MEMO: The Erosion of Reproductive Freedom and Democracy One Year Under Trump

TO: Interested Parties
FROM: Reproductive Freedom for All
RE: The Erosion of Reproductive Freedom and Democracy One Year Under Trump
DATE: January 20, 2026

The Erosion of Reproductive Freedom and Democracy One Year Under Trump

One year ago, Donald Trump returned to the White House and launched an onslaught of attacks against reproductive freedom and other fundamental rights—all while swiftly punishing those who dared to defy him. Those efforts have caused real harm to people across the country: gutting health care, destabilizing families, silencing dissent, and laying the groundwork for a nationwide abortion ban that no one voted for.

Trump isn’t working alone. Congress and courts have the authority — and responsibility — to push back against his unlawful actions. Instead, too many lawmakers and judges are enabling his attempts to completely overhaul the federal government—installing anti-abortion, anti-freedom loyalists at every level, in every branch, to create a system where executive power reigns above all. (Spoiler alert: That system looks a lot more like authoritarianism than democracy.)

This is not politics as usual. It’s a coordinated effort to weaken democracy by targeting reproductive freedom, because controlling people’s bodies has always been a shortcut to controlling their lives. What follows is a look at the damage Trump and his allies have inflicted in just one year: chipping away at reproductive freedom, forging a path to ban abortion nationwide, and trampling the checks and balances that protect our democracy.

THE COURTS

By stacking the courts with ideological allies, Trump has turned the judiciary into a central tool for entrenching his extremist agenda and insulating it from public accountability:

• Trump has nominated and secured the confirmation of 13 anti-reproductive freedom judges to lifetime appointments on the federal bench in 2025, selected for their loyalty to him
• The Supreme Court has repeatedly rubber-stamped Trump’s radical agenda through devastating decisions, including Medina v. Planned Parenthood South Atlantic and United States v. Skrmetti

THE LEGISLATURE

Instead of serving as a check on executive overreach, congressional Republicans have helped carry out Trump’s agenda:

• Gutted Medicaid, cutting more than $930 billion over 10 years, which the nonpartisan Congressional Budget Office estimates will rip coverage away from more than 10 million Americans and put 144 rural hospitals at risk of closing labor and delivery units
• Barred Medicaid reimbursements to (defunded) Planned Parenthood and certain health care providers who also provide abortion care, forcing health center closures and threatening care for more than 1.1 million patients
• Enacted work requirements with burdensome reporting that will disproportionately affect women
• Confirmed Trump’s extreme cabinet nominees to key positions that impact reproductive freedom —including Robert F. Kennedy Jr., Martin Makary, Pam Bondi, Russell Vought, Mehmet Oz, Marco Rubio, Harmeet Dhillon, and more
• Refused to extend the Affordable Care Act (ACA) enhanced premium tax credits that 22 million people relied on to afford their health insurance, leading costs to skyrocket and families to lose coverage
• Stripped a provision from the National Defense Authorization Act (NDAA) that would have expanded IVF insurance coverage for active duty military members and their families

THE WHITE HOUSE AND FEDERAL AGENCIES

Trump has weaponized federal agencies and used executive authority aggressively and indiscriminately to dismantle reproductive freedom, undermine public health, and silence opposition:

• Signed an executive order targeting trans people and inserting “personhood” ideology—which lays the groundwork to ban abortion and restrict IVF, birth control, and other reproductive health care—into official administrative policy
• Rescinded President Biden’s executive order establishing the White House Gender Policy Council, which was charged with advancing gender equity and equality, including reproductive freedom
• Challenged existing election systems and democratic norms to tilt the political scales in favor of Republicans ahead of the 2026 midterms
• Launched a politically motivated FDA “safety review” of mifepristone, ignoring decades of science at Trump’s direction and pressure from anti-abortion organizations, citing a debunked anti-abortion report
• Rescinded Biden-era guidance that reaffirmed hospitals’ requirement to provide lifesaving abortion care under the Emergency Medical Treatment and Labor Act (EMTALA), endangering patients’ lives and inflicting chaos and confusion for providers
• Directed the Department of Justice (DOJ) to drop United States v. Idaho, a federal lawsuit brought by the Biden administration that sought to protect emergency care for pregnant people
• Slashed  reproductive health care for service members, veterans, and their families by effectively banning all abortion at the VA, reinstating abortion care and counseling exclusions from the VA medical benefits package, and revoking leave policy and travel reimbursement for non-covered reproductive health services
• Withheld roughly $35 million in Title X family planning funding from more than 16 organizations, threatening the nationwide network of clinics that provide affordable contraception, cancer screenings, and other services to millions of patients
• Eliminated Title X in the Office of Budget Management (OMB) FY26 Discretionary Budget Request, effectively gutting the nation’s sole federal family planning program and jeopardizing affordable reproductive health care for millions.
• Gutted the Centers for Disease Control (CDC) Division of Reproductive Health, including teams on contraceptive guidance and maternal mortality
• Pardoned 23 anti-abortion extremists convicted under the Freedom of Access to Clinic Entrances (FACE) Act, which protects providers and patients from violence and harassment
• Directed the DOJ to drop FACE Act charges and  roll back enforcement of the law, emboldening perpetrators of anti-abortion violence
• Reinstated the Global Gag Rule, cutting off funding to international NGOs that provide abortion services or information
• Terminated $377 million in UNFPA grants for reproductive health in humanitarian settings
• Dismantled the United States Agency for International Development (USAID), ending all international family planning grants and abruptly severing lifesaving reproductive health care access for millions worldwide

These attacks aren’t random—they’re part of a coordinated effort to dismantle democracy, strip away fundamental rights, and roll back reproductive freedom everywhere. And the blueprint is in the pages of Project 2025, which is already 50% completed one year into Trump’s second term.

But sweeping wins for reproductive freedom in the 2025 election cycle proved that voters remain engaged, motivated, and unwilling to surrender their rights or their voice. It’s clear that Trump and his allies do not want to make reproductive freedom a visible issue heading into this year’s midterm elections—but it’s too late for that. They’ve already put it front and center by laying the groundwork to ban abortion in all 50 states, and they must answer for that in 2026.

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For over 55 years, Reproductive Freedom for All (formerly NARAL Pro-Choice America) has fought to protect and advance reproductive freedom at the federal and state levels—including access to abortion care, birth control, pregnancy and post-partum care, and paid family leave—for everybody. Reproductive Freedom for All is powered by its more than 4 million members from every state and congressional district in the country, representing the 8 in 10 Americans who support legal abortion.