While serving in the New York State Assembly from 1999 to 2004, Higgins consistently voted anti-abortion. Since running for Congress in 2004, Higgins identifies himself as pro-choice. In 2006, Higgins was given a rating of 9% by the NRLC, which indicates a pro-choice stance. Higgins received a score of 100% (a perfect score) from Planned Parenthood in 2012 and from NARAL Pro-Choice America in 2011.
Jack Quinn, a moderate Republican who had represented the heavily Democratic 27th since 1993, unexpectedly announced his retirement in 2004. In April 2004, Higgins entered the race, and narrowly defeated then-Erie County Comptroller Nancy Naples. Even after redistricting following the 2000 census, the district was made slightly friendlier for Quinn (in part, by adding mostly rural Chautauqua County), but was still at the time the most Democratic district in the country to be represented by a Republican. The district has since reverted to form, and Higgins was reelected three times without serious difficulty, never dropping below 60 percent of the vote. He easily dispatched his 2008 and 2010 opponents even after they posted six-figure fundraising numbers. In both 2006 and 2008, Higgins garnered more than 70% of the vote.