Andrea Miller at the Champions of Choice event in New York City in April 2022.(Jared Siskin / Patrick McMullan via Getty Images)
When I learned that the reproductive health activist Andrea Miller had died suddenly in late October, my first thought was that we had lost Miller right when we most needed her. Miller led the National Institute for Reproductive Health for 12 years, where she specialized in bold state and local policies. She was a source I turned to often for hope, because even amid the national backslide on reproductive health care, there were states and localities that, with NIRH’s help, were issuing public funding for abortion, expanding access to contraception, and experimenting with ways to stop deception by anti-abortion pregnancy centers.
“When you think about the history, just on the abortion issue, it has really always begun and ended at the state level,” Miller told me in 2021. A year later, when the Supreme Court struck down Roe, this work took on new urgency. Within three months, 17 states and at least 24 municipalities expanded or protected abortion access. “There is a real new awakening to the importance of state and local advocacy, politics, and health care access,” Miller told me in 2022.
Much of the credit for that awakening belongs to Miller, who understood that the potential for bold change was in the states, not in the federal courts.
Early in her career, she worked for Katheryn Kolbert, the attorney who argued Planned Parenthood v. Casey, the Supreme Court case that, per the talking point Miller helped create, blew “a hole in Roe big enough to drive a Mack truck through.”
“Watching Casey play out, realizing our opposition will never rest, and understanding the power of state and local policies radicalized my abortion advocacy,” Miller wrote in a piece for Elle in June. “I’m offering a cautionary tale to supporters of reproductive freedom: The compromises we make will never satisfy anti-abortion operatives.”
The article was a clarion call for a movement struggling to define itself after Dobbs. It was all the more exceptional because it came from a white woman who served as executive director of a movement nonprofit and was willing “to name and own how a white supremacist culture led to a generation of policies that guaranteed the legal right, but not an equitable right, to abortion.”
Former colleagues told me that Miller’s gift as an organizer was the ability to balance this uncompromising vision with a plan that would get there.
“Something I really learned from her was, just because they tell you it’s impossible doesn’t mean it is impossible,” Rebecca Hart Holder, president of Reproductive Equity Now, told me. “It just means you might need more data; you might need better messaging; you might need better polling. You just have to figure out the right tools to make it possible.”
Miller had served as the head of the Massachusetts NARAL affiliate that became Reproductive Equity Now. But she did not fight only for blue states like Massachusetts. “Her point of view was that we can win everywhere when we have the right resources to do so,” Kelly Baden, vice president for public policy of the Guttmacher Institute and a former staffer of NIRH, told me. “Andrea was very clear: We don’t write states off.”
My last conversation with Miller was about a fraught subject. I was writing about ballot initiatives like the one Ohio voters approved Tuesday to enshrine a right to abortion in the state Constitution. Ohio’s initiative allows the state legislature to ban abortion at viability, a compromise organizers believed was necessary for it to pass. Miller was among those who believed these compromises risked repeating past mistakes by leaving later abortion patients behind. In our interview, she was bold and uncompromising and yet pragmatic and unifying at the same time.
“What we know is that creating carve-outs of who can access abortion care creates a road map for anti-abortion politicians to punish and criminalize the people who need or provide abortions,” Miller told me during that last interview in July. “It creates an opening to carve out others in the future. That’s certainly what happened under Roe.” At the same time, Miller said, she could “absolutely empathize with the urgency in states where abortion is banned already or where bans are on the horizon.”
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She advocated for a “both and” approach that would leverage the political opportunity presented by outrage over Dobbs to do “the best we possibly can for people.” “Let’s not default to a lowest common denominator, or old-school conventional wisdom,” she said.
Miller was excited about new polling that seemed to support what she and her colleagues at NIRH have long understood about the public’s strong support for abortion rights.
“While we’ve always firmly believed, and our research and experience in the states has shown, that you can run and win on an affirmative platform—on not just Roe but really, access to abortion care—it was a very steep hill to climb to get that infused into the political bloodstream,” Miller told me.
That infusion is her legacy. The National Institute for Reproductive Health will continue it in her absence, bearing in mind the mantra that Miller repeated over and over in the months before her death, Bonyen Lee-Gilmore, NIRH’s vice president of communications, told me.
“‘Leave no one behind,’” Lee-Gilmore said. “That is the thing she repeated the most.”
Amy LittlefieldAmy Littlefield is The Nation’s abortion access correspondent and a journalist who focuses on reproductive rights, healthcare, and religion. She is the author of the forthcoming book American Crusaders, a history of the anti-abortion movement over the last fifty years, to be published in 2026.