Democrats are not necessarily pro-abortion: they are pro-choice and believe that abortion should be safe and legal. President Joe Biden’s Build Back Better bill supports that by including provisions that could help reduce unwanted pregnancies by expanding health care coverage for poor women and demand for abortions by expanding the social safety net to lower the cost of raising children.

As the Center for American Progress noted back in 2006 in a piece titled “The Right Way to Reduce Abortion”: “Simply put there are two key ways to reduce abortion—by making it less necessary or by making it less available. In our view, only the former approach is humane, effective and just.”

It may surprise some but abortion rates have fallen the most under Democratic administrations, and remained flat or decreased only marginally under Republican administrations. Just compare abortion rates under Presidents Barack Obama and George W. Bush. Under Bush, abortion rates hovered at about 16 per every 1,000 women for most of his two terms, then dropped from 15.8 in 2008 to 15 in 2009, according to Quartz. When Obama was president, abortion rates fell from 16.9 per every 1,000 women in 2011 to 13.5 in 2017, a drop of 20%, according to The Guttmacher Institute, a research and policy organization committed to advancing sexual and reproductive health and rights worldwide.

What’s the difference? Bush funneled money to the abstinence-only sex education hucksters, which did little to reduce unintended pregnancies. Obama supported medically accurate sex education and the Affordable Care Act took effect in 2012. It made contraception accessible to more people as private health insurance plans were required to cover reproductive care, and Medicaid was expanded to cover more women. According to The Guttmacher Institute, under the ACA, the proportion of women aged 15-44  nationwide who were uninsured dropped more than 40% between 2013 and 2017. What the ACA did was reduce the number of unintended pregnancies, one of the main reasons patients seek abortions. 

In another report, The Guttmacher Institute said that “one of the two most common reasons women choose abortion is because they cannot afford a(nother) child.” Back in 2006, the Center for American Progress said a second positive way to reduce abortion is to ensure that a parent “has the means to have and raise a child in health and safety should she wish to do so.”

And that’s exactly what Biden’s $1.75-trillion Build Back Better plan does, although not to the extent we would like, thanks to Sens. Joe Manchin and Kyrsten Sinema. TIME magazine summed up some of the House bill’s provisions (which could be reduced by the Senate) that ease the cost of raising a child:

$400 billion for universal pre-K education for three- and four-year-olds. According to the bill, families earning less than $300,000 a year will pay no more than 7% of their income on child care for kids under age six.
$200 billion for child tax credits. The bill provides a one-year extension of the pandemic-era child tax credit, which provides parents with $300 monthly per child under age six and $250 every month per child ages six to 17.
$200 billion for four weeks of paid leave. The bill establishes a permanent national paid leave program that gives workers four weeks of paid family and medical leave, which can be used for caregiving or personal illness.
$150 billion for affordable housing. The bill calls for building more than 1 million new rental and single-family homes, and would provide rental and down-payment assistance through an expanded voucher program. 
$165 billion for health care spending. The bill would reduce health care premiums under the Affordable Care Act by several hundred dollars a month, making it easier for some people who are currently uninsured to gain health insurance. It would permanently fund the Children’s Health Insurance Program, which covers 10 million low- and middle-income children.

The bill would also provide coverage to several million people, many of them people of color in the 12 states, including Mississippi and Texas, that have locked them out of Medicaid. 

A 2012 Supreme Court decision upheld the constitutionality of the Affordable Care Act, but allowed individual states to opt out of the act’s expanded Medicaid coverage. That expansion of Medicaid coverage makes the BBB human infrastructure bill more urgently needed than ever given the likelihood that the Supreme Court next summer will cripple or overturn Roe v. Wade. For starters, it will provide reproductive care, reduce unwanted pregnancies, and result in fewer abortions.

At the Dec. 1 Supreme Court hearing on the Mississippi law banning nearly all abortions after 15 weeks, the Handmaid’s Justice Amy Coney Barrett indicated that she had no problem forcing people to take a pregnancy to term and then using “safe haven” laws to put the newborns up for adoption. Barrett can easily afford to raise her seven children, two of them adopted. She has been a law professor at Notre Dame and a federal judge, and her husband was a partner in a South Bend, Indiana, law firm before moving to D.C.

She failed to take into account that the U.S. has the highest maternal mortality rate among developed countries. Mississippi has the highest infant mortality rate in the nation, according to the federal Centers for Disease Control and Prevention. Studies have shown that getting a legal abortion is safer than giving birth, especially now that medically induced abortions are more available.

In her response to Barrett, Julie Rikelman, a lawyer for the Center for Reproductive Rights, said, “It’s 75 times more dangerous to give birth in Mississippi than it is to have a pre-viability abortion, and those risks are disproportionately threatening the lives of women of color.”

The BBB bill at least would lower the risk to the lives of poor women of color in states like Mississippi by ensuring prenatal coverage under Medicaid if they’re forced to carry a pregnancy to term should Roe be overturned. It would also protect people nationwide by expanding Medicaid coverage to new parents for a full year after giving birth, instead of just two months as in some states like Mississippi, allowing more time to address postpartum medical complications.

In March, as Mississippi was asking the Supreme Court to uphold its 15-week abortion ban, the state legislature failed to approve a measure that would have extended postpartum Medicaid coverage to a full year, the Associated Press reported. Mississippi’s Medicaid program usually offers only two months of coverage after giving birth.

A Kaiser Family Foundation Medicaid budget survey found that about 67% of all births in Mississippi in 2017 were covered by Medicaid, according to the AP story. About one-quarter of the state’s population is covered by Medicaid.

Democrats need to hammer these hypocritical faux-Christian GOP legislators at the state and federal level for their failure to do anything before and after birth to help people they want to force to carry a pregnancy to term.

Democrats also should make people aware that policies like the BBB bill, which expand health care coverage and lower the costs of raising children, will reduce abortions in a way that is safer and more effective than the bans pushed by Republicans—which do little to lower demand for abortions. Instead they give patients the choice of seeking a costly out-of-state abortion or resorting to other options that put them at more risk of severe illness or even death.

The looming threat to Roe makes it even more urgent to pass the BBB bill. Although unlikely, Senate Democrats should use the changed circumstances to get at least one of the two pro-choice Republican senators, Susan Collins of Maine and Lisa Murkowski of Alaska, to flip and support the Build Back Better bill.