From the Hyde Amendment to the Helms Amendment to Black maternal mortality rates, here's how the two Democratic presidential primary candidates stack up on reproductive health platforms.

So where do the Democratic Party’s two remaining viable candidates in the Democratic presidential primary stand on critical reproductive rights and justice issues?

Jonathan Bachman/Getty Images, Drew Angerer/Getty Images

UPDATE, March 12, 2020, 2:05 p.m.: The Democratic National Committee announced Thursday afternoon that Sunday’s debate is being moved to Washington, D.C.

U.S. Sen. Bernie Sanders (I-VT) and former Vice President Joe Biden will face off on the debate stage Sunday night in Arizona, a week after Sanders released a reproductive justice platform and criticized his opponent’s record on abortion rights.

Released Saturday, Sanders’ plan, “Reproductive Health Care and Justice for All,” details how his administration would use executive power to unravel abortion restrictions, protect reproductive rights from future attacks, and address the maternal mortality crisis in Black communities. The plan has drawn praise—along with some critiques—from reproductive justice advocates.

Ilyse Hogue, president of NARAL Pro-Choice America, called Sanders’ plan “robust” in a tweet: “We’ve tussled in the past with the good Senator, so I am here to say this is a very solid plan on its merits. We’d love to see the same from [Biden].”

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Biden has not yet released, to quote Hogue, “a stand-alone plan on reproductive rights, freedom and justice,” though he addresses many of the issues in his health-care platform, “Health Care and Communities of Color.”

Cherisse Scott, founder and CEO of SisterReach, a reproductive justice organization in Tennessee, told Rewire.News that Sanders’ plan addressed “many of the needs and disparities that impact Black women and our families.”

Stephanie Gomez, an abortion activist and social worker from Texas, said the plan is “a good starting point … It touches on a lot of issues that I feel are often left out of the typical position discussion regarding abortion access and reproductive justice.”

The Sanders campaign has tried recently to draw a contrast on reproductive rights between the candidate and Biden, who has waffled on abortion rights over his decadeslong career. As a senator in 1982, for example, Biden joined Republicans in voting for a constitutional amendment that would have allowed states to overturn Roe v. Wade‘s abortion protections.

Renee Bracey Sherman, a reproductive justice activist and founder of the #AskAboutAbortion campaign, has warned abortion rights advocates to be wary of Biden, whose “record shows we cannot trust his word on these issues when he goes behind closed doors to advocate against us.”

“A lot of his surrogates are spending their airtime saying ‘we need to go back to normalcy,’ but the Obama-Biden years were brutal assaults on abortion access,” Bracey Sherman tweeted, pointing out that the Affordable Care Act (ACA) did not include nationwide coverage for abortion care. “Most of the restrictions we see today went into effect then. The ACA specifically left out abortion. We can’t go back. … I want to see accountability for his past actions that have hurt abortion access.”

So where do the Democratic Party’s two remaining viable candidates in the presidential primary stand on critical reproductive rights and justice issues? Rewire.News breaks down their respective platforms below.

The Hyde Amendment

The Hyde Amendment, a federal budget rider that’s been in place since 1976, blocks the use of federal Medicaid funding to cover the cost of abortion care. The Democratic Party’s 2016 platform was the first party platform to endorse repealing the amendment.

Biden supported the amendment for decades but then changed his position last year after criticism from abortion rights groups and activists. Biden now says that as president he would support ending Hyde.

Sanders’ Medicare for All policy would repeal the Hyde Amendment “and all reproductive health services will be provided free at the point of service,” according to the senator’s plan. Sanders has attacked Biden’s past support for Hyde in recent stump speeches.

The Helms Amendment

Since its passage in 1973, the Helms Amendment has ensured that “no foreign assistance funds may be used to pay for the performance of abortion as a method of family planning.” Though it technically should allow for funding of abortion in cases of rape, incest, and the life or health of the pregnant person, the Helms Amendment, named for segregationist Sen. Jesse Helms of North Carolina, has essentially banned foreign assistance for abortion care in practice.

Biden’s platform doesn’t mention Helms, and he did not respond to a question from Rewire.News previously about his stance on the amendment. Nor did he answer the question when asked in a New York Times survey on abortion published in November. In 1981, Biden—then a U.S. senator—introduced his own amendment “prohibiting foreign aid to be used in any biomedical research related to abortion,” the Cut reported.

In contrast, Sanders vows to repeal Helms—a stance he also took in the 2016 Democratic primary, when he pledged to work with Congress to repeal the restriction.

Black Maternal Mortality

Both candidates have pledged to address Black maternal mortality rates. According to the National Partnership for Women and Families, Black women are “more likely to experience preventable maternal death compared with white women,” and “three to four times more likely to experience a pregnancy-related death than white women.”

Biden’s plan is to nationalize a California program designed to curb maternal mortality rates. Seven years after state officials formed the California Maternal Quality Care Collaborative, a public-private partnership, California’s maternal mortality rate was cut in half. The program addressed overall maternal mortality rates, however, and did not improve the disparity in outcomes for black mothers.

Sanders’ plan, in contrast, focuses specifically on the racial disparities in the maternal mortality crisis. His plan would bolster “access to and funding for reproductive services and facilities in communities of color” and coordinate maternal health policy with organizations led by people of color. His administration would increase “funding to hospitals where the concentration of Black mothers and parents receive care, so that they can implement evidence-based protocols and strategies to lower mortality rates.”

Under Sanders’ plan, hospitals that receive funding from the federal government would be required to “hire culturally competent care liaisons to field complaints, and provide training to all labor and delivery staff, including nurses, doctors, and clerks.” Hospitals would also be required “to rapidly address postpartum hemorrhage, a leading cause of maternal mortality in Black women.”

TRAP Laws

Targeted regulation of abortion providers, or TRAP laws, passed by Republican-majority state legislatures, have devastated reproductive health-care access in the United States, shuttering clinics and making abortion inaccessible for people who might not be able to afford the added costs (childcare, travel, and time off work) these regulations bring.

Biden’s health-care platform doesn’t include details on how his administration would address these clinic shutdown laws, but he offers a pledge that his “Justice Department will do everything in its power to stop the rash of state laws that so blatantly violate the constitutional right to an abortion, such as so-called TRAP laws, parental notification requirements, mandatory waiting periods, and ultrasound requirements.”

Sanders vows to ban state TRAP laws, and he has adopted a policy from Sen. Kamala Harris’ (D-CA) presidential run known as federal pre-clearance. This would mean state-level laws restricting abortion would not take effect until they were cleared by the federal government, the same way voting restrictions in states with fraught civil rights histories once required pre-clearance.

Both candidates have said they support codifying Roe v. Wade protections into federal law.

Over-the-Counter Contraception

Sanders’ platform includes support for free over-the-counter (OTC) birth control access through his Medicare for All plan.

Biden doesn’t mention OTC contraception on his campaign site and didn’t answer a question about OTC birth control in the Times‘ abortion survey.

Title X Family Planning Funds

Biden and Sanders, along with the rest of the 2020 Democratic field, have pledged to overturn the Trump administration’s domestic “gag rule” if they make it to the White House.

The domestic gag rule bars Title X funding recipients from referring patients to abortion providers even if the patient wants to end their pregnancy, and requires Title X clinics to financially and physically separate out any abortion-related services. The gag rule, which primarily harms people with low incomes and people of color, forced Planned Parenthood to leave the Title X program last year.

Biden’s health-care platform says he would reverse the domestic gag rule and “reissue guidance specifying that states cannot refuse Medicaid funding for Planned Parenthood and other providers that refer for abortions.”

Sanders similarly promises to undo the gag rule. He also pledges to ensure anti-choice pregnancy centers no longer receive Title X funding or other federal funding, as they have under Trump. Sanders also says he would “significantly expand” funding for the Title X program and Planned Parenthood.

Where Both Candidates Fall Short

Gomez noted areas where Sanders’ platform could have gone further, pointing out that it failed to mention “minors’ access to abortion, the right to a self-managed abortion, the trans communities’ access to abortion,” and later abortion care. These issues are also absent from Biden’s proposals.

Gomez said she was also “disappointed in the [Sanders] plan’s decision to not use gender-inclusive language when referring to abortion care, especially since we know that a reproductive justice framework must be queer and trans inclusive and that gender non-conforming and trans individuals experience unique barriers to accessing abortion care.”

And she criticized Biden’s plan for making the same oversight. “How can either of these candidates state that they are committed to ensuring queer, trans, and gender nonconforming individuals can access abortions but their policy plans don’t make the effort of at least using gender inclusive language?” Gomez said.

Maleeha Aziz, a community organizer and reproductive rights advocate in Texas, said she supports the Sanders campaign and thinks “Senator Sanders is a bigger champion of reproductive health care in comparison to Joe Biden.” But she also criticized Sanders’ platform for lacking gender-inclusive language, as well as ignoring abortion access for both minors and incarcerated people.

Scott said Sanders’ reproductive justice plan “is a step in the right direction,” though she “would like to see a plan that includes Black men and boys, since unlike mainstream feminism, Black feminism and womanism centers our whole families intentionally and unapologetically.”