Health Care

Reproductive rights divide states 2 years after Dobbs decision

The debate has expanded beyond abortion to include access to contraception, IVF, and maternal and infant health care.
Protesters gather outside the Supreme Court in Washington, Friday, June 24, 2022, after the Supreme Court ended constitutional protections for abortion that had been in place nearly 50 years. (AP Photo/Jacquelyn Martin, File)

Reproductive rights disputes continue to roil state legislatures two years after the Supreme Court ruling that allowed states to set their own abortion policies.

With states largely divided between those that protect and restrict abortion rights, the state-level debate has expanded to include access to contraception, in vitro fertilization, and maternal and infant health care.

Abortion rights have also become central to the 2024 election, when voters in as many as 12 states could also weigh in on abortion-related ballot measures.

While Republican campaigns have focused on economic issues, immigration and crime, Democrats hope widespread support for at least some abortion rights could drive turnout in their favor in state and federal battleground races.

“The past two years have proven that overturning Roe v. Wade wasn’t the end. It’s just the beginning of Republicans’ assault on reproductive health care,” Alabama Rep. Marilyn Lands (D) said Friday in a press call organized by the Democratic National Committee.

Here’s a snapshot of the reproductive rights landscape in the states on the two-year anniversary of the Dobbs v. Jackson Women’s Health Organization decision.

New restrictions: Since June 24, 2022, 14 Republican-controlled states have banned abortion at all stages of pregnancy, with limited exceptions. Six other states have introduced gestational limits ranging from about 6 to 15 weeks.

That includes Florida, where a law signed by Gov. Ron DeSantis (R) in April banned all abortions after 6 weeks, before most women know they are pregnant. The new law brought Florida in line with its southern neighbors, most of which had trigger bans that went into effect as soon as the Dobbs ruling was announced or quickly moved to enact restrictions.

Other notable laws passed this year in GOP-led states include one in Louisiana, signed last month by Gov. Jeff Landry (R), that criminalized possession of the abortion-inducing drugs mifepristone and misoprostol. Also in May, Tennessee Gov. Bill Lee (R) signed a law making it a crime for an adult to help a minor receive an abortion. It’s the second so-called abortion trafficking law in the country, along with an Idaho law seeking to prohibit minors from traveling over state lines for abortions that is currently blocked by a federal judge.

Enhancing access: Democrat-led states have continued to take actions to strengthen abortion rights protections and to become sanctuaries for out-of-state patients seeking care.

California passed a law last month that allowed Arizona doctors to cross state lines to perform abortions for patients from that state. The law was fast-tracked in response to an Arizona Supreme Court ruling in April that reinstated a Civil War-era abortion restriction. The legislature repealed that law weeks later.

IVF and contraception: More than a half-dozen Republican-controlled states scrambled to protect in vitro fertilization in the aftermath of an Alabama Supreme Court ruling in February that declared frozen embryos created through IVF are people.

Those efforts have stumbled thanks to disputes over when life begins. Only Alabama and Kentucky have so far passed laws to protect IVF access, though critics said both laws still left providers and patients vulnerable to prosecution.

States have also considered dozens of bills to protect the right to contraception, mostly advanced by Democrats.

More targeted measures to make it easier to stock up on birth control pills have attracted bipartisan support and were passed in Idaho, Nevada, Oklahoma, Tennessee and Virginia. The Oklahoma bill is still awaiting Gov. Kevin Stitt’s (R) signature. Indiana legislators passed a law that requires Medicaid recipients be given the option to receive long-acting subdermal contraception after giving birth.

Those measures don’t apply to intrauterine devices or emergency contraception, popular methods that some anti-abortion groups inaccurately characterize as abortifacients.

On the ballot: Abortion-related ballot measures have been approved in five states: Colorado, Florida, Maryland, New York and South Dakota. Another seven states could join them: Arizona, Arkansas, Missouri, Montana, Nebraska, Nevada and Pennsylvania.

Voters in Nebraska and Pennsylvania could see initiatives that would curtail abortion rights. But
the majority of ballot initiatives have been spearheaded by abortion rights supporters. They’re seeking to build on the success of standalone abortion protection measures: the side favoring abortion rights has prevailed in each of the 6 states that have considered abortion-related ballot measures in the past two years.