Would Donald Trump try to ban abortion nationwide if he returns to the White House? His allies have dodged the question by saying it’s irrelevant, because the policy is unlikely to get enough votes to pass Congress. Trump himself has said he would refuse to sign any such legislation.

Thing is, he wouldn’t need to: The next president could sharply limit access to reproductive care nationwide unilaterally, through administrative action alone. As incoherent as Trump’s many abortion stances have been, there are plenty of signs he would choose this path.

Trump has said he “solved” the problem of reproductive rights by punting the issue to the states. But even post-Dobbs, the executive branch retains significant influence over access to abortion (and miscarriage and fertility) care throughout the country. In fact, while it’s gotten relatively little coverage this election, the Biden-Harris administration has worked valiantly to protect women’s access to care through regulatory decisions and lawsuits, all of which Trump as president could easily unravel or reverse.

Consider, for example, the ongoing legal fight over whether hospitals must provide abortion care when necessary to prevent serious harm to the mother’s health. (Yes, this is seriously up for debate.)

Six states with abortion bans or early gestational limits have no exception for the health of the mother. Other states say they have exceptions, but their laws are vague about when those kick in or how close to death’s door patients must be to shield providers from criminal liability. So, risk-averse providers withhold or delay care, leading to traumatic and sometimes tragic consequences.

In Tennessee and Oklahoma, hospitals have turned away women bleeding out from miscarriages and told them to return when their conditions are sufficiently life-threatening. In Texas and Georgia, women have been forced to go into sepsis before doctors will intervene, risking their future fertility, and in especially horrible cases, their lives.

Enter the Biden-Harris administration.

There’s already a federal law requiring hospitals to provide “stabilizing treatment” to patients experiencing emergencies; the Biden administration has instructed states and hospitals that this legally required stabilizing treatment includes abortion care. This guidance has been the subject of multiple federal lawsuits, with states such as Texas arguing that their abortion bans can’t be preempted by federal law.

If Trump returns to office, he could easily stop defending the Biden interpretation in federal court — or more simply, just withdraw the Biden guidance entirely. This is precisely what Project 2025, the policy playbook written by scores of Trump aides, recommends he do.

The Biden administration has also issued regulations to protect the privacy of patients who go out of state for lawful abortion care. One such regulation prohibits doctors, hospitals and insurers from giving state law enforcement officials information about reproductive treatments that are legal where they’re provided — in the event that, say, Texas seeks to punish a resident for terminating a pregnancy in Illinois.

This is no hypothetical. Last month, Texas sued to block this new rule, calling it “a backdoor attempt at weakening Texas’ laws.” Again, a future president could decide not to defend the case or to rescind the policy so that it’s easier for Texas to prosecute women who cross state lines for reproductive care.

Those are measures Trump could take to make reproductive care (even) less accessible to pregnant women in red states. But he would have influence over the treatments women in blue states receive, too — including through potential restrictions on medication abortion.

Most abortions nationwide are done via medication, with doctors prescribing pills that are also used to treat miscarriage. The Biden-Harris administration has expanded access to these drugs, including through telehealth appointments.

Meanwhile, anti-choice hard-liners have been trying to block the availability of these prescriptions, through multiple strategies. One is by suing to revive the Comstock Act, a long-dead law from 1873 that prohibits mailing materials that are “obscene” or that might be used to carry out an abortion (which theoretically could include not just the meds, but also surgical gloves, masks and scrubs used during in-person procedures, explains Laurie Sobel, associate director of the health-care nonprofit KFF).

Another is by claiming that the Food and Drug Administration lacked the authority to approve one of those drugs, mifepristone, even though it has been on the market for decades.

Where does Trump stand on this? At times, he has publicly indicated support for revoking access to mifepristone. Project 2025 also says the FDA should withdraw its approval of mifepristone and revive the Comstock Act. And Trump’s running mate, Sen. JD Vance of Ohio, signed a letter in January 2023 urging enforcement of the Comstock Act, which would be a “de facto national ban,” KFF explains.

These and other technical, bureaucratic possibilities haven’t received much airtime this election cycle. But they matter. There might not be much more the next White House occupant can do to unilaterally improve women’s access to critical (and sometimes lifesaving) reproductive care, but there’s plenty they can do to destroy it.

Email: crampell@washpost.com.