Proponents of abortion access have endured a challenging four years in the United States. Since 2016, Republican-controlled state legislatures have passed hundreds of laws restricting abortion, the coronavirus pandemic led at least 11 states to temporarily suspend abortion services, and 41 independent abortion clinics have been forced to close their doors in the last two years alone.
Looking back at how her first full year at the helm of Planned Parenthood has gone, Alexis McGill Johnson can’t help but laugh in disbelief. “There is a lot on our plate,” she says. But rather than seeming exhausted, she sounds energized.
McGill Johnson, who was officially named president and CEO of Planned Parenthood and its political arm this summer after becoming acting president and CEO in 2019, following the abrupt departure of Dr. Leana Wen, says that after years of setbacks for abortion rights, Joe Biden’s election lays the groundwork for progress. But, she says, she’s also girding for more battles ahead. Progressive groups are already jockeying for the new Administration’s attention and she plans to push hard to not only reverse the Trump Administration’s limits on abortion and other reproductive health services, but also to expand protections for abortion access.
Earlier this year, Planned Parenthood and more than 90 other organizations focused on reproductive health, rights and justice released a “first priorities” policy agenda that laid out immediate asks for a new administration, including an executive order and a presidential budget that reflects a commitment to reproductive health. The budget has been a key issue for reproductive justice advocates for years, because of provisions including the Hyde Amendment, which prohibits the use of federal funds to pay for abortion except in the cases of rape, incest or to save the life of the mother, and the Helms Amendment, which similarly bars U.S. foreign aid programs from funding most abortion services. The movement to get rid of these amendments has picked up steam in recent years. President-elect Joe Biden announced in 2019 that he was changing his position—he now supports eliminating the Hyde Amendment—and a House Appropriations subcommittee held a hearing this month on how the amendment impacts poor people and communities of color.
On a recent Thursday, TIME caught up with McGill Johnson to discuss how Biden can reverse many of Trump’s health policies on his own, what this year’s racial reckoning has revealed about American health care, and how Planned Parenthood plans to push its agenda with a moderate Democrat in the White House.
The following conversation has been edited and condensed for clarity.
What are your top priorities for the new Administration?
We have been working for quite some time with our coalition partners in sexual and reproductive health, rights and justice to come up with what we call the Reproductive Blueprint First Priorities. And key among them are on day one, an Executive Order that will demonstrate the Administration’s commitment to sexual and reproductive health care. So that order [would aim] to eliminate the global gag rule, to keep medication abortion easier to access during the pandemic, to begin the process of rolling back the harmful policies like the Title X domestic gag rule, the Trump birth control rules that allow employers to essentially force their personal beliefs on employees.
We’re also working with coalition partners and with congressional partners to think about what it means to have a budget that reflects that commitment to sexual and reproductive health care. A budget that will eliminate the Hyde and Helms Amendments and laying the course for us to repeal Hyde.
Could getting rid of the Hyde Amendment actually happen under this Administration?
Yeah, absolutely. Our reproductive justice partners, like All* Above All and others, have led on [calling out] the discriminatory nature of Hyde. And so it is their leadership that we are following to make sure that we are in lockstep around that. The hearings this week were incredible. Representative [Rosa] DeLauro is such a strong champion.
Biden won the election, but Democrats did not do as well as expected in the House. How do you interpret this year’s results?
Biden was delivered a very strong mandate. Over 7 million more Americans voted for Biden/Harris, and that was delivered by a coalition of young people, people of color, women, Black women, who have very strong analyses around the various intersectional issues that are facing their communities—our communities. And so I think that progressive coalition and the understanding of their lived experience should be what is informing the Biden administration, the future DNC, as well as folks who might be concerned about it, because I think it’s actually here to stay.
I also think that what we’re seeing with respect to the appointments that have already been made, is an understanding that this administration needs personnel that also reflects those intersectional values. The idea that Biden appointed a COVID equity czar is so powerful, because it really speaks to a recognition that racism is a public health crisis.
What do you think of Biden’s choice of Xavier Becerra to lead the Department of Health and Human Services?
I think it’s tremendously exciting. Becerra is a staunch sexual and reproductive health champion. He understands how urgent it is for us to tackle inequity in our health care system. He helped drive the passage of [the Affordable Care Act], which we worked with the Obama administration on to make sure that it helped to expand sexual and reproductive health care. He’s one of the folks who’s been fighting back as [California’s attorney general] around the domestic gag rule and Trump’s attempts to limit birth control access. So I think he’s fairly proven that he is a champion. The Administration is demonstrating a clear message that sexual and reproductive health care is health care.
With Trump appointing Justice Amy Coney Barrett, there’s now a solid conservative majority on the Supreme Court. How does that affect the future of reproductive rights?
Look, for as long as I’ve been involved in this part of the movement, and at Planned Parenthood, we have relied on the courts as a backstop to protect our health and rights. For the last 10 years, in particular, the number of restrictive bans that we’ve seen, our courts have been an important vehicle for us to stop these harms. We now know that we are long past the point where we can rely on the courts as a backstop. There are about 18 cases that are literally one step away from the [Supreme] Court that could threaten access even more or overturn Roe if not just gut it irrevocably.
So we’re going to continue to work with our partners to elect champions up and down the ballot, because we know that on the federal level, there’s work that has to be done, but that a lot of the fights are going to be happening in states over the next few years.
During the presidential primaries, Sen. Kamala Harris proposed a law, modeled on the Voting Rights Act, that that would protect the right to abortion nationwide. With Harris as Vice President, is that kind of law something Planned Parenthood would pursue?
Even with Roe in place, access to abortion is still limited. As our reproductive justice colleagues always say, Roe is the floor, not the ceiling. We need to engage with our congressional champions, as well as the administration and think about how do we go beyond Roe to fulfill the promise to safe, legal abortion for all. I don’t think that’s a single policy solution. It’s not a single congressional or regulatory solution. You know, it’s about the right, but also the access.
Harris also made other women’s health issues a focus during her campaign for President. How will having her in the White House impact your work?
I really value her leadership on issues like maternal mortality, which is part of sexual and reproductive health care. The Momnibus bill that she was a lead on are ways to talk about the full spectrum of sexual and reproductive health and what is happening in communities and communities of color and Black communities in particular. With all of these appointments and conversations, I think it’s giving us a lot of hope about the ways in which this Administration is using the power of the personnel appointments to demonstrate and signal the direction of policy that isn’t neat. We don’t just live in one neat agency. All of these agencies impact us. And I think that’s really exciting that they are thinking about how we all show up in all of these agencies.
How is Planned Parenthood thinking about its own work in the context of health equity and racial justice?
First order work that any health care provider should be doing right now [is] to make sure that they’re providing the best possible care that is free from bias and racial anxiety in particular. We are doing a lot of equity and belonging work across the federation as well, to ensure that our own internal personnel and strategies are reflecting our values and opportunities for growth to make sure that we can best serve in community. Planned Parenthood is a 104 year old organization. The reckoning has hit us as well. And I think it’s been very powerful to lean into the work, and to think about, with the patient at the center of everything we do, how we develop a stronger intersectional claim that allows us to deliver care with the values that we espouse.
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Write to Abigail Abrams at abigail.abrams@time.com