Every Congress since 2019, the same bill has been filed to make abortion reporting complete — the Ensuring Accurate and Complete Abortion Data Reporting Act. It doesn't create a registry of people. It applies the reporting standard the country already uses for cancer and deaths.
The bill can't simply order states around — so it uses the same tool the federal government uses for most national standards: it attaches the requirement to money the states already take. Tap each part.
This is contested policy — and the divide runs right through the data itself. Here's each side at its strongest.
The country already runs complete, mandatory counts for cancer, overdose, and maternal deaths. A voluntary abortion count is the outlier — it leaves policymakers, researchers, and the public guessing about roughly a quarter of the total.
Supporters argue that asking for the same standard already applied elsewhere isn't ideological — it's basic data integrity, and the baseline for any evidence-based health policy.
— Sponsors of S.178 / H.R.627; Lozier InstituteHere's the twist: the ~30% undercount figure comes from the Guttmacher Institute — and Guttmacher now argues that in the post-Dobbs climate, mandatory reporting's harms outweigh its benefits, and it specifically opposes tying federal funds to reporting.
The worry is that expanded collection could be turned toward surveilling or prosecuting patients and providers. The bill's answer is part 03 — aggregate, de-identified only. Whether that safeguard is enough is exactly where the fight is.
— Guttmacher Institute policy analysis, 2025