Dear Alan, My boyfriend voted for Donald Trump!

A friend of mine is distressed because her boyfriend voted for Donald Trump. He voted for Trump because he thinks that Biden "is into killing babies."

Wrong. If anybody is into killing babies, it's Republican politicians, including Trump.

Everybody -- Democrats, Republicans, pro-choice voters, and pro-life voters -- agrees that there are too many abortions in this country. There are too many abortions because there are too many unwanted pregnancies. There are too many unwanted pregnancies because of failure to use contraception.

The Democratic strategy to eliminate abortion, supported by Joe Biden, is to eliminate unwanted pregnancies by making affordable, reliable contraception available to women. This strategy works. From 1981 to 2016, which is the last year for which the CDC has released data, the abortion rate fell by more than half. It fell 48% during the sixteen years of the Clinton and Obama administrations, but only 11% during the twenty years of the Reagan, GHW Bush, and GW Bush administrations.



The Affordable Care Act, passed during the first term of the Obama/Biden administration, has done more than any other Act of Congress to reduce the abortion rate. It brought health care, including contraception, to more than 20 million Americans who didn't have it before. Furthermore, the contraceptive mandate of the Affordable Care Act guarantees women access to reliable contraception without any out-of-pocket costs.

Throughout President Obama's entire second term, the abortion rate was lower than in 1972, the year before Roe v. Wade, when abortion was illegal in 44 states. It fell below the 1972 level in 2013, the year the contraceptive mandate of the Affordable Care Act went into effect for most health plans, and it continued to fall throughout the rest of the Obama/Biden administration. Thanks primarily to the Affordable Care Act, the U.S. abortion rate fell 26% during the Obama/Biden administration.

When we examine annual changes in the U.S. abortion rate, the superiority of the Democratic approach becomes even more obvious.



The CDC's data from 1998 (when the CDC began to report the change in the abortion rate to an accuracy of 0.1 abortions per 1000 women rather than 1 abortion per 1000 women) through 2016 (the last year for which the CDC has reported data) includes eleven years under Democratic administrations (Clinton and Obama) and eight years under the George W. Bush administration. The ten largest percentage decreases in the abortion rate all occurred in Democratic administrations. If annual changes in the abortion rate were independent chance events, there would be less than one chance in 37,000 that Democrats would be this much more successful in reducing the abortion rate than Republicans.

The Republican abortion strategy, supported by Donald Trump, is to:

• Claim to be "pro-life";


• Oppose the Democratic strategies that actually work;


• Cut off funds to medical facilities that provide abortions or abortion counseling, even though these facilities also provide contraception;


• Appoint conservative justices to the Supreme Court who might overturn Roe v. Wade, the ruling that legalized abortion in every state.

Every part of this Republican plan has problems.

• Claiming to be "pro-life" appeals to pro-life voters but does nothing. Republican politicians who claim to be pro-life are either lying or unaware of the effects of the policies they support. Any politician who is in touch with reality and sincerely wants fewer abortions in this country logically must support the Affordable Care Act.


• Opposing the Democratic strategies that actually work creates abortions and kills people.
  
  Republican politicians supported legislation to repeal the Affordable Care Act, and they asked the Supreme Court, in a case that is still pending, to have the ACA declared unconstitutional. They succeeded in getting the Supreme Court to weaken the contraceptive mandate of the ACA. Republican politicians in many states oppose Medicaid expansion, another feature of the ACA, which brings health care, including contraception, to millions of Americans. Researchers from the University of Michigan, UCLA, the National Institute of Health, and the Census Bureau estimate that approximately 15,600 deaths would have been avoided from 2014 through 2017 if every state had adopted Medicaid expansion in 2014.


• Cutting off funds to medical facilities that provide abortion counseling creates more abortions than it prevents.
  
  Trump reimposed the Mexico City Policy, first imposed through presidential decree by Ronald Reagan in 1984. This policy denies U.S. foreign aid to foreign medical providers that provide abortion or abortion counseling. We have known since 2011 that this policy creates more abortions that it prevents, because the medical providers also provide contraception. Statisticians found that imposition of the Mexico City Policy during the G.W. Bush administration increased the abortion rate by about 40% in thirteen countries.
  
  Trump also imposed the Title X domestic gag rule, which denies Title X funding to medical providers that refer pregnant women to abortion providers. Again, these medical providers also provide contraception. Although the effect of this rule has not been studied quantitatively, there is every reason to believe that it creates more abortions than it prevents.


• From the point of view of a pro-life voter, Trump’s strategy of appointing conservative justices to the Supreme Court is not entirely without merit. The Court has allowed some restrictions on abortion that are consistent with Roe v. Wade, and it is possible that the Supreme Court will overturn Roe someday. Nevertheless, this strategy has many flaws.
  
  
  • Surprisingly few people want Roe overturned. According to a 2019 survey, a narrow majority of pro-life voters and the vast majority of pro-choice voters believe that Roe should be upheld.
  
  
  • Republicans have had 47 years to get Roe repealed and have come up empty. During this entire time, justices nominated by Republican Presidents have formed a majority on the Supreme Court. So far, most of them have supported Roe. In 1992, the Supreme Court upheld Roe when eight of the nine justices had been nominated by Republican Presidents.
  
  
  • We have no way of knowing if the Supreme Court will ever overturn Roe. It might happen next year or it might never happen. Stephen Breyer, Elena Kagan, and Sonia Sotomayor support Roe. John Roberts and Samuel Alito may uphold Roe on the grounds of stare decisis, which states that a precedent of the Court is settled law and should not be overturned without a compelling reason. In Gonzales v. Carhart (2007), Roberts and Alito had the opportunity to join an opinion by Clarence Thomas arguing that Roe should be reversed, but they did not do so.
  
  
  • If Roe were repealed, the abortion rate wouldn't fall much, because Democrats have already reduced the abortion rate below its pre-Roe level. Without Roe, some states would make most abortions illegal, but most women in those states seeking abortions could travel to states where abortion remained legal.
  
  
  • In order to get three additional conservative justices on the Supreme Court during the Trump administration, the Republican Senate ignored their Constitutional responsibility to advise on Supreme Court nominations, and they undermined two important Constitutional principles: the separation of powers and the system of checks and balances. After Antonin Scalia died 269 days before the election, the Senate refused to consider Obama's nomination of Merrick Garland, yet after Ruth Bader Ginsburg died 46 days before the election, the Senate, controlled by Republicans, confirmed Amy Coney Barrett. In their partisan rush to appoint conservative justices, Republicans have undermined public trust in the Supreme Court.
  
  
  • The conservative justices on the Supreme Court have undermined our health care and our right to vote.
    
    In NFIB v. Sebelius (2012), the Court allowed states to decline Medicaid expansion. In Burwell v. Hobby Lobby (2014), they allowed closely held companies to ignore the contraceptive mandate of the ACA.
    
    Trump recently said that if it were easier for people to vote, "you’d never have a Republican elected in this country again." In Shelby County v. Holder (2013), the Court gutted the Voting Rights Act of 1965, allowing states to pass voter suppression laws without judicial review. After that decision, Republican state legislatures in at least seven states passed laws that made voting more difficult. In Lamone v. Benisek (2019) and Rucho v. Common Cause (2019), the Court held that gerrymandering is deplorable, but there is nothing they can do about it. In Citizens United v. Federal Elections Commission (2010), the Court allowed unlimited election spending by corporations.
  
  
  Joe Biden is a church-going Catholic. He is personally opposed to abortion but doesn't wish to impose his belief on the rest of the country. Donald Trump goes to church irregularly or not at all, and mispronounces the names of some books of the Bible. Back in 1999, Donald Trump said that he was "pro-choice in every respect." Did he change his mind, or is he merely posturing?
  
  Does Donald Trump care about fetuses? Trump nominated three justices who probably will oppose Roe, but did he act out of conviction or out of political expediency?
  
  To actually care about abortion one way or the other, he would have to have a conscience, which I have not observed in him. He had an extramarital affair with a porn star, and he paid her hush money; he undermined the US Postal Service to such an extent that 300,000 absentee ballots could not be traced; he has told more than 23,000 lies as President; he held 18 rallies that produced more than 30,000 confirmed cases of COVID-19 and likely led to more than 700 deaths; and, as of October 2020, his intentional neglect of the COVID-19 epidemic led to between 130,000 and 210,000 avoidable deaths. As of this writing, he has refused to admit that Joe Biden won the election, and he is making unfounded claims of Democratic voting fraud.
  
  A wise man who was dying of cancer wanted to give his daughter advice about dating boys, but she was only eighteen months old. So he wrote a book and put his advice in the book for his daughter to read when she was older. His advice: "Just ignore everything they say and only pay attention to what they do." The same advice holds true about politicians.
  
  Republican politicians claim to be pro-life, but they create abortions. Democratic politicians prevent abortions. Pro-life voters should vote for Democrats. Pro-choice voters should continue to vote for Democrats because Democrats uphold the Constitution and support a woman's Constitutional right to choose.