Defying Surveillance: California's Stand Against Federal Overreach in Reproductive Privacy

A second Trump administration is poised to weaponize surveillance and data collection to restrict reproductive rights, threatening tenuous progress on privacy and civil liberties. Evidence of this ambition abounds, from the Heritage Foundation’s Project 2025 to Vice President-elect JD Vance’s past support for using medical records to investigate those who travel to seek reproductive healthcare. Coupled with President-elect Donald Trump’s anti-abortion and anti-LGTBTQ+ rhetoric during his first term and in the lead-up to his second, these developments underscore the alarming trajectory of abortion surveillance under Trump’s leadership.

In the face of this potential federal overreach, California emerges as a critical battleground. The state is committed to shielding reproductive autonomy and setting a national precedent for privacy and resistance. But to truly be a sanctuary for reproductive freedom, California must adopt bold, innovative strategies to fortify privacy and defend against this unprecedented era of surveillance.

The Threat of Federal Overreach in the Surveillance Era

Project 2025, a policy blueprint developed by the Heritage Foundation before the 2024 US presidential election, serves as a roadmap for the Trump transition team. It proposes sweeping expansions of federal authority, including stringent abortion data reporting requirements for all states. The plan directs the Department of Health and Human Services (HHS) to use "every available tool" to compel states to disclose detailed abortion data, including the number of procedures, gestational ages, and methods used.

Even without explicit identifiers related to patients or providers, the risk of re-identification in such public health surveillance data is profound. A 2021 IEEE analysis found that supposedly anonymized data, when cross-referenced with auxiliary datasets, can be used to uncover individuals' identities with alarming precision. Demographic details and unique behavioral patterns serve as digital fingerprints, enabling the exposure of sensitive personal information. Under a second Trump administration, such data collection could be weaponized to strip away privacy protections under the guise of governance, creating a chilling environment for anyone seeking reproductive or gender-affirming care.

The stakes for states are immense. Project 2025 suggests the possibility of withholding critical federal funding, including Medicaid, from states like California that refuse to comply with invasive reporting mandates. For California—home to over 14.2 million Medicaid beneficiaries—such an ultimatum could force an impossible choice: abandon its robust privacy protections or face devastating cuts to healthcare funding.

The incoming administration’s likely commitment to abortion surveillance is further underscored by Vice President-elect JD Vance’s public opposition to privacy protections. In 2022, Vance signed a congressional letter condemning a Biden administration rule aimed at safeguarding patients’ reproductive health data from being weaponized to enforce abortion bans. The letter accused the rule of “thwarting compassionate laws protecting unborn children” and called on HHS to prioritize law enforcement access to reproductive health records. Framing privacy protections as obstacles to justice, Vance and other signatories laid the groundwork for legitimizing invasive surveillance practices in the name of “compassion.”

President-elect Trump’s shifting positions on abortion, driven more by political expediency than principle, only heighten these concerns. While Trump’s rhetoric vacillates—sometimes calling for moderation, other times for punitive measures—his track record demonstrates a willingness to leverage executive power and the federal surveillance apparatus to target vulnerable populations. During his first term, Trump expanded surveillance powers to target immigrants, protesters, communities of color, and political opponents. There is little doubt he would use these same tools to surveil people seeking abortions or gender-affirming care.

The breadth of federal surveillance tools is alarming and expanding rapidly. On November 6, 2024, mere hours after news outlets declared President-elect Trump’s reelection, Immigration and Customs Enforcement (ICE) issued a notice soliciting proposals from companies to help expand its surveillance infrastructure substantially. The plans called for a system of ankle monitors, GPS trackers, biometric check-in technologies, and human agents to monitor non-citizens awaiting immigration court hearings or deportation. ICE’s vision isn’t incremental—it proposed scaling its surveillance network to cover up to 5 million people, compared to under 200,000 currently. The possibility of a swift mobilization of surveillance technologies underscores how Trump’s administration is prepared to leverage federal resources against immigrants on an unprecedented scale, raising alarms about how such tools could be repurposed to police reproductive or gender-affirming care.

Federal surveillance powers remain vast and largely unchecked. President-elect Trump’s previous administration expanded warrantless surveillance programs, such as signing into legislation to reauthorize Section 702 surveillance and allowing federal agencies to spy on protesters, surveil social media accounts, and leverage partnerships with private companies to access vast amounts of data. These tools are ripe for misuse under his leadership, including their potential use to intimidate those seeking reproductive care or those supporting abortion rights. Trump’s willingness to weaponize the powers of the federal government against his perceived adversaries underscores the gravity of the threat to privacy and civil liberties in this new era.

While President-elect Trump has wavered on the specifics of abortion bans, what remains consistent is his broader strategy: winning at all costs. His remarks in recent interviews—whether feigning neutrality on punitive measures or ambiguously endorsing a 15-week federal abortion ban—are thinly veiled attempts to deflect responsibility while enabling states to enforce intrusive surveillance policies and intimidating those that don’t. This approach aligns seamlessly with the broader Republican agenda to surveil and control reproductive healthcare through sweeping federal initiatives like Project 2025.

As President-elect Trump’s second term looms, the question isn’t whether he will leverage surveillance to advance his anti-abortion agenda but how far he will go in weaponizing federal powers to achieve it.

A Case Study: The Danger of Reverse Warrants

The federal push to intensify surveillance reaches beyond abortion data reporting mandates, laying the groundwork for even more invasive tactics, such as reverse warrants. Already in use across the US, these warrants enable law enforcement to collect vast troves of data from individuals, including location data and search histories, to identify potential suspects. Under a second Trump administration, these tactics—currently on the rise—could gain further momentum, undermining state-level privacy protections, exploiting the data collected by law enforcement, and granting federal authorities unprecedented access to sensitive personal data.

Unlike traditional warrants targeting specific individuals, reverse warrants cast a broad net. They compel tech companies to provide identities based on aggregated location data or search histories, often implicating innocent individuals. A stark example of this can be seen in San Francisco, where a reverse warrant resulted in data collection from seven healthcare facilities, including Kaiser Permanente and One Medical. This sweeping collection of data exposed anyone visiting these locations—whether for abortion care, gender-affirming treatment, or unrelated healthcare—to the risk of having their movements, internet searches, and other private information revealed to law enforcement.

The growing trend of reverse warrants is deeply concerning. In 2020 alone, Google received 11,554 geofence warrants, a significant increase from 982 in 2018. California, the leading state for these requests, saw a large number of such warrants, signaling an alarming escalation. And there is evidence that companies largely comply; for instance, Facebook disclosed data in 88% of cases during the latter half of 2021. In 2022, Politico reported that Google received 5,764 geofence warrants between 2018 and 2020 from police in ten states that have now banned abortion. There is a real risk such data could be weaponized in states where abortion is criminalized.

These examples illustrate the potential for data surveillance to be weaponized against individuals seeking reproductive and gender-affirming care. The indiscriminate nature of reverse warrants jeopardizes privacy, exposing people—without their knowledge or consent— to the potential misuse of their data by both state and federal authorities.

California’s Fight for Privacy

California has made strides to protect its residents. Assemblymember Mia Bonta’s AB 793 seeks to prohibit law enforcement from using reverse warrants to target individuals seeking or providing reproductive or gender-affirming care. San Francisco’s Reproductive Freedom Act (Prop O) shields healthcare providers from out-of-state prosecution. Most recently, state lawmakers introduced legislation to guarantee the availability of abortion pills and impose penalties on local governments that block the construction of abortion clinics. But while these efforts mark important progress, they fail to address the expansive surveillance ecosystem, leaving residents vulnerable to federal overreach.

Historically, California has been a leader in challenging federal overreach. In the 1980s, the state defied federal immigration policies by enacting sanctuary laws, setting a powerful precedent for local resistance and shaping the national debate. Decades later, California’s SB 54 reaffirmed this legacy, enduring significant legal challenges during Trump-era immigration crackdowns. This tradition of defiance continues today as the state faces potential federal mandates on abortion and healthcare data.

California’s leadership influences other states and shapes global discourse on privacy and civil liberties. President-elect Trump’s policies amplify the need for California to fortify its protections, as they aim to coerce states into sharing sensitive abortion data, undermining patient privacy and exposing individuals to potential criminalization. The state’s refusal to comply with federal mandates could trigger a constitutional showdown over privacy rights and state sovereignty. With landmark laws like the California Privacy Rights Act (CPRA), California has empowered residents to control their data, but federal pressure threatens to undermine these hard-won protections.

The Path Forward: Local Action as National Resistance

As the threat of federal surveillance expands, California must move beyond conventional protections to build a comprehensive digital defense infrastructure. While California leads in privacy legislation, current tools are insufficient against sophisticated federal data collection and dragnet surveillance technologies. The state must consider the rapidly changing surveillance ecosystem to pioneer new protections that match the scale and complexity of these threats.

In particular, I recommend that California pursue the following actions to protect its citizens:

1. Launch State-Operated Secure Healthcare Infrastructure

California should Implement city-controlled data privacy systems that screen and end-to-end encrypt sensitive healthcare data before reverse warrant disclosures to local and state law enforcement — expanding on an operational framework I developed for San Francisco through the Aspen Institute's Policy Academy. To deliver on such a vision, the state should pioneer a secure cloud system specifically for healthcare providers, implement mandatory end-to-end encryption for healthcare data, and create strong firewalls between local healthcare data systems, law enforcement databases, and federal surveillance tools to prevent unauthorized access, exploitation, and misuse of sensitive healthcare information.

2. Create a Healthcare Privacy Innovation Fund

California should launch the first public-private partnership specifically targeting privacy-enhancing technologies for healthcare, incentivizing California's tech sector to develop next-generation privacy solutions. The fund could be modeled on other successful state innovation funds but tailored to address this urgent new need.

3. Advocate for a National Reproductive Data Privacy Law

California officials should lead the push for comprehensive federal legislation to regulate how local, state, and federal agencies use individuals' data, with a focus on protecting reproductive and gender-affirming healthcare data. Such legislation must prohibit reverse warrants and other warrantless dragnet surveillance practices targeting reproductive and LGBTQ+ care, and leverage California’s leadership in privacy innovation to set a precedent and influence national policy conversations.

4. Establish a State Privacy Operations Center

Perhaps most ambitiously, California should devise and establish the first dedicated state-level institution to actively detect and resist federal surveillance attempts, building on California's existing privacy agency infrastructure but with a crucial new mandate. Such a center could create rapid response capabilities that are currently missing in all 50 states.

The federal push toward expanded surveillance demands an equally ambitious response. California has the technological expertise, legal framework, and political will to implement these first-in-nation protections. We must build this infrastructure before federal surveillance capabilities expand further.