How leaving abortion laws up to the states puts women’s health at risk

From the moment the U.S. Supreme Court ruled in Dobbs v. Jackson Women’s Health Organization in June 2022 and overturned Roe v. Wade, ending the constitutional right to abortion, former President Donald Trump, his vice presidential running mate Ohio Sen. J.D. Vance, and a slew of Republican lawmakers have stood firm on the idea that the regulation of abortion should be left up to the states.

Erin Case is the executive director of the Montana Abortion Access Program, an abortion fund that provides financial and practical assistance to clients seeking abortion care.

“Abortion is health care, and people deserve access to health care regardless of where they live,” Case told the Montana Independent. “Your access to health care that you need should not be dependent on what state you live in.” 

Case said that patients applying for financial help in traveling to Montana for abortion care is up sevenfold since 2020. Abortion is legal in Montana up to the point of fetal viability, usually considered to be 24 to 26 weeks of pregnancy.

Since the Dobbs decision, 21 states have either banned or severely restricted abortion care, while voters in several states have turned to ballot initiatives as a way of protecting reproductive rights.

Polling has shown that two-thirds of Americans disagree with the Dobbs decision and that voters in a majority of states want abortion to be legal in all or most cases.

On Oct. 7, the Supreme Court declined to hear a case from President Joe Biden’s administration appealing Texas’ rejection of a federal law that requires providers to perform abortions when needed for pregnant patients in emergency situations. The federal Emergency Medical Treatment and Labor Act came up against Texas’ near-total abortion ban. The justices left in place a lower court ruling in Texas’ suit against the administration that charged the federal government with exceeding its authority in the area, and ultimately the issue was unresolved nationally. 

“The Supreme Court’s failure to act to protect the lives and health of pregnant people is shameful,” Reproductive Freedom for All president and CEO Mini Timmaraju said in a statement. “When Trump says decisions about abortion should be left to the states, he’s saying that denying people potentially life-saving, emergency care should be allowed.”

Studies have shown that the reversal of Roe has resulted in dangerous outcomes for women’s reproductive health. 

A study by the Commonwealth Fund health care foundation released in July found that the Dobbs decision “significantly altered both access to reproductive health care services and how providers are able to treat pregnancy complications in the 21 states that ban or restrict abortion access.”

The report says that bans on abortion have driven providers to leave states, deepened the maternity care crisis, and put access to contraception and infertility treatments at risk. 

Aileen Gleizer is a member of the board of the Montana Abortion Access Program. Gleizer told the Montana Independent that leaving abortion laws up to individual states has forced people to travel far from home, take time off of work, and find child care in order to obtain reproductive care. 

“The false rigidity of this purported state-by-state solution exacerbates that, so folks are forced to travel. It’s this kind of abortion exceptionalism, where for a subset of procedures like abortion care and gender-affirming care, people are having to leave a state that they call home, that they get their other medical care,” Gleizer said. 

Gleizer noted that Montana is a large state, and patients travel an average of more than 400 miles to receive the care they need.

Case said that people who live in states that protect abortion rights could still see impacts from abortion bans in other states. 

“We live in a society together. What happens to one person impacts everyone else in that society, and what happens in one state will unfortunately have impacts in the surrounding states, the region, across the country,” Case said. “And so I don’t think it’s as simple as, What does abortion access look like in your state? You have to take into account what that impact looks like for people in your neighboring states, for your region, for your country, and what level of access that you want to see for folks across the country, not just within your own area.”