Iowa Democratic voters, who will get the first say in picking their party’s presidential nominee next year, prioritize a women’s right to abortion above any other major issue heading into the meat of the 2020 campaign, according to a new survey.

CNN asked Iowa voters about what positions are must-haves in selecting a presidential nominee. More Democrats selected supporting a woman’s right to have an abortion as a must-have — 79 percent of in-person Iowa caucus-goers and 80 percent of virtual caucus-goers — than any other issue. (Iowa is letting people virtually participate in its caucuses for the first time for 2020, but that is an explainer for another day and another newsletter.)

Abortion ranked slightly ahead of recognizing climate change as the greatest threat to humanity (about 75 percent of all caucus-goers) and well ahead of the other positions CNN asked about, like supporting the Green New Deal, expanding student debt forgiveness and breaking up big tech companies. Abortion rights also topped the other big health care issue the pollsters asked about: Medicare-for-all. Nearly but not quite half of Iowa caucus-goers said that supporting a shift to a completely government-run health care system was a must-have for them.

It looks like abortion rights will be one of the most animating issues of the 2020 campaign, especially as Republican-led states pass aggressive abortion restrictions. It might not divide Democratic candidates in the same way single-payer does, but, after Joe Biden’s tortured reversal on the Hyde Amendment last week, it has quickly become a dominant issue in the 2020 debate.

I spoke separately with NARAL Pro-Choice America’s Kristin Ford and Erin Davison-Rippey, state executive director for Planned Parenthood in Iowa, about the polling and why abortion has surged to the front of the political discourse. Those conversations have been combined and lightly edited for clarity and length.

Dylan Scott

I was a little bit surprised by the CNN finding, to be candid. Not that abortion rights were important to Democratic voters, but that it outranked every other issue that the pollsters asked about as a must-have for presidential candidates.

Kristin Ford

I think the reason behind that is the threats are so acute right now. They’ve ramped up in such a significant way in a period of just a few months across the country. Voters in Iowa see this firsthand because their state was really ground zero. Iowa passed a six-week abortion ban last year, which was struck down by the courts, but it really animated the electorate there. Those types of really extreme bans on abortion are sweeping the nation and really capturing public attention in an unprecedented way.

There’s so much at stake right now given the way [President Donald] Trump has stacked the judiciary with anti-choice judges, the fact that Brett Kavanaugh sits on the Supreme Court. Anti-choice forces in this country feel really, really emboldened and voters know that they feel emboldened and they know what’s at stake.

Erin Davison-Rippey

I think what we are seeing is people responding to what has now been in Iowa three years of relentless attacks on legal abortion, on access to reproductive health and birth control. It has reached a point where people absolutely are no longer willing to accept anything less than folks being in complete support of these issues.

Dylan Scott

What has happened in Iowa that has made this such a salient issue for voters there?

Erin Davison-Rippey

After the 2016 election, we have seen unrelenting attacks on a variety of issues related to sexual and reproductive health. In Iowa, there was a power shift in the Senate. Democrats had held a narrow majority until then, so we had seen a partisan balance in the legislature. The GOP controlled and continues to control the Iowa House, Senate, and governor’s office.

The second bill out of the Iowa Senate in the 2017 legislative session was a bill to defund Planned Parenthood. They came out of the gate. That bill did take the entirety of session to make it to the governor’s desk because there was voracious opposition. What ended up passing first was a 20-week abortion ban and a forced 72-hour waiting period. That went to the governor’s desk and was passed. They eventually snuck the defunding into the budget.

Planned Parenthood sued over the 72-hour waiting period. In the meantime, we ended up in another legislative session, in 2018. We then saw the introduction of what was at that time the country’s most restrictive abortion ban, banning abortion at six weeks of pregnancy, which is before many people know they are pregnant. So the attacks we are seeing across the country started last year in Iowa. Iowa was used as the test case for how far can we get the most restrictive bill.

Again, it took them the entirety of the legislative session and they ultimately got enough votes to pass the six-week abortion ban. Again, Planned Parenthood sued and the courts put a temporary hold on that.

In the meantime, the 72-hour case worked its way up to the Iowa Supreme Court. The Iowa Supreme Court, in the summer of 2018, came back and ruled in our favor on the 72-hour waiting period. They came out and said according to the Iowa Constitution, abortion is a constitutionally protected right held to the highest level of scrutiny. It was a really strong protection coming from the Iowa Supreme Court. So when we were successful at the district court level on the six-week ban, even the governor declined to appeal to the Iowa Supreme Court because everyone was very clear that based on that ruling that abortion was a constitutionally protected right. There is just no way the six-week abortion ban would be constitutional.

What we have heard time and time again of people standing up and stepping forward and saying I can no longer stay silent. These issues are too important. You hear a lot of people say I took for granted that these rights would be safe. I never thought people would try to make abortion illegal. You see more and more people saying this has gone too far.

Dylan Scott

Obviously, this has been a long-running debate since Roe v. Wade and even before that. Why do people view this as a pivotal moment?

Kristin Ford

There’s this interesting tension, which is that the anti-choice GOP and the anti-choice activists have been working for decades in a really systematic, strategic, long-term way to gut Roe. This has been their master plan basically since the Supreme Court guaranteed the constitutional right to an abortion.

But with Trump in the White House, with the make-up of the courts being what they are thanks to Trump, they see a real opportunity and they’re leaning into it with all of their strength. I think voters see that and they’re very alarmed about what that means. They’ve been trying these attacks for years, but they’re really ramping up.

Dylan Scott

The polling on abortion has always been interesting to me. My read on it has been that Americans do feel conflicted to some degree. There are a sizable amount of people who don’t oppose abortion altogether but who think that maybe some restrictions make sense.

How do you balance those factors, recognizing that there are powerful political forces that would like to see abortion restricted as much as possible if not banned outright with this somewhat more modulated view that the American electorate sometimes seems to have?

Kristin Ford

One of the things that can often happen is that the labels pro-life and pro-choice can confuse the question. Because there are a number of people who personally identify as pro-life. They may feel morally opposed to abortion or it’s not something they would choose for themselves. But 7 in 10 Americans don’t believe it’s their place to decide for other people.

That’s where I think the conversation can get confused or muddied. It’s really the government’s role or the role of politicians. Sometimes, there’s a conflation between self-identifiers and what your stance is on preserving the access to abortion as a safe and legal choice, even if it’s a choice you wouldn’t make yourself as an individual.

Dylan Scott

So you see it as important to maintain that delineation between personal choices and what the government actually mandates or restrictions it sets.

Kristin Ford

Yes. Because Roe has been seen as the law of the land for 40-some years, it’s important to measure and gauge how people feel about that, and support for Roe has hit all-time highs. As it is increasingly under threat in ways it has not been in the past, it has become more and more clear that, regardless of personal orientation, strong majorities of Americans support what was enshrined under Roe v. Wade.

Dylan Scott

So I have to ask about Joe Biden’s Hyde Amendment rollercoaster last week.

Erin Davison-Rippey

I think it’s pretty clear people believe abortion should be safe and legal and accessible to people, regardless of their income. What we have seen over the years in chipping away at abortion access is that it is not enough for something to be legal on paper. If you look at the Hyde Amendment, what you are doing is you are discriminating against people who have lower incomes and we know this disproportionately affects people of color.

Folks are realizing it is not just enough for abortion to be legal, and therefore safe, it must be accessible. The Hyde Amendment just does not align with that. We are glad that it appears folks are all on the same page across the board.

Dylan Scott

Is that the kind of thing you think people can move past? Is it a warning sign that we had to go through that roller coaster in the first place? Or is it that he’s landed where he landed and we can move on?

Kristin Ford

So Tim Ryan is an interesting example. When Tim Ryan got to the House, he was anti-choice and he experienced this evolution on the issue. We certainly want to encourage politicians who aren’t 100 percent where we would like them to be and where the American public would like them to be, to give people space to evolve and change in positive directions, to listen to women. I think that’s what we saw last week.

Dylan Scott

During that news cycle last week, I think there was a risk of treating it as Joe Biden versus the rest of the Democrats, who are a monolith and they’re all exactly the same on this issue. Are there any other notable nuances in some of the other candidates’ positions on abortion or reproductive rights that voters should know about?

Kristin Ford

On the question of Hyde, I think Biden was an outlier among the major candidates and now they’re all aligned.

To your broader question, though, we are certainly encouraging strong leadership and concrete plans from all of the candidates on what they will do to safeguard reproductive freedom, especially in light of these unprecedented assaults.

We’ve seen some candidates step up with pretty specific plans. Kamala Harris’s plan was similar to the Voting Rights Act in the role that the Justice Department would play in authorizing bills that are related to reproductive rights. It’s an interesting approach, and we’re certainly excited to see those kinds of plans. Elizabeth Warren has a concrete plan out. We’ve seen from Kirsten Gillibrand and Julian Castro a commitment to appoint judges who would pledge to uphold Roe v. Wade, which is also an important part of the equation.

We would like to see all the candidates put forth concrete proposals on how they would protect and safeguard reproductive freedom in their administration going forward.