State Abortion Restrictions and the New Supreme Court: Women's Access to Reproductive Health Services

The US Supreme Court's landmark 1973 ruling in Roe v Wade established a privacy right to choose abortion. However, in more recent years, many judicial cases have emerged as blatant challenges to this ruling. The recent balance shift of Supreme Court justices to a conservative-leaning majority has many concerned that the new legal environment would make it more likely to curtail reproductive rights by limiting the affordability of or access to abortions. The court is unlikely to review outright bans, but appears poised to incrementally uphold various restrictions. Evidence to this effect includes 7 states enacting bans on all or most abortions in 2019, which is in direct violation of Roe v Wade and a 1992 reaffirmation of Roe in Planned Parenthood of Southeastern Pennsylvania v Casey. Georgia, Kentucky, Ohio, Louisiana, Mississippi, and Missouri all banned abortion after a fetal heartbeat can be detected (approximately 6 weeks of pregnancy), with statutes even limiting exceptions for rape and incest. Thirty-four states and the District of Columbia prohibit public funding for abortions (unless the woman's life is endangered or for rape or incest). Insurance coverage for public employees is prohibited in 22 states. Additionally, 11 states prohibit private insurance from covering abortions, and 26 prohibit abortion coverage in plans offered through Affordable Care Act insurance exchanges. While it is unlikely that the Supreme Court will overturn Roe outright, should the court uphold the limitations put forth by the various states assuming they wind their way through the lower courts making their way to the Supreme Court, it could limit the ability of many women to access services. Already, the expense of abortion, coupled with a lack of health care coverage in many states, prevents low-income women from accessing these procedures. Thus, the expansion of regulations limiting abortion funding will, in turn, exacerbate current health, social, and economic inequities. One concerning legislative approach is to define fetuses as legal "persons." In states that do so, abortions would be serious crimes, and there is a concern for abortion providers to face serious consequences. Burdensome rules will also prevent health professionals and institutions from providing abortions, which can jeopardize women's physical and mental health.