Dear Fellow Marylanders,

Fifty-one years ago this Monday, the Supreme Court of the United States made it the law of the land that Americans have the right to control their own bodies, including whether and when they might be pregnant. The Roe v. Wade decision, which explicitly stated that we, as a nation, trusted women to make decisions about their own bodies and their future, remained precedent for nearly 50 years.

Today, we are trapped once again in a fight to ensure that everyone throughout the country, wherever they live, has the right to determine their own reproductive future. While the Constitution has not been amended since 1992, the makeup of the high court has, and the 2022 conservative-majority court struck down Roe and Planned Parenthood v. Casey with its decision in Dobbs v. Jackson Women’s Health Organization.

In the short time since the Dobbs decision, 14 states have enacted total bans on abortion care. Seven states restrict the procedure earlier than the nationwide standard that had been set by Casey and Roe. In total, about 25 million women do not have full access to health care because of these new laws. An astounding 1 in 3 women of reproductive age in this country do not have access to abortion where they live, according to Planned Parenthood.

Reproductive health care is an essential component of routine health care. Delays and denials of care have negatively affected health outcomes for pregnant individuals, some of whom are being forced to forgo cancer treatment, developing sepsis, being left bleeding for days after incomplete miscarriage, enduring risk of rupture due to ectopic pregnancy, and being forced to continue carrying a nonviable fetus.

Thankfully, Maryland is one of 22 states and the District of Columbia that have worked to protect access to reproductive health care. Our state leaders in Annapolis have taken measures to safeguard legal reproductive health care, including abortion care and securing adequate supplies of necessary medications. They have protected patients and providers through laws that prioritize privacy and shield Maryland providers and out-of-state patients from potential penalties imposed by restrictive states. I am proud to say that Maryland will continue to be a safe haven for those who need reproductive health care.

The struggle continues though. Extremists are not satisfied with simply overturning Roe. They want a national ban on all forms of abortion services and to cut off access to contraception.

Justice Clarence Thomas’ concurring opinion in Dobbs provided the roadmap for extremists. He wrote that the Court should reconsider its 1965 Griswold v. Connecticut decision, which established the right to use contraception without government interference. If this were to happen, it could have grave consequences for the 72 million women in the U.S. that are of reproductive age, 65% of whom are currently using a contraceptive method.

Emboldened by the recent Supreme Court decisions, at least 12 states allow some health care providers to refuse to provide services related to contraception based on their own personal beliefs. Additionally, as of June 2023, at least four states have tried to ban access to some or all contraceptives by restricting access to public funding for these products and services. At the forefront of this crusade are Arkansas, Mississippi, Missouri, and Texas, all of which have infringed on people’s ability to access their contraceptive care by violating the free choice of provider requirement under the Medicaid program.

Back in 1998, Maryland was the first state to mandate contraceptive coverage. In 2018, it made improvements with the Contraceptive Equity Act, which went into effect, which provides Marylanders expanded access to birth control at little to no cost. It ensures that expenses will no longer be a barrier to Marylanders seeking birth control by eliminating most co-payments for birth control, lifting pre-authorization requirements for obtaining IUDs and implants, providing insurance coverage for over-the-counter contraceptive medications, like emergency contraception such as Plan B, and allowing an individual to receive six months of birth control at one time.

That said, over 250,000 Maryland women live in contraceptive deserts, counties that lack reasonable access to the full range of methods, and nearly 2,000 of those Maryland women live in counties without a single health center that provides the full range of methods.

At the federal level, the struggle to protect reproductive health care is made more difficult thanks to the razor slim majority in the Senate and Republican majority in the House of Representatives. There is legislation at the ready though, including:

• Women’s Health Protection Act: I am a cosponsor of this bill that would protect the right to abortion free from medically unnecessary restrictions and create a statutory right for providers to provide and patients to receive care. This would codify Roe v. Wade and prevent states from continuing to enact restrictions on reproductive freedoms.

• Equal Access to Abortion Coverage in Health Insurance (EACH) Act: Also a bill I have cosponsored, this bill would reverse the Hyde Amendment and related abortion coverage bans. These bans deny abortion coverage for people enrolled in federal health insurance programs or who receive health care through a government provider from accessing affordable reproductive care. This effects military service members, veterans, federal employees and their dependents, Native Americans and Indigenous people, Peace Corps volunteers, immigrants, people in federal prisons, and residents of Washington, D.C.

• Affordability is Access Act: This legislation I have cosponsored would require private health insurance plans to cover over-the-counter contraceptives that are approved for use by the FDA without a prescription. The bill would also prohibit interference with an individual’s access to oral contraceptives that are meant for routine, daily use without a prescription.

Important legislation in this area also includes the Affordable Care Act, which guarantees women insurance coverage of 18 methods of birth control without additional out-of-pocket costs. Since going into effect in 2012, this provision has benefited over 62.4 million women who now have coverage of birth control and other preventive services without out-of-pocket costs.

I will continue to work with the Biden administration and fellow Senators to confirm judges that will protect constitutional rights and the right to privacy, in order to help repair some of the damage done to the federal judiciary after the appointment of extreme right-wing ideological judges in the Trump administration. 

But as the Supreme Court continues down a path of overturning decisions and restricting the rights of Americans, Congress must act. Safe abortions have become inaccessible in much of the country. Even medications approved by the FDA and used for decades are at risk.

Under the guise of saving a life, this effort has done more damage to the lives of women and families than imaginable. Such decisions belong with women and their doctors and not with politicians, legislatures or the courts. Our work won’t stop until all those who need it have access to this critical care.

Thank you for your time on such a critical issue. Please feel free to reply to this email to share your thoughts on this or any other topic. I value your thoughts.

In solidarity,

Ben Cardin