American healthcare was fundamentally reshaped a year ago with the passage of H.R. 1. The sweeping federal budget reconciliation bill President Donald Trump called the One Big Beautiful Bill was signed into law on July 4, 2025.

One year later, the country’s sexual and reproductive health system is in crisis, and we are at a devastating inflection point, leading all high-income countries in a statistic that should shame every lawmaker: maternal mortality. 

To truly save the lives of American moms, we must adopt a policy framework rooted in medical expertise, research and human rights. Here’s what we propose.