GOP Presidential Candidates Offer Varying Views on Federal Abortion Ban

— But Wednesday's 2-hour debate contained few other mentions of health policy

A photo of Republican presidential hopefulls on the debate stage.

Republican candidates for president expressed varying views on a federal abortion ban during a raucous debate in Milwaukee on Wednesday night -- the first such event during the Republican primary season.

"We cannot let states like California, New York, and Illinois have abortions on demand up until the day of birth," Sen. Tim Scott (R-S.C.) said during the debate, which was hosted by Fox News. "That is immoral, it is unethical, and it is wrong. We must have the president of the United States advocate and fight for a 15-week limit ... We must fight for life."

Former vice president Mike Pence agreed. "As president of the United States, the American people will have a champion for life in the Oval Office," he said. "Can't we have a minimum standard in every state that says when the baby is capable of feeling pain, abortion cannot be allowed? A 15-week ban is an idea whose time has come."

Haley Proposes Consensus-Based Approach

Former South Carolina governor Nikki Haley was skeptical about the possibility of a federal ban. Passing such legislation "will take 60 Senate votes and the majority of the House," she said, adding that getting that many votes is unlikely. "I'm unapologetically pro-life ... but we need to stop demonizing this issue."

"Let's find consensus," Haley said. "Can't we all agree that we should ban late-term abortions? Can't we all agree that we should encourage adoption? Can't we all agree that doctors and nurses who don't believe in abortion shouldn't have to perform them? Can't we all agree that contraception should be available? And can't we all agree that we are not going to put a woman in jail or give her the death penalty if she gets an abortion? Let's treat this like the respectful issue that it is and humanize the situation and stop demonizing the situation."

North Dakota Gov. Doug Burgum said he was opposed to a federal ban, citing the 10th Amendment. "In the constitution ... it says there were certain duties allowed to the federal government -- delegated to them by the states -- the rest are left to the states, or to the people," he said. "The feds are stepping into people's lives; they're stepping into people's businesses over and over. If we say the feds should be in on this one, where do we stop? What's going to work in New York will never work in North Dakota, and vice versa."

Asa Hutchinson, the former Arkansas governor, seemed to take a middle-ground approach. "It's most likely going to be addressed in the states, but it's certainly fine to be addressed on the national level as well," he said. "I signed 30 pieces of pro-life legislation while I was governor and every state can determine a different outcome here, and it is the most important issue for women and for the unborn child and for our country that we get this right ... Let's talk about this in terms of compassion, in terms of protecting the lives and also understanding how we have to enhance adoption services and how we have to enhance maternal care."

Florida Gov. Ron DeSantis said he was proud to have signed a bill in Florida that outlawed abortions after 6 weeks of pregnancy; he did not directly address the issue of a federal ban. "I believe in a culture of life," he said. "We're better than what the Democrats are selling ... We are not going to allow abortion all the way up until birth, and we will hold them accountable for their extremists ... I will support the cause of life as governor and as president."

Analysts Weigh In

Out of all those answers, which of the candidates stood out? "Nikki Haley continued her pragmatic play for suburban women in prioritizing softer pragmatic approaches, but those appeals are less likely to work in early Republican primaries," Thomas Miller, JD, resident fellow at the American Enterprise Institute, in Washington, said in an email. "Ron DeSantis first tried for the easier ground of opposing late-term abortions and delegating decisions to states, but he made clear eventually where he would stand (Florida's very short-duration limits) ... Tim Scott was energetic but brief in pushing his 'fight for life' stance."

"Only friends, family, campaign staff, and a handful of likely primary voters will remember the lesser remarks of Doug Burgum and Asa Hutchinson," Miller added. "Pointing out flip-flops over what should be state-driven and what should be federally prohibited is far too nuanced to register with those holding firm views one way or the other, and voting on them."

Wendell Primus, PhD, visiting fellow at the Brookings Schaeffer Initiative on Health Policy, in Washington, and formerly an advisor to representative and former House Speaker Nancy Pelosi (D-Calif.), said in an email that Haley seemed to stand out. "She recognized the political reality of the Senate and also how Republicans needed to speak to women about this issue -- contraception and late-term abortions." He noted that Burgum, for his part, didn't seem to be penalized for saying that states should be allowed to vary on the issue.

Kip Piper, MA, a health policy analyst in Washington, mentioned in an email that Haley "wisely took the opportunity to mention she was the only person on stage to have given birth and face complicated pregnancies."

COVID-19, Mental Health Also Mentioned

While abortion was by far the dominant healthcare issue in the debate, other issues -- including some favorite targets of Republicans -- did creep in. DeSantis said one reason the country was "in a mess" was "because how this federal government handled COVID-19 by locking down this economy ... It never should have happened."

"In Florida, we kept our state free and open, and as your president, I will never let the deep state bureaucrats lock you down," he said. "You bring him in, you sit him down, and you say, 'Anthony, you are fired.'" DeSantis was referring to Anthony Fauci, MD, the former chief medical advisor to President Biden and former director of the National Institute of Allergy and Infectious Diseases.

Asked what he would do about gun control, Chris Christie, the former governor of New Jersey, said that "the problem is not going to be solved by more money. The problem is that these prosecutors in these localities, in the states, are refusing to do their job and to arrest violent criminals. So President Christie would appoint an attorney general who would instruct each of the 93 U.S. attorneys that they are to take over the prosecution of violent crime in every one of those cities that are failing to do so. We have plenty of room in federal prisons to lock up these violent criminals and clean up what's going on."

Christie also addressed the issue of fentanyl addiction, if somewhat indirectly. "China is sending these chemicals to these drug cartels for them to create the fentanyl that's killing hundreds of thousands of our citizens," he said. "The Chinese are engaged in an act of war against us. We better make that priority one in our conversations with China ... Because if we don't, we're going to lose more and more of our citizens."

Entrepreneur Vivek Ramaswamy said that "we have a mental health epidemic in this country. Just over the same period that we have closed mental health institutions, we have seen a spike in violent crime."

"It's not drugged out people in the psychiatric institutions with Zoloft and Seroquel; it's a deeper issue," he continued. "We're in the middle of a national identity crisis ... The reason we have that mental health epidemic is that people are so hungry for purpose and meaning at a time when family, faith, patriotism, and hard work have all disappeared. What we really need is a tonal reset from the top."

How much all of this discussion will matter in the primary is unclear. "Health policy has fallen toward the bottom of the list of concerns among most Republican primary voters," Miller said, adding that "to paraphrase Samuel Johnson, finding a Republican presidential candidate preaching on health policy is more like a dog's walking on his hind legs. It is not done well, but you are surprised to find it done at all."

Piper noted that "the moderators asked no questions on Medicare, Medicaid, healthcare costs, drug prices, and other hot-button healthcare issues. Candidates could have mentioned healthcare in the brief 'free' time allotted, but that would have been unwise. Health policy and health finance issues are too complex, fraught with political minefields, and open to fearmongering attacks. And no good debater takes a position on a new topic in closing remarks."

One person notably absent from the debate stage was former president -- and current Republican front-runner -- Donald Trump, who chose to skip the event and instead publicized his pre-recorded interview with former Fox News host Tucker Carlson.

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    Joyce Frieden oversees MedPage Today’s Washington coverage, including stories about Congress, the White House, the Supreme Court, healthcare trade associations, and federal agencies. She has 35 years of experience covering health policy. Follow