To a large extent the ability of Congress to address access to abortion is limited by the filibuster. Leaving aside questions of removing the filibuster or expanding the Supreme Court — congress can pass reconciliation bills on appropriations with a simple Senate majority not subject to filibuster.
So what can be done regardless of the the filibuster?
First remove the Hyde Amendment from Appropriations bills. (This past year, the House didn’t include it in the appropriation bill, but reconciliation sorts out discrepancies between the House and Senate bills). This affects Medicare, health insurance for federal employees (Tricare and FEHB), and even the Health Insurance Exchanges. The appropriations bill could not just drop prohibitions on federal funding of abortions; it could require that Medicare, health insurance for federal employees and the insurance exchanges all cover abortion health care. Get rid of this idea on the exchanges that there is a separate bill for that coverage.
If Dick’s Sporting Goods can offer a travel benefit for employees that need that for access to health care (and the military has been talking about that as well — shouldn’t the health insurances mentioned above also include that coverage? Consistent with the Exchanges principle of not penalizing those with pre-existing conditions, I think it would be fair to prohibit coverage varying on the basis of gender or age (although location would obviously be a fair item to consider in establishing premiums.)
We also need to protect our troops. Apparently studies show that women in the military have a higher rate of unplanned pregnancies than the general population. One approach is to provide support to those that need to cross state lines, but we should also be asking why we are assigning troops to areas where they don’t have access to health care. It may not be feasible to reassign troops immediately, but we can certainly stop funding construction projects at bases in states were troops don’t have access to health care. There are billions a year spent on such projects.
I think first of the military because when they sign up they don’t know where they will be assigned, but there are federal employees around the country who now lack access to healthcare where they live. We should be making sure that they have that access (see above) — but we should also be looking at decisions on where the federal government employs people.
I’m old enough to remember when Congress decided that the drinking age should be raised. They didn’t establish a national prohibition on sale of alcohol to those younger than 21; they threatened to withhold highway funding from states that didn’t raise the drinking age. Every state responded by doing so. No guarantees that the dynamic would be the same, but it can’t hurt.
Caveat: the 2022 Omnibus Appropriation Act wasn’t passed until March 2022. Unless Congress can act more expeditiously this year, it won’t be this Congress that passes the 2023 Appropriations Bill — it will be the Congress elected this November.