In the end, after months of playing coy and extracting concessions, Manchin reluctantly agreed to support a differently named, less sprawling legislative package—but only if paid leave and the Child Tax Credit were left out. It was a bitter pill, but Biden and congressional Democrats had no choice but to swallow it. They secured the most important climate legislation in history and investments in many key priorities. But once again, “women’s issues” were left on the cutting-room floor.
In 2022, American women lost constitutional rights that we’ve counted on for decades. An ultraconservative majority on the Supreme Court is poised to continue ripping away progress we’ve made for women and families. Right now, it can feel like all we can do is play defense and fight like hell to claw back what we’ve lost. But that’s right where they want us. Lowering our sights. Limiting our ambitions. Yes, we need to regain the ground we’ve lost. But it’s also crucial to stay on offense. Keep dreaming big about how to build a better, fairer country. We need a “yes, and” approach. Yes, Democrats must do everything possible to defend and restore legal abortion—and we must also champion investments in childcare and education. Yes, stop attacks on maternal health—and keep advocating for paid family and medical leave. Yes, fight back against attempts to deport millions of immigrants that will decimate America’s care workforce—and push to give care workers better pay and benefits. We might not achieve all this tomorrow or even in the next four years. But it’s important to set lofty goals that people can organize around and dream about, even if it takes generations to achieve them.
That’s what happened with universal health care. For a hundred years, Democrats campaigned on giving all Americans access to affordable, quality care. Bill and I tried to get it done in the 1990s, and we succeeded in creating the Children’s Health Insurance Program to cover children in working- and middle-class families with parents who worked jobs without employer-provided health insurance but made too much to qualify for Medicaid. It wasn’t until Obama was swept into office with a supermajority in the Senate that we could finally pass the Affordable Care Act in 2010. Even then, it was a hodgepodge of imperfect compromises. But that historic achievement was possible only because Democrats had kept universal health care as our North Star for decades.
We also simply need to elect more women who will fight for working parents. History has shown that unless women have the power to drive these reforms they won’t happen. Men should understand that these are their issues, too, and the smart ones do. That’s why Bill signed the FMLA, Obama passed the Affordable Care Act, and Biden made such ambitious proposals. But too many men, even Democrats, don’t prioritize these issues.
It’s important to note that it’s not just men who oppose care policies. Plenty of Republican women are against them, too. As Nancy Pelosi was trying to pass paid family leave through Congress in 2021, Colorado representative Lauren Boebert (bizarrely) explained she was against it because she allegedly gave birth to one of her children in her truck: “I delivered one of my children in the front seat…. Because, as a mom of four, we got things to do. Ain’t nobody got time for two and a half months of maternity leave.” (Actually, they do.) And in response to Governor Gretchen Whitmer’s push to improve paid leave, Christina Doerr, a spokesperson for Michigan House Republicans, published a memo criticizing Whitmer’s plans to support hardworking families by calling paid leave a “summer break for adults.” As my friend Madeleine Albright said, there’s a special place in hell for women who don’t help other women.
At a 2024 rally hosted by a coalition of organizations, advocates, and caregivers called Care Can’t Wait, Biden proposed historic care laws, including national paid family leave, affordable childcare, investments in early childhood education, and extending the Child Tax Credit. He was joined on-stage by hardworking Americans whose lives have been impacted by our country’s lack of these policies—people like Crystal Gail Crawford, who lost her job as a nanny when COVID hit, was injured in a car accident a few months later, and relied on her mom to care for her during her recovery. “That’s when I realized in a whole new way how important care is,” she told the crowd. “It’s a constant in my family.”
It’s a constant in Sylvia Liang’s family, too. Sylvia quit her job to care for her autistic son full-time because she couldn’t find anyone to help care for him. And Tiffany Mrotek, who struggled with postpartum depression, said she “desperately needed paid time to come back to myself and find my identity as a mom.” She went on to say that even though she had some maternity leave through her employer, it hadn’t been nearly enough. “I am heartbroken for parents who don’t get that privilege. We want all women and new parents to get the opportunity to have that pause and be present.”
Each of their stories affirms the importance of the policies Democrats are fighting for. It’s just one of the many reasons to be excited about the 2024 election and what it could mean for our future. We’re not just voting against Donald Trump; we’re voting for a future where families thrive, our economy prospers, and women can actually balance family and work. To do that, we need what the 1971 childcare coalition did not have but has steadily been building ever since: a mobilized majority of voters seizing power and applying political pressure. We need all of us.
Franklin Roosevelt famously told a group of activists who sought his support for bold legislation on civil rights, “You’ve convinced me. Now go out and make me do it.” Movements succeed with political pressure from both outside and within. That’s why advocacy groups are so important. Why voting is so important. Why making our voices heard in every legislative fight is so important. We haven’t won them all, but we’re getting closer and closer.
DOBBS
AND DEMOCRACY
On a hot August day in 2022, the nation’s eyes were on the reliably conservative state of Kansas. Across the state, Kansans stood in long lines to vote in the first referendum on abortion rights since the U.S. Supreme Court overturned Roe v. Wade two months before, ending the constitutional right to abortion nationwide. The question was whether to amend the state constitution to remove the right to an abortion, which had been affirmed by the Kansas Supreme Court in 2019. If the measure passed, it would allow Republicans in the legislature to ban abortion statewide. If it failed, then women in Kansas would keep both their freedom to choose and their right to access needed health care despite the fall of Roe.
The outcome was anything but certain. Though Kansas had been the first state to hold a referendum on women’s suffrage, the first state to elect a female mayor, and one of the first states to ratify the Equal Rights Amendment, it had a long history of hostility to abortion rights. Lawmakers had repeatedly tried to ban the procedure. Thirty years ago, abortion opponents staged a “Summer of Mercy” in Wichita that was anything but merciful. They lay down in front of cars to prevent women from reaching clinics and getting the care they needed. In 2009, Dr. George Tiller, an abortion provider whose clinic was bombed in 1986 and who survived an assassination attempt in 1993, was shot dead while serving as an usher at his Wichita church by an anti-abortion extremist. And Donald Trump, who promised to appoint Supreme Court justices who would overturn Roe, had won the state by fifteen points over Joe Biden in 2020. So there were plenty of reasons to expect Kansas voters would embrace an amendment to end abortion rights in their state.
But after Roe was overturned, the ground seemed to shift. The week after the ultra-right-wing majority on the U.S. Supreme Court announced their decision, voter registration in Kansas increased by over 1,000 percent. More than 70 percent of those newly registered voters were women. Was this a political earthquake or a blip? It was hard to tell. Registered Republicans still far outnumbered Democrats statewide, and going into Election Day, polls showed voters narrowly divided.
As temperatures reached the triple digits that August day, more than nine hundred thousand Kansans showed up to the polls—the biggest turnout for a primary (or referendum) in the state’s history. The last voter, a woman in Wichita, cast her ballot at 9:45 p.m. after waiting in line for nearly three hours.
Kansans held their breath (I did, too) until the result was announced around midnight. Unexpectedly strong support for abortion rights from independent voters led to a landslide victory of 59 to 41 percent. Fourteen counties that went for Trump in 2020, as well as all five that went for Biden, voted against the amendment and for reproductive freedom. Abortion rights were safe in Kansas—for now.
I was relieved but painfully aware of how much work remained and how much suffering lay ahead. Earlier that summer, when I read the Supreme Court opinion authored by Justice Samuel Alito striking down Roe, I thought about the women whose health or lives were saved because they had access to a safe and legal abortion. I’m old enough to remember life in the United States before Roe, when thousands died from botched, illegal abortions and untold numbers of women had no choice as to whether they became mothers—regardless of their personal situations.
I’ve also seen what it’s like when the heavy hand of the state reaches into women’s lives and bodies, robbing them of autonomy and liberty. I have visited countries around the world where governments forced women to bear children against their will or made them terminate pregnancies they wanted to keep. I will never forget meeting survivors of the brutal dictatorship in Romania, which strictly outlawed abortion. Every month, women were subjected to humiliating examinations in their workplaces to check if they were using contraception or pregnant, in which case the secret police would monitor them to make sure they delivered (something Trump has proposed allowing states to do if he’s reelected). In China, I met women who endured similar government intrusion with the opposite goal: The Communist Party forced them to have abortions or be sterilized in order to limit population growth. I knew that without the shield of Roe, many American women who had long taken our freedoms for granted would now face a dangerous future.
Since then, it’s been chilling to watch Republican lawmakers race to propose new state laws to criminalize abortion, sometimes without exception—not for rape or incest or, in some cases, even to save a woman’s life. Never mind that doctors have recounted delivering babies to young girls forced to carry to term, including one who clutched a teddy bear while in labor. Never mind that women with high-risk pregnancies are dying from lack of access to lifesaving abortion care—like Yeniifer Alvarez-Estrada Glick of Luling, Texas, who died at age twenty-seven from serious, life-threatening complications during pregnancy just weeks after Texas enacted its harsh new abortion ban. Multiple experts who reviewed Yeniifer’s case said that her death was preventable, that an abortion would have likely saved her life, but her doctors denied her medical information and treatment. One in three women of reproductive age in the United States now lives under an abortion ban. This has devastating consequences. Women in states with laws that limit or ban abortion in most cases are up to three times more likely to die during pregnancy, childbirth, or soon after giving birth. Infant mortality goes up, too. For example, after Texas banned abortions after six weeks, the state’s infant death rate increased and more babies died of birth defects. And an Everest of evidence shows that when women are forced to carry unwanted pregnancies, it negatively impacts their health, lives, and safety. Abortion bans also have a chilling effect among doctors. Ninety-three percent of OB-GYNs in states that have banned or severely restricted abortion say they have been unable to follow standards of care because of abortion laws. Abortion bans are driving doctors out of hostile states (Idaho lost nearly a quarter of its practicing OB-GYNs since Roe was overturned, including more than half of the state’s high-risk doctors). And medical students are less likely to apply for residency in states with abortion bans.
We’re also seeing the criminalization of pregnancy outcomes, like when a woman named Brittany Watts in Ohio faced criminal charges for miscarrying a pregnancy at home. I was grateful those charges were later dropped, but data shows that upward of 1,200 women have been arrested for pregnancy outcomes post-Roe. These arrests are usually in the South and typically target poor Black pregnant women.
The zeal with which some right-wing extremists seek to punish women and doctors, including proposing classifying abortion as homicide and giving prosecutors the power to seek the death penalty, echoes the ugly misogyny of foreign dictators. Think of Russia’s Vladimir Putin decriminalizing domestic violence, or Iran’s religious authorities assaulting, imprisoning, and killing young women for removing their headscarves, or the Taliban stoning women in Afghanistan. Misogyny is hatred of women. It’s the rage that makes men confuse cruelty for morality—that makes them think they should own women’s bodies and dictate women’s choices.
This dark reality is what I feared would eventually happen when George W. Bush nominated Alito to replace Sandra Day O’Connor on the Supreme Court in 2005. O’Connor was a true conservative, appointed by Ronald Reagan, and I disagreed with her about many things—especially her complicity in the truly egregious decision in Bush v. Gore that handed the 2000 election to the Republicans. But O’Connor stood up for civil liberties and fundamental freedoms at key moments, including the right to a safe and legal abortion. By comparison, Alito struck me as an angry, unconstrained ideologue, and as senator from New York I strongly opposed his confirmation. “This nomination could well be the tipping point against constitutionally based freedoms and protections we cherish as individuals and as a nation. I fear that Judge Alito will roll back decades of progress,” I warned on the Senate floor, adding, “Roe v. Wade is at risk; the privacy of Americans is at risk; environmental safeguards; laws that protect workers from abuse or negligence; laws even that keep machine guns off the streets. All these and many others are in peril.” I take no pleasure in having seen what was coming.
In his Dobbs v. Jackson decision, Alito claimed that overturning Roe would “allow women on both sides of the abortion issue to seek to affect the legislative process.” “Women,” he wrote, “are not without electoral or political power.” Translation: Stop complaining. If you don’t like us taking away your rights and turning the clock back on women’s equality, just try to stop us. You’ll find that we Republicans will beat and block you at every turn. Which of course misses the whole point that having a constitutional right means that it’s yours wherever you live, whether it’s popular or not.
To what I can only imagine is the great surprise and consternation of Alito and his ilk, women did, in fact, rise up and seize that political power. The Kansas referendum was the first big sign that a wave of anger and activism was building that could remake the political landscape. The results—and the depth of support for abortion rights—shocked Republicans and, frankly, a lot of Democrats, too. Since then, we’ve seen that Kansas was no fluke. Women (and a lot of men) have voted to enshrine reproductive freedom in overwhelming numbers at virtually every opportunity. They’ve done it in reliably blue states like Vermont and California, swing states like Michigan, and even red states like Montana, Kentucky, and Ohio.
For a lot of voters, this goes beyond politics. It’s visceral and personal. It’s fundamental. Abortion bans are a denial of women’s citizenship and humanity. There is no freedom without bodily autonomy—and no autonomy without full reproductive health care.
Watching women and men rise up for abortion rights in places like Kansas and Kentucky reminded me of a great line from Shirley Chisholm, the first Black woman to be elected to Congress and to run for president. “The law cannot do it for us,” she said. “We must do it for ourselves. Women in this country must become revolutionaries.” Amen.
All of this terrified Republicans, turning their long-sought holy grail into a poisoned chalice. Alito’s patronizing comment about women’s political power had come true in ways they never expected. They needed to do something or risk disaster. Would they moderate their policies? Seek compromise? Listen to voters? To women? Of course not.
Instead, Republican leaders across the country made a strategic decision. If people were going to vote for abortion rights, then they just had to make it harder for them to vote at all.
In 2023, Republican lawmakers introduced fifty-eight proposals intended to make it harder for ballot measures to come before voters. This was not a coincidence. They’re trying everything they can think of to make it harder for grassroots abortion rights campaigns to succeed, from requiring more signatures across a district for an initiative to reach the ballot (known as “geographic distribution requirements”) to raising the bar for passage and requiring large supermajorities. The Brennan Center for Justice rightly noted this is “part of a larger anti-democracy blueprint—yet another example of state officials trying to manipulate the rules of elections and obstruct the will of voters.”
The Ohio secretary of state, a Republican named Frank LaRose, said the quiet part out loud: “It’s 100 percent” about keeping abortion off the ballot.
I’ve paid particular attention to what’s been happening in Arkansas, where a near-total abortion ban threatens to make already-high maternal mortality rates even worse. When I gave birth to Chelsea in Little Rock in 1980, Arkansas’s maternal and infant mortality rates were among the highest in the country, in large part because of lack of access to quality health care. Many rural hospitals did not offer labor and delivery services for expectant mothers. I saw this firsthand as chair of a state task force on rural health care. As governor, Bill made it a priority to provide better care for pregnant women and infants. He ran public awareness and educational campaigns across the state and invested heavily in rural hospitals. I was proud of the progress we made in Arkansas, and the lessons we learned later informed our push for national health care reform. So it breaks my heart that women in Arkansas are again losing ground.
The state’s draconian abortion ban means that women are being denied essential health care services. Sixty percent of rural hospitals still do not offer labor and delivery services and Black women are more than twice as likely to die from pregnancy-related causes than white women. A 2023 report found that 92 percent of pregnancy-related deaths in Arkansas were likely preventable. To keep abortion inaccessible and prevent Arkansas voters from improving access to reproductive health care, Republican governor Sarah Huckabee Sanders tripled the number of counties where signatures must be gathered for proposed initiatives to qualify for the ballot. She did this even though, in 2020, Arkansans rejected a measure that sought to add hurdles by increasing geographic distribution requirements, instituting a 60 percent supermajority, and eliminating the opportunity to fix any problems with voter signatures. In 2022, they again voted down a supermajority requirement. Sanders and Republican legislators pushed through the changes anyway, ignoring the state’s motto, Regnat populus, “The people rule.”
Undaunted, Arkansans gathered signatures to put a constitutional amendment on the ballot to reverse the state’s abortion ban and limit government interference in health care decisions. By July 2024, they had enough to overcome the state’s hurdles. But the secretary of state is now challenging their paperwork to keep abortion off the ballot. We don’t know the final outcome as of now, but Arkansans are fighting back. John Brummett of the Arkansas Democrat-Gazette wrote, “However it turns out, and it may turn out well, this abortion petition effort, amid intimidation without outside money or manpower and against all odds, is heroic.” I’m proud to support the Arkansans working on this effort through Onward Together, an organization I launched in 2017 to empower those working for democratic progress. I’m hoping that in November we’ll see a repeat of what happened in Kansas.
A similar story has played out in a number of Republican-controlled states. The attorney general of Montana tried to stop a constitutional amendment to protect abortion access from going before voters. The state’s supreme court ruled against him, and supporters are gathering the sixty thousand required signatures needed to put it on the November ballot. In Missouri, where abortion rights advocates are trying to amend the constitution, Republicans have repeatedly attempted to change the rules so that any amendment would have to receive not only a majority of the vote statewide but also a majority in five of eight congressional districts (five of which are deeply conservative). In Mississippi, which already bans most abortions, state lawmakers are trying to pass an initiative that would make it impossible to change abortion laws through statewide elections. In Florida, which recently banned abortions after just six weeks, Republican attorney general Ashley Moody asked the state supreme court to block a proposed abortion rights initiative from reaching voters, saying that the language would “hoodwink” them. The state’s supreme court ruled that the initiative could proceed, and advocates collected enough signatures to put an amendment on the ballot this November. And after voters in Ohio approved a constitutional right to abortion in 2023 (overcoming a new supermajority requirement), Republican legislators are now trying to prevent the courts from enforcing it.
It’s been infuriating but not surprising to watch anti-choice Republicans—who for years repeated the talking point that abortion policy should be left to the states and the democratic process—suddenly change their tune. Now, many are all in for a federal abortion ban. And the last thing they want is for Americans to be able to vote on any of this. They’ve learned the hard way that voters overwhelmingly support reproductive freedom and oppose government overreach. Don’t just take my word for it. Former Republican senator Rick Santorum complained, “Pure democracies are not the way to run a country…. You put sexy things like abortion and marijuana on the ballot and a lot of young people come out to vote.” (Yes, Rick. That’s how democracy works—voters cast ballots for issues they care about.)
But make no mistake, abortion will be on the ballot this November, and reproductive rights are very much at risk even in the bluest states. If Trump returns to the White House, he and his allies will seek to ban abortion nationwide. We shouldn’t be fooled that the braggart who crowed about “terminating” Roe is now trying to minimize backlash by obfuscating his position on the issue. One week he promises to sign a national abortion ban. The next, he says states should decide, including whether to monitor women’s pregnancies and prosecute those who seek illegal abortions. Then he says he’s personally for protecting the life of the mother and for exceptions for rape and incest, but he wants states to have the power to ban those exceptions and even jail women who disagree. He can’t be trusted.
What we know is that if he wins in 2024, his whole administration will be filled with people doing everything they can to erase reproductive rights, full stop. On day one he could also sign an executive order canceling the Food and Drug Administration’s approval of mifepristone and misoprostol (used to induce abortion and essential for treating miscarriages) without congressional approval. He could categorize abortion medication as controlled dangerous substances like Louisiana legislators did in May 2024, criminalizing women and anyone who helps them obtain these drugs. He could enforce the Comstock Act, a long-dormant 1873 law that criminalizes the mailing of any materials used in an abortion, including abortion pills and medical equipment used in surgical abortions. That would likely force many clinics in the country to close. He could reverse the Biden administration’s requirement that federally funded hospitals perform lifesaving abortions, even in the sixteen states with near-total bans. In April 2024, Idaho argued before the Supreme Court that its ban (which only allows abortion to prevent a woman’s death) doesn’t conflict with the federal law—even if denying an abortion means the loss of reproductive organs, future fertility, or other organs. As writer Jessica Valenti put it, “It’s pretty discouraging to watch the nation’s highest court hear arguments over just how sick you have to be, or just how many organs you can lose, before hospitals are legally required to give you care.” The Court later dismissed the case on a legal technicality, essentially kicking the can down the road while anti-choice extremists are doing everything they can to control women’s bodies.
It’s not just abortion that’s at risk. In 2024, some clinics in Alabama briefly stopped offering in vitro fertilization (IVF) services after the state supreme court ruled that frozen embryos are people. (No one knows better than a woman undergoing IVF that an embryo is not a child.) The blowback was intense, and the Alabama legislature scrambled to pass a temporary fix. But Republicans in Congress blocked Senator Tammy Duckworth’s efforts to protect IVF nationwide. Tammy, who had both of her children with the help of IVF, said, “IVF made our family. It made my heart whole. It made my life full.” In a second Trump administration, this vital treatment could disappear everywhere. Reproductive rights groups are worried about so-called fetal personhood bills, which lawmakers in more than a dozen states are considering and which could be used to prosecute pregnant people for miscarrying or potentially for undergoing IVF. Trump would also likely ban fetal stem cell research. And don’t be surprised if they come for contraception next. House Republicans voted overwhelmingly against federal protection for birth control after Dobbs, and extremists on the Supreme Court want to revisit Griswold v. Connecticut, which legalized contraception for married couples in 1965.
Trump doesn’t talk much about abortion on the campaign trail. He knows all this is deeply unpopular. But he brags to his base that he’s the president responsible for finally killing Roe, and it’s true. If given the chance, he’ll go even further next time. As Vice President Harris has said in rally after rally, another Trump term means “more bans, more suffering, and less freedom.” I believe voters will ultimately see through his lies, recognize the threat, and stand up for their rights, just as they did in Kansas. Despite right-wing efforts to silence voters and shut down the democratic process, we still have a voice and a vote. It’s imperative we use both.
Panicky Republican efforts to restrict direct democracy to prevent voters from protecting abortion rights brings together two issues at the heart of the 2024 election: Dobbs and democracy. Yet the truth is abortion rights and democracy have always been entwined, even if before the fall of Roe it was rarely framed that way. Democracy is about voting and fair elections and majority rule (all of which are now under assault)—and it’s also about civil rights, individual freedoms, and protections for minorities that should not be subject to the whims of the majority. Nearly thirty years ago I caused a bit of a stir when I said that women’s rights are human rights. They still are. A country can’t be a true democracy if women are denied the right to make decisions about their own bodies and their own health care.
