Developments in Abortion, Autonomy, and Access:
In this week’s Reproductive Health Digest, we discuss an important Supreme Court case about Medicaid and Planned Parenthood, newly introduced and passed state legislation, developing policy trends, and updated reporting and analysis on public opinion about reproductive healthcare and abortion. As always, we welcome your feedback on how we can best make this Digest suit your needs and support your work. Please read on to the end for the news that you need to know.
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This Week’s Must Read:
This week’s must-read is a long, but important, one. The National Women’s Law Center has published a new report outlining the myriad strategies being employed to undermine access to birth control post-Roe. Access to abortion and access to birth control are inextricably intertwined issues, and there are many ways to erect barriers to contraception that don’t require passing a sweeping ban. The strategies described in the Report are ongoing in many states, and we will be watching closely as the policy landscape develops.
Legislation & Litigation:
Overview:
On April 2nd, the U.S. Supreme Court heard oral arguments in a case about Medicaid funding for Planned Parenthood that will have sweeping implications for the rights of Medicaid recipients nationwide;
Texas is considering a bill that purports to clarify its abortion ban, but it has met resistance from both sides of the aisle;
North Carolina lawmakers have proposed a total abortion ban;
Texas has filed a lawsuit against San Antonio, arguing that the city’s allocation of funds for abortion travel violates state law;
The Oklahoma House has passed a bill that would treat the possession and delivery of abortion-inducing medications as a drug trafficking offense;
A federal judge has ruled that the Alabama Attorney General cannot prosecute people for helping individuals obtain lawful out-of-state abortion care;
Nevada is poised to reinstate parental notification requirements for minors seeking abortion care in the state; and
The Illinois House has passed novel protections for abortion medications.
U.S. Supreme Court Hears Case About Medicaid Funding for Planned Parenthood:
As we reported in our last Digest, the U.S. Supreme Court heard oral arguments on April 2nd about whether individual patients have standing to bring a lawsuit challenging the denial of Medicaid funding for Planned Parenthood. Federal law allows Medicaid recipients to obtain care from any qualified provider. But, South Carolina Governor Henry McMaster has sought to block funding from going to Planned Parenthood, despite conceding its qualifications. The outcome of this case will have far-reaching consequences for Medicaid recipients’ ability to choose their provider without political interference from the state.
Oral arguments centered on whether or not the specific language in the relevant Medicaid provision gives individuals the ability to enforce their federally-conferred right to see a qualified provider of their choosing. John Bursch, arguing on behalf of South Carolina, urged that it does not, because the Medicaid statute doesn’t use the word “right” or its “functional equivalent.” During arguments, several of the Justices appeared skeptical of this argument, with Justice Kagan pointing out that the Medicaid Provision was revised specifically to include a freedom of choice requirement. Justice Barrett appeared to echo the concern that the state’s argument would roll back this congressionally created right. A decision in the case is expected this summer.
Texas Considers Abortion Bill ‘Clarification’:
The Texas legislature’s consideration of a bill purporting to clarify the state’s abortion ban has sparked controversy. The bill, SB 31, does not expand access to abortion, but–according to its proponents–clarifies when a doctor is able to intervene and provide care to protect their patient. Specifically, the measure removes the words “life-threatening” from the exception for the life or health of the pregnant person and states that an emergency does not need to be imminent or irreversible in order for a doctor to act. The latter change is intended to address cases where doctors have been forced to wait until their patient gets “sick enough” before they are able to provide care.
Proponents of the law argue that it is a clear-cut measure that merely provides needed clarity. However, it has drawn opposition from both sides of the aisle. During a House committee meeting, some lawmakers raised concerns that the amendment could be used as a loophole for clinicians to provide ‘abortion on demand.’ Conversely, pro-choice groups point to the law’s potential to bolster arguments that a 1925 pre-Roe abortion ban can be revived and enforced. Abortion advocates have also raised concerns that these kinds of clarification bills give anti-choice legislators political cover while failing to meaningfully address the healthcare crisis precipitated by post-Roe abortion bans.
North Carolina Proposes Total Abortion Ban:
North Carolina lawmakers have introduced a total abortion ban, entitled the “Human Life Protection Act of 2025.” The bill would ban abortion at all gestational ages with only an exception to save the life of the pregnant person. At present, abortion is banned in North Carolina after 12 weeks, with exceptions for rape, incest, lethal fetal anomalies and the life or health of the pregnant person. If passed, the Human Life Protection Act would significantly curtail access in the state and further strangle reproductive healthcare in the South, where most states already ban abortion.
Texas Files Lawsuit Against San Antonio Over Allocation of Funds for Reproductive Healthcare:
Texas Attorney General Ken Paxton has filed a lawsuit against San Antonio, based on the city’s allocation of $100,000 for reproductive health. The money, which was recently approved by the San Antonio City Council, will be used for out-of-state abortion travel. Although none of the money will directly fund abortion, Paxton alleges that the funding is a “misuse of public funds” and an attempt to “circumvent state law and take the innocent lives of unborn children.” He is requesting a temporary restraining order and injunctive relief on the grounds that the city has violated Texas’s Gift Clause, Human Life Protection Act, and other pre-Roe abortion statutes.
Oklahoma House Passes Abortion Medication ‘Trafficking’ Bill:
The Oklahoma House has passed a bill that would treat the possession or delivery of “abortion-inducing drugs” as a drug trafficking offense, subject to up to $100,000 in fines and 10 years in prison. The bill would not allow for the prosecution of someone possessing the drugs for their own use, and it would not apply to cases where the intended use of the drug was lawful, such as to treat an ectopic pregnancy or manage a miscarriage. Several other states where abortion is banned have passed similar restrictions on access to medication abortion. The measure will now go to the state senate for consideration.
Federal Court Rules Alabama Attorney General Cannot Prosecute People for Helping Others Obtain Lawful Out-of-State Abortions:
In a critical victory out of Alabama, District Court Judge Myron Thompson has ruled that Alabama Attorney General Steve Marshall cannot prosecute people for helping others obtain lawful out-of-state abortion care. Following the Dobbs decision, Marshall repeatedly threatened that individuals who helped others cross state lines for abortions could be prosecuted under the state’s conspiracy and abortion statutes. Judge Thompson’s decision found that these threats violated constitutionally protected speech and travel rights. The Court’s ruling allows providers to once again freely and openly counsel their patients on their lawful healthcare options. Alabama is likely to appeal this decision up to the 11th Circuit Court of Appeals, but Judge Thompson’s decision is an important precedent as anti-choice states test the boundaries of their abortion restrictions.
Nevada Poised to Revive Parental Notification Requirement for Minors:
Nevada appears poised to revive a long-dormant 1985 parental notification requirement for minors seeking abortion care. Although the law has been blocked by an injunction for decades, a group of district attorneys argued that the Dobbs decision rendered it once again enforceable. U.S. District Court Judge Anne Traum agreed. The law is set to take full effect on April 30th; however, it is likely that advocates will request that it remain blocked while they litigate its constitutionality.
Illinois House Passes Protections for Medication Abortion:
The Illinois House has passed a novel piece of legislation bolstering protections for medication abortion. In anticipation of potential federal restrictions, the bill would allow healthcare providers to continue providing abortion medication as long as the World Health Organization recommends it, even if the FDA revokes its approval. FDA approval of mifepristone is the subject of ongoing litigation, and the Trump Administration has indicated its interest in Health and Human Services Secretary Robert F. Kennedy Jr. reviewing the safety of abortion pills.
Trend & Policy Watch:
Missouri Rejects Planned Parenthood’s Complication Plan:
In Missouri, where voters overturned a total abortion ban last November, the state continues to erect roadblocks to access. In late March, the Missouri Department of Health sent a letter to Planned Parenthood Great Rivers informing them that their complication plans did not meet state requirements. Under an emergency rule published that same day, the state requires facilities that prescribe medication abortions to more than 10 patients a month to set forth a complication plan that meets certain strict requirements. Following the rejection of their plan, Planned Parenthood renewed its challenge to the complication plan requirements, citing Missouri’s “endless end-runs around” the abortion ballot measure passed 5 months ago.
Wisconsin Supreme Court Race is a Victory for Reproductive Rights:
Wisconsin scored a victory for reproductive rights with the election of Judge Susan Crawford to the state Supreme Court. Judge Crawford has a history of supporting abortion rights, including previously representing Planned Parenthood in litigation. Her election secures a liberal majority on the court at a time when it has two cases about an 1849 abortion ban before it.
States Show Appetite to Prosecute Abortion-Seekers:
Trends across state legislatures show an appetite to increase restrictions on abortion, including prosecuting the pregnant person themselves, a line that the anti-abortion movement has historically been unwilling to cross. Although few, if any, of these bills are likely to pass this session, the increase in their volume and their repeated introductions in state legislatures year after year show an alarming trend.
Study Shows Low Support for Fetal Personhood:
Recent analysis from the National Women’s Law Center shows that support for fetal personhood is low. And, the more people learn about its implications, the less supportive they are. The analysis also shows that there is significant concern around government interference in pregnancy decisions, and that support for abortion and reproductive choice remains high.
Emergency Contraception Will Be Available for Free in England:
In an effort to reduce healthcare inequalities, England is set to make emergency contraception, or the morning after pill, free. In the United States, emergency contraception is legal and available over the counter at many pharmacies, but the medication’s cost can be a barrier to access. It has also become a subject of significant post-Roe political debate, with some lawmakers inaccurately casting it as an abortion-causing drug and calling for it to be restricted or made illegal.
American Doctors Go to Mexico to Receive Abortion Training:
American doctors and medical students are turning to other countries, including Mexico, to gain comprehensive abortion training and experience. Even in abortion-supportive states, residents frequently receive minimal abortion training, as medical schools run by large hospitals often take risk-averse approaches to providing training for fear of losing funding or other support.