For Donald Trump and Congressional Republicans, cruelty is the point. Their passage of the Republican Budget is a calculated, catastrophic decision that prioritizes tax breaks for billionaires over the health, dignity, and autonomy of millions of people. This legislation is not just a federal overreach that blows a $3 trillion hole in the nation’s deficit — it wages a backdoor war on reproductive health care.
This budget emergency, manufactured by the extremists behind Project 2025, threatens to shutter nearly 200 health centers and could eliminate 1 in 4 abortion providers nationwide — disproportionately harming patients in states where abortion remains legal. And while Medicaid does not fund abortion, this budget directly targets Planned Parenthood, threatening to close half of its abortion providing health centers.
At the taxpayers’ expense, Congressional Republicans have kneecapped hospitals and health centers — including labor and delivery departments — and will strip Medicaid coverage from 11.8 million people. The Republican Budget also jeopardizes SNAP, which provides food and nutrition assistance to 40+ million Americans. It imposes burdensome and unnecessary Medicaid eligibility requirements and defunds critical care systems that are vital to reproductive and pregnancy care access — especially for people with low incomes, young people, immigrants, people of color, and folks living in rural communities.
This is a crisis. And while the federal government has chosen political theater over public health, states now carry the responsibility to lead. This is where the fight turns. Governors and state legislators must meet this moment with urgency, not hesitation. The National Institute for Reproductive Health Action Fund calls on state and local leaders to take swift, decisive action to mitigate the damage and ensure access to care. That includes:
- Convening emergency legislative sessions to address gaps created by this budget catastrophe;
- Extending state Medicaid coverage, expanding eligibility, and removing barriers to reproductive care;
- Launching or strengthening public funding programs for abortion and pregnancy-related care;
- Protecting patients and providers with shield laws and data privacy safeguards;
- Codifying Affordable Care Act protections and reproductive health access into state law;
- Limiting or eliminating out-of-pocket costs for contraception, medication abortion, and hormone therapy; and
- Prioritizing government efficiency reforms over harmful cuts to essential services.
This is the moment to act — not in defense of the status quo, but in pursuit of something stronger. NIRH and the NIRH Action Fund will mobilize every tool at our disposal to support policymakers, advocates, and communities in building durable, equitable systems of care—especially in states that are ready to lead.