She had barely opened her town hall to questions when Rep. Mariannette Miller-Meeks, a Republican from a competitive district in Iowa, was pressed to defend her opposition to abortion rights.
“One of the main functions of the federal government is to protect life,” Miller-Meeks, who won election in 2020 by just six votes, told a sparse crowd this month in Iowa City, a younger, more progressive part of her district where she rarely campaigns.
Miller-Meeks then quickly pivoted to politically safer terrain, telling her constituents about how she had also sponsored legislation aimed at expanding access to contraception.
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“The best way to prevent abortion is to prevent pregnancy,” she said.
It is an increasingly common strategy among vulnerable House Republicans — especially those in politically competitive districts — who are trying to reconcile their party’s hard-line anti-abortion policies with the views of voters in their districts, particularly independents and women.
While many of these GOP lawmakers have cast votes in the House this year to limit abortion access — maintaining a stance that some Republicans concede hurt their party in last year’s midterm elections — Miller-Meeks and others spent part of the summer congressional recess talking up their support for birth control access, which is broadly popular across the country and across party lines.
Appearing to embrace access to contraception has become an imperative for Republican candidates at all levels who are concerned that their party’s opposition to abortion rights has alienated women, particularly after the Supreme Court’s decision last year to overturn Roe v. Wade and the extreme abortion bans in GOP-led states that have followed.
“Can’t we all agree contraception should be available,” Nikki Haley, the only Republican woman in the presidential primary, said last week at the first primary debate, seeking to blunt attacks from Democrats on the issue of reproductive health care.
In states where abortion is now prohibited, 43% of voters say abortion access should be easier, up from 31% in 2019, according to a recent Pew Research survey.
Championing access to contraception in these states is “smart politics and good policy,” said Nicole McCleskey, a Republican pollster. “Republicans have long said we need to find alternatives to abortion. This is one. There are a lot of Republicans who have long-standing records of promoting contraception. It’s a meaningful effort to engage women voters.”
Just ahead of lawmakers’ long summer break, Miller-Meeks was part of a group of House Republican women who introduced the Orally Taken Contraception Act of 2023, a bill that they pitched as a way to expand access to contraception and that she called “a significant step forward for health care.”
Abortion rights advocates argue that the legislation is essentially meaningless and merely an effort by Republican lawmakers to mislead voters about their positions on women’s health. But for the GOP women who are backing it, the bill offers an elegant way to shift the conversation away from the divisive issue of abortion.
Joining Miller-Meeks on the legislation was Rep. Jen Kiggans, R-Va., a top target of Democrats in next year’s elections. Kiggans, a nurse practitioner, voted with her party in July to attach language to the annual defense policy bill that would reverse a Pentagon policy aimed at preserving access to abortion services for military personnel regardless of where they are stationed, and has spent the weeks since emphasizing her advocacy for expanding access to contraception.
In addition to co-sponsoring the birth control access bill, Kiggans supported an amendment to the defense measure by Rep. Veronica Escobar, D-Texas, to eliminate co-pays for contraception for military members and their families.
The contraception bill introduced in July, co-sponsored by at least eight Republican women and endorsed by the anti-abortion group Susan B. Anthony Pro-Life America, would direct the Food and Drug Administration to issue guidance for companies that want to make oral contraception available without prescriptions. But it is not clear what practical effect it would have.
Only two drug companies are actively working to offer birth control over the counter. One of them, Opill, was already approved for sale without a prescription before the legislation was introduced. The other, Cadence Health, is years into the application process with the FDA and does not need the guidance that the bill directs the agency to issue.
Abortion rights groups have dismissed the bill as a stunt aimed at masking Republicans’ drive to crack down on both abortion and contraceptive access.
“The legislation is not a genuine attempt to expand birth control,” said Karen Stone, the vice president of public policy at the Planned Parenthood Action Fund. “They’re posturing to save face with voters, all while failing to support existing legislation that would actually help people access over-the-counter birth control.”
The legislation adopts the language of abortion opponents, suggesting that pregnancy begins at the point of fertilization rather than when a fertilized egg is implanted in the uterus. Oral contraception is defined in the bill as a drug that “is used to prevent fertilization.”
“The language is kowtowing to the anti-abortion lobby and part of an orchestrated effort to redefine pregnancy based on religious ideology,” said Dana Singiser, the co-founder of the nonprofit Contraception Access Initiative. “This is the latest in a long line of bills that Republicans throw out there that purport to be pro-contraception bills. When you peel back the layers of the onion, there’s always a catch.”
Miller-Meeks, a physician, defended the legislation, a version of which she has been championing since her days in the Iowa Senate.
“Taking a market-based approach will encourage investment in the over-the-counter birth control space without price controls or mandates, leading to increased access to these products without government overreach,” she said. “As a pro-life congresswoman, I believe preventing unwanted pregnancies is paramount to protecting the sanctity of life.”
Miller-Meeks, along with other co-sponsors including Rep. Stephanie Bice of Oklahoma, have opposed Democratic-led efforts to safeguard access to birth control. They voted last year with the vast majority of House Republicans to oppose legislation to ensure access to contraception nationwide, a right that was regarded as newly under threat after the Supreme Court’s overturning of Roe v. Wade. Anti-abortion groups encouraged lawmakers to oppose the measure, claiming that its definition of contraceptives could be interpreted to include pills that induce abortions. Only eight Republicans voted with Democrats to support the bill, and most of them are no longer in Congress.
The Republican playbook on contraception that Miller-Meeks and others are employing isn’t new. In 2015, former Sen. Kelly Ayotte of New Hampshire, toiling to appeal to moderate female voters, introduced a similar bill that purported to allow women greater access to contraception by encouraging drugmakers and the FDA to make it easier to sell contraceptive pills over the counter.
Democrats at the time dismissed the bill as a political ploy, saying it would result in less access to contraception because it would allow insurers to stop covering some types of birth control.
Since then, Republicans’ concerns about appealing to female voters and independents have only grown, especially after last year’s Supreme Court ruling. In Iowa, the state with the fewest obstetrician gynecologist specialists per capita in the country, Gov. Kim Reynolds last month signed into law a new ban on abortions after roughly six weeks of pregnancy, when many women do not know they are pregnant.
The situation has left Miller-Meeks in a precarious position. Democrats hope that flipping her seat will be part of their path to winning back the House majority in 2024. This month Christina Bohannan, a former state lawmaker who lost to Miller-Meeks in 2022, announced she would run for the seat again. She immediately raised $276,000, more than any other congressional candidate in Iowa had raised in their first 24 hours.
Bohannan plans to make abortion rights central to her campaign to unseat Miller-Meeks.
“About 61% of Iowans support the right to abortion in all or most cases,” she said in an interview. “Rep. Miller-Meeks has aligned herself with the most extreme members of her party instead of the people of Iowa on this issue, proposing one abortion ban over another.”
Bohannan dismissed the contraception bill as a “purely political” text that was drafted “to provide political cover for her own record.”
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