This story first appeared in Courier Texas
On Nov. 3, Texas voters will make pivotal decisions on reproductive healthcare by choosing between Attorney General Ken Paxton (R) and State Rep. James Talarico (D) for a seat in the US Senate.
The candidates are at opposite ends of the abortion debate. Paxton, who praised the overturn of Roe v. Wade in 2022, has threatened legal action against medical practitioners performing abortions in life-threatening circumstances. Talarico criticizes what he views as “extreme” abortion bans and proposes measures to combat Texas’ maternal mortality rates.
Where do Talarico and Paxton stand on Texas’ abortion ban?
Paxton has been a vocal advocate for anti-abortion policies. Following the repeal of Roe v. Wade via the Dobbs decision, he described previously federally protected abortion rights as “unconstitutional and unconscionable.” He has supported Texas’ stringent abortion ban, which allows exceptions only in rare instances, and opposed the Biden administration’s interpretation of the EMTALA law as including emergency abortions, arguing it would turn ERs into “abortion clinics.”
The 5th Circuit Court of Appeals ruled that Texas’ abortion laws supersede EMTALA, even for emergencies requiring an abortion.
Talarico, on the other hand, criticized the state’s abortion restrictions for stripping women and healthcare providers of autonomy. “I don’t believe that’s a place for the government. I don’t believe that’s a place for the state,” Talarico stated, noting his stance is informed by his Christian faith.
He argues the ban poses risks, citing Texas’ narrow exceptions for medical emergencies. “They should be deeply disturbed by this abortion ban in Texas because we have women who are literally dying in emergency room parking lots because doctors are too afraid to provide the healthcare they need,” he stated in an interview.
Dallas resident Lauren Miller faced a dire situation when a rare pregnancy complication required her to leave Texas for a procedure. She and her husband discovered one of her twins had Trisomy 18, a fatal condition. “The risk of miscarriage with a Trisomy 18 baby is so severe that I could have lost both babies,” Miller shared in a 2025 interview.
To save the healthy twin, she needed a selective abortion. Despite being severely ill from hyperemesis gravidarum, Miller had to fly to Colorado for the necessary procedure. “I needed an abortion of an obviously unviable twin in order to protect the life of a viable twin. I was heading towards organ failure but apparently I wasn’t dead enough,” she recounted. “The decision between Ken Paxton and James Talarico comes down to a simple question: If you believe that a politician should make life or death medical decisions for you and your kids, by all means vote for Ken Paxton. If you believe you and your doctor know your medical needs better than a politician, vote for James Talarico.”
Talarico’s legislative efforts reflect his commitment to women’s healthcare rights. In 2022, he introduced HB 819 to repeal pre-Roe v. Wade abortion restrictions, including the “trigger ban” and a 1925 law threatening women with criminal charges for seeking abortions. Despite reaching the House State Affairs Committee in 2023, the bill did not advance.
How would each candidate handle medical exceptions to the ban?
Amanda Zurawski nearly succumbed to sepsis when her water broke at 18 weeks. She led a case to the Texas Supreme Court challenging the state’s abortion ban’s medical exceptions. Paxton opposed the case, which asked for allowances for fatal fetal anomalies.
“To me, the choice is incredibly obvious. It’s night and day,” Zurawski said. “I’ve met James (Talarico) as a state legislator and he’s been supportive of my work and of the other women who were plaintiffs.” The Texas Supreme Court refused to clarify exceptions, a decision Paxton welcomed.
“Ken Paxton has made life worse for us, and his legal team insisted in our court case that we weren’t even harmed by the abortion ban,” Zurawski commented. Concerns extend to other reproductive services, including IVF.
When Kate Cox, diagnosed with a fatal fetal anomaly, received a judge’s approval for an abortion, Paxton threatened legal action against her OBGYN, Dr. Damla Karsan, and any assisting hospital. “Ken Paxton threatened to come after me if I had performed the abortion. He threatened me with 99 years in jail, a $100,000 fine and the loss of my medical license,” Karsan revealed.
Cox, already gravely ill, had to travel out of state for the procedure. “Ken Paxton doesn’t care if Texas women die as a result of the abortion ban,” Karsan said. “The ban has had a chilling effect on having children.”
Talarico consistently opposes Texas’ strict abortion bans. A spokesperson for Talarico stated, “Ken Paxton has consistently pushed to criminalize women’s healthcare and put politicians in the middle of decisions that should be left to Texas women, their doctors, and their faith.”
Talarico co-sponsored SB 31, “The Life of The Mother Act,” which allows doctors to intervene under specified conditions to save a patient’s life or prevent severe impairment.
What would they do about Texas’ maternal mortality rate?
Texas’ maternal mortality rate is higher than the national average, with grave impacts on women of color. In Harris County, 83 Black women died per 100,000 live births between 2016-2020.
In 2026, the family of Tierra Walker, who died from preeclampsia, sued Paxton and others, attributing her death partly to Texas’ abortion laws, as reported by ProPublica. Paxton has not commented on the case, but his campaign website mentions working with President Trump to “Make America Healthy Again.”
Talarico has addressed maternal mortality, advocating for policies like doula and midwife insurance coverage and supporting programs like Healthy Start to enhance maternal and infant health in Dallas County.
His campaign website outlines goals to “end maternal care deserts, improve data collection, provider training, and investment in maternal health research, extend eligibility for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)” and ensure new mothers can take time off work for their health.
Dr. Austin Dennard, a Dallas OB-GYN, had to travel for an abortion after a fatal fetal diagnosis in her third pregnancy. “I have spent my entire adult life training to care for women in the moments when minutes matter,” Dennard shared. She criticized politicians like Paxton for intervening in medical decisions.
“We have seen the consequences of that approach in Texas: fear, confusion, delayed care and physicians forced to consider the legal consequences of treatment while standing at a patient’s bedside,” Dennard stated. She advocates for Talarico’s approach, which she believes respects women’s autonomy and trusts physicians. “OBYNs don’t need politicians practicing medicine from the Capitol. We need them to get out of the exam room and let us do the jobs we sacrificed so much of our lives to learn how to do.”
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