Donald Trump’s name adorned the first casino in America to have an in-house strip club. He is the first American president to have made a cameo appearance in a soft-core pornography film, and he has called his struggle to avoid sexually transmitted diseases while sleeping around his “personal Vietnam.” When Trump the candidate was asked last year whether any of his paramours had had an abortion, he refused to answer.

This is not a man who shares the longtime Republican goal of rolling back the sexual revolution. Nevertheless, after nearly six months in office, Mr. Trump has already surpassed George W. Bush as the American president most hostile to reproductive rights and measures to promote sexual health. There is a deeply insulting irony in this: American women are being stripped of their sexual and reproductive autonomy not by a moralizing puritan but by an erotically incontinent libertine.

This will be true whether or not the Republicans’ health care plan ever passes — though that plan, with its multifaceted attack on obstetric and gynecological care, is a particularly bald expression of contempt for women. There are differences between the bill that passed in the House and the one that may or may not make its way through the Senate. But both could be said to accomplish legislatively what Mr. Trump boasted, in the infamous “Access Hollywood” tape, that he likes to do to women physically.

That assault includes blocking Planned Parenthood from collecting Medicaid reimbursements for a year. This would force the more than half of Planned Parenthood clients who rely on the program to seek care elsewhere, whether or not alternatives exist. (In many places, they don’t.) Medicaid itself, which pays for half of American births, would be severely cut. States would be allowed to let insurers opt out of guaranteeing coverage for maternity care. Tax penalties would restrict individuals and small businesses from buying private insurance plans that cover abortion. And the Senate bill, which would free some insurance plans to charge co-pays for preventive care, would end Obamacare’s guarantee of no-cost birth control.