trump’s DOJ and Department of Homeland Security. Today, he heads America First Legal with Stephen Miller. Renewing enforcement of Comstock is an idea that has been promoted on the vanguard of the anti-abortion movement by activists like Mark Lee Dickson — one of the chief figures behind local ordinances banning abortion and abortion “trafficking” — who has touted Comstock’s potential as a “de facto abortion ban.”

The inclusion of Comstock in this document is somewhat stunning, though, and it marks one of the first times that the idea has been embraced openly by anyone near the mainstream of the Republican Party. Hamilton writes: “Following the Supreme Court’s decision in Dobbs, there is now no federal prohibition on the enforcement of [the Comstock Act]. The Department of Justice in the next conservative administration should therefore announce its intent to enforce federal law against providers and distributors of such pills.” He refers specifically to providers and distributors of pills, but, Ziegler notes, “he deliberately quotes language that’s much, much broader than that.”

Under the broadest interpretation of Comstock, Ziegler says, health care providers, distributors — and even pregnant women themselves — could be arrested and prosecuted for sending or receiving the abortion medication and emergency contraception in the mail. Hamilton himself writes that federal law prohibits mailing “[e]very article, instrument, substance, drug, medicine, or thing which is advertised or described in a manner calculated to lead another to use or apply it for producing abortion” — a virtually endless list.

The attacks on mifepristone and resurrection of Comstock stand out as particularly harmful proposals, but they are only two of the dozens of ways the Republicans behind Project 2025 envision restricting access to abortion and contraception if they win the White House next year. Elsewhere in the document, there are proposals to eliminate the morning-after pill from the Affordable Care Act’s contraceptive mandate under the rationale that it is a “potential abortifacient”; to revoke a Biden-era rule that allows members of the military and their dependents who are stationed in states with abortion bans to seek medical care in other states; to prohibit Planned Parenthood from receiving Medicaid funds; to punish states that require insurance to cover abortion; and to end the requirement that hospitals provide medically necessary abortions under the Emergency Medical Treatment and Active Labor Act and, separately, use the law to “investigate” hospitals and doctors who provide abortions.

The chapter on the U.S. Agency for International Development suggests not only that the next administration remove references to “abortion,” “reproductive health,” and “sexual and reproductive rights” from all agency materials, but also propose creating a new position that would involve, among other responsibilities, pressing the United Nations for “assurances that language promoting abortion will be removed from U.N. documents, policy statements and technical literature.”

The Trump campaign did not respond to an inquiry about Project 2025, and whether the former president would seek to implement its policy recommendations on abortion if he wins a second term next year. Trump has previously resisted pressure to commit to a 15-week national abortion ban like some of his rivals for the GOP nomination, and Rolling Stone has reported on his intention to campaign as a “moderate” on abortion in the general election, despite having appointed three Supreme Court justices who voted to overturn federal protections for abortion rights.

Project 2025, meanwhile, is already pre-screening applicants for jobs in the next Republican administration, filtering out candidates based on their answers to a list of questions, including whether they agree or disagree with the statement: “Life has a right to legal protection from conception to natural death.”

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