The Texas Supreme Court’s recent decision to block a Dallas woman from terminating a troubled pregnancy has cast a bright new light on GOP efforts to ban abortions and kindled a new fire under outraged Democrats, who are vowing to make the issue a central element of their 2024 campaign message.

The court’s ruling, passed down last week, found that Kate Cox was not eligible to receive an abortion under Texas’s strict law banning the procedure in almost all cases, despite a fatal genetic condition detected in the fetus and doctors’ warnings that giving birth posed a threat to Cox’s own health. To avoid the risk, Cox, a 31-year-old mother of two, fled Texas to secure an abortion in a state where the procedure is legal. 

The episode quickly intensified the partisan fight over the future of women’s reproductive rights in the wake of the U.S. Supreme Court’s 2022 decision to overturn Roe v. Wade and the many state prohibitions that followed. As the details of Cox’s case emerged last week, Republican abortion opponents widely hailed the Texas court for upholding the state law, while Democrats sounded dire warnings that GOP policymakers are intruding on personal decisions best left to women and their doctors. 

It’s a warning Democrats are ready to trumpet all the way to the polls next November. 

“For House Democrats, absolutely: Preserving a woman’s reproductive rights — restoring them, in fact — is going to be at the top of our list,” said Rep. Veronica Escobar (D-Texas), a co-chair of the party’s messaging arm. “People are really shocked.”

The strategy has proven effective in the past. 

In last year’s midterms, Republicans were widely expected to benefit from a red wave that would win them control of the House — with a considerable majority — and perhaps also the Senate. Instead, Republicans eked out a House victory, with just a four-seat majority, while Democrats retained control of the upper chamber — surprise results that were broadly seen as a referendum on the toppling of Roe just months earlier by the Supreme Court’s conservative majority.

Democrats are quick to acknowledge that the simple passage of time may dull the emotional response to that ruling by the time the polls open in 2024. But they’re hoping high-profile episodes like the one involving Cox — as well as ongoing lawsuits challenging new abortion restrictions in states such as Texas and Kentucky — will keep the issue front and center heading into the elections.

“You can never predict just how potent an issue will remain going forward,” Escobar said. “But I hope women continue to fight for their rights in court, primarily because they deserve those rights, but also — frankly, politically — I think it will be a consistent reminder to the public that there’s one party that wants to strip women of all of their rights.”

There’s another factor that could keep abortion in the headlines through next year: Former President Trump, who appointed three of the conservative justices who helped overturn Roe, is the heavy favorite to win the GOP presidential nomination. And Democrats have wasted no time tying him to the plights of women such as Cox. 

“He campaigned on overturning Roe versus Wade. He then appointed ultrareligious justices who overturned Roe vs. Wade. He then bragged about it. He also said women should be punished for having abortions, and now you see Republicans carrying out Donald Trump’s orders,” said Rep. Ted Lieu (Calif.), vice chair of the House Democratic Caucus. 

“That is what is at stake in November.”

Texas is among the many GOP-led states that quickly adopted tougher abortion restrictions, or outright bans, following the Roe decision last year. Under the state’s new restrictions, abortions are banned after fetal cardiac activity can be detected, as early as the six-week mark, except in cases of medical emergency.

Cox was roughly 20 weeks pregnant when testing revealed that the fetus was afflicted with trisomy 18, a rare chromosomal condition that is typically fatal. Her doctor also warned that carrying the pregnancy to term could harm her health, including her ability to bear children in the future. She filed a lawsuit to allow an exemption to the abortion ban, which was shot down by the nine Republican judges on the Texas Supreme Court, who ruled that Cox’s doctor had not sufficiently demonstrated that her life was at risk. 

Separately, Texas Attorney General Ken Paxton (R) had warned even before the court ruling that any doctor or hospital that helped Cox terminate the pregnancy would be held criminally liable to the fullest extent of state law, which could mean the loss of a medical license, a lifetime prison sentence or a minimum $100,000 fine.

Republicans quickly hailed the decision, saying the court had simply done its job.

“They upheld Texas law. It’s just that simple,” said Rep. Randy Weber (R-Texas). He rejected the notion that the court was encroaching on the doctor-patient relationship. 

“They do their due diligence. They look into this. And they have experts, and they have staff, that will go back and do that research,” Weber said. “And they have medical staff that will address issues to the medical — to doctors — that have that expertise. And then they make their decision.” 

“I trust the court to make the right decision,” echoed Rep. Don Bacon, a moderate Nebraska Republican. “They’re there to interpret law, and that was what the law says.”

Democrats had a starkly different view, accusing Republicans of trampling on personal medical decisions to advance their true goal: a total abortion ban with no exceptions. 

“It’s a kind of totalitarian approach, where we’re going to have complete control over you in spite of the already very restrictive law that should allow her and her doctors to have made that decision,” Rep. Joaquin Castro (D-Texas) said. 

“They actually don’t want any exemptions to exist. And so while those exemptions exist in the law in writing, practically speaking they’re going to bully and intimidate and threaten and do everything they can to keep women from having any freedom of choice about reproductive decisions.”

The ultimate impact of the abortion debate on the 2024 elections, of course, remains to be seen. Some Republicans in battleground districts said they’re accustomed to the Democratic attacks, predicting they would survive them.

“It’s not their first time playing that game,” said Rep. David Valadao (R-Calif.), who represents a district won by President Biden in 2020. “It’s not one that I spend a lot of time worrying too much about.”

Another factor hanging over the Democrats’ strategy is the simple fact that abortion issue is not universally beneficial for the party. Regional considerations are also at play, especially in districts with large numbers of Catholic voters.

“The [Democratic Congressional Campaign Committee] was doing all these ads for me, beating up on my opponent for being anti-abortion. And I was like, ‘Guys, you all got this wrong,’” said Rep. Vicente Gonzalez (D-Texas), referring to the Democrats’ campaign arm. “It’s an issue that’s best to not talk about.”

Still, most Democrats have been encouraged by recent polls indicating that an overwhelming majority of Americans oppose a complete ban on abortion, especially in the earliest stages of pregnancy and when the health of the mother is at risk. Encouraging them further, voters in Ohio last month approved a constitutional amendment solidifying abortion access statewide. 

“I wish they weren’t treating people like this,” Castro said. “But, yeah, of course you’re going to draw a clear contrast between us and them. We would not treat people like this.” 

Even Republicans staunchly opposed to abortion concede the potential political perils of having the 2024 elections be a referendum on abortion. 

“This is an issue, there’s no question. We know that,” Rep. Roger Williams (R-Texas) said. “It’s an issue, and it’s a moving issue.”

Yet Williams also defended the Texas restrictions, praising Paxton and the state court for their handling of the Cox case. 

“It’s the Texas law; that’s it,” he said. “There [are] cases probably that the doctor recommends that the death of the mother might be engaged. I think you’ve got to think about that. But outside of that, I’m pro-life all the way. And the Texas law is what the Texas law is.”

Yet there are also signs that at least some Republicans are concerned about the potential political fallout from the Cox saga. Last week, both of Texas’s Republican senators ducked reporters’ questions about the case, and some House lawmakers followed suit. 

“I don’t feel like I’m enough up to speed to comment on it right now,” said Rep. Ronny Jackson (R-Texas), a former physician.

Other Republicans went a step further, suggesting they disagree with how Cox was treated.

“I haven’t talked to [Cox], I don’t know what her medical condition is,” Rep. Beth Van Duyne (R-Texas) said. “But I’ve been consistent that if a woman’s health is at risk, she should be able to receive the health care that she needs.” 

Rep. Nancy Mace (R-S.C.), a frequent critic of her party’s approach to abortion, was much more scathing, saying Republicans “want to bury our heads in the sand” on the issue.

“It’s a deeply emotional issue, and I feel the pain of that mother,” she said. “I winced when I saw the ruling.”