More states codifying abortion access in face of SCOTUS ruling: Protective measures taking effect
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* Kim Krisberg

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Activists rally at the U.S. Supreme Court in Washington, D.C., on May 14 in support of abortion rights. Protests sparked after a draft opinion showed the court was considering overturning Roe v. Wade, the 1973 ruling guaranteeing abortion rights.

Photo by Jose Luis Magana, courtesy AFP/Getty Images

> “We’re preparing for more people pushed into later gestational periods than they wanted, facing more health risks, with higher levels of stress and anxiety.”
> 
> *— Amanda Carlson*

Just a month before news broke in May of a draft Supreme Court decision that would overturn *Roe v. Wade*, Colorado passed a law codifying the right to an abortion, joining more than a dozen other states now poised to become safe harbors for abortion.

In April, Colorado Gov. Jared Polis signed the Reproductive Health Equity Act, which enshrines a person’s “fundamental right” to abortion and bans state and local public entities from interfering. Amanda Carlson, MSW, senior policy associate at Cobalt, a Colorado reproductive rights group, said advocates began mobilizing for the law’s passage in the fall, both in anticipation of Roe’s possible reversal and after seeing the fallout of Texas’ recent six-week abortion ban.

Carlson said within two weeks of that ban taking effect last year, a third of people coming to Cobalt’s Abortion Fund for financial help were from Texas.

“We’re preparing for a national health crisis,” Carlson told *The Nation’s Health*, referring to the SCOTUS decision. “We’re preparing for more people pushed into later gestational periods than they wanted, facing more health risks, with higher levels of stress and anxiety.”

With the Supreme Court seemingly set to strike down the constitutional right to abortion, states such as Colorado have been on the front lines of abortion access like never before. As of May, 16 states and Washington, D.C., had laws that protect the right to an abortion, according to the Guttmacher Institute. On the other side, 23 states had laws that could be used to restrict abortion if Roe falls; 13 have laws that automatically outlaw abortion if *Roe v. Wade* is overturned.

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People gather at the U.S. Capitol in Washington, D.C., in November in support of legal access to abortion services.

Photo by Gayatri Malhotra via Unsplash

Nearly half of U.S. women of reproductive age — or more than 36 million people — could lose abortion access if Roe is up-ended, with women of color and poor women disproportionately impacted, estimates a 2021 report from Planned Parenthood and In Our Own Voice: National Black Women’s Reproductive Justice Agenda. Polls show a majority of Americans do not want Roe reversed: A May survey from NPR and partners found 64% of Americans do not want the case overturned, 75% do not want to criminalize doctors who perform abortions and 63% want abortion to be allowed at any- time to protect the health of a pregnant woman.

“Right now, states are key,” said Elizabeth Nash, MPP, state policy analyst at Guttmacher Institute, a research and policy organization focused on reproductive health.

More states have been taking up abortion protections not only to secure the right to abortion, but to expand access to it, Nash said. For example, in addition to Colorado, New Jersey and Washington also passed laws this year protecting abortion rights, while voters in Vermont will decide on an abortion-rights amendment to the state’s constitution in November.

In Maryland, lawmakers recently passed a bill expanding the types of health practitioners who can provide abortions. Connecticut adopted a similar law in May, as well as protections for out-of-state abortion patients. In California, Gov. Gavin Newsom recently signed a bill prohibiting insurers from instituting cost-sharing for abortion, and in Oregon, lawmakers created a $15 million fund to support abortion providers and patients.

“Much of what we’re seeing in these progressive states is that it’s not just about their own residents,” Nash said. “They’re also preparing for more people to come in from out of state… What we learned from the Texas experience is that people don’t only go to the state next door.”

Ensuring abortion is accessible — in addition to being legal — is the next step in New Jersey.

“Even while Roe has been in place, it hasn’t been a reality for lots of people,” said Alejandra Sorto, campaign strategist at ACLU New Jersey, which helped lead efforts to pass state-level abortion protections earlier this year. “Legal rights and access have to go hand in hand.”

In January, New Jersey Gov. Phil Murphy signed the Freedom of Reproductive Choice Act, which codified the right to abortion. A few months earlier, the state’s Board of Medical Examiners also voted to eliminate targeted regulations of abortion providers, more commonly known as TRAP laws, and expand the pool of providers who can perform abortions.

Sorto said advocates are now focused on passing measures that address financial barriers to abortion — provisions that had been included in, but were eventually stripped from, the bill signed in January.

In May, Murphy proposed legislation reviving the provisions, including one requiring private insurers to cover abortion without costs to patients.

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In May, Franz Theard, MD, consults a patient from Oklahoma at Women’s Reproductive Clinic, an abortion provider in Santa Teresa, New Mexico. If the Supreme Court overturns *Roe v. Wade*, abortions would remain legal in the state.

Photo by Paul Ratje courtesy The Washington Post/Getty Images

“This is a moment that can only be met with collective action and care,” Sorto said. “There’s no other option than to come together and organize and fight for our rights.”

In some states, the aftermath of overturning *Roe v. Wade* is less clear. In West Virginia, for example, a statute criminalizing abortion has been on the books since the late 1800s, said Margaret Chapman Pomponio, MA, executive director of WV FREE, a reproductive rights and justice organization.

So far, she said, lawmakers have been unsuccessful in trying to strike the old code, so it is possible abortion opponents could seize on it if Roe falls.

Voters in the state also approved a ballot initiative in 2018 that amended the West Virginia constitution to say it does not secure the right to abortion or require funding for abortion services. The change already led officials to cut off Medicaid funding for the procedure.

West Virginia has only one abortion clinic left, in its capital city of Charleston.

“It’s hard to say what would happen here (if Roe were overturned),” Chapman Pomponio said. “It’s been a real wake-up call for folks across West Virginia…People are mobilizing, and now it’s our job to channel that into effective change and influence on our leaders.”

Missouri is also down to one abortion clinic. If Roe is overturned, the state has a so-called “trigger law” on its books, which would automatically ban abortion.

Michele Landeau, board president of the Missouri Abortion Fund, said news of the draft Supreme Court decision “felt like getting punched in the stomach.” But if Roe is struck, she said it would change little about the abortion landscape in Missouri, noting that of the 1,800 abortions the organization funded in 2021, just two happened in the state. At the same time, Roe’s reversal would mean the states that Missourians usually rely on for abortion access would be inundated with new patients.

“It’ll overload all the clinics Missourians have been fleeing to for years,” Landeau said. “Wait times will get longer, abortion will get more expensive, people will have to travel farther.”

She said grassroots education will be key in the coming years.

“We have to change the culture and conversation around abortion,” she said. “People don’t know how hard it is to get an abortion until you need one because no one talks about it.”

Back in Colorado, advocates are readying to protect and expand the state’s new abortion rights law. Aurea Bolaños Perea, MA, strategic communications director at the Colorado Organization for Latina Opportunity and Reproductive Rights, which led efforts to pass the law, said conservative lawmakers are already campaigning on overturning it and trying to create so-called “sanctuary cities” where abortion would be banned.

Even though Colorado has relatively few abortion restrictions compared to other states, Bolaños Perea said getting rights put into law was no easy task, highlighting the importance of having strong supporters in elected office. In fact, debate in the Colorado House of Representatives over the law lasted 24 hours, the longest in the chamber’s history.

“Right now, it’s our job to continue to educate communities that abortion is still legal, abortion is good and abortion is community care,” she said.

For more, visit [www.guttmacher.org](http://www.guttmacher.org).

*   Copyright The Nation’s Health, American Public Health Association