New Report shows state efforts to protect, restrict abortion access
A comprehensive study from CRR shows where improvements have been made, and where they need to be
A new report report highlights 2023 state legislative trends impacting people’s access to abortion care, maternal health care, and assisted reproduction.
The Center for Reproductive Rights released its 2023 State Legislative Wrap-up report, which was a year-end summary of the attempts to protect and restrict abortion rights across the country.
The report's first section deals with shield laws enacted to protect transgender healthcare, data privacy, and clinic access. Colorado, New York, Vermont, and Washington were four commonwealths that advanced protections for telemedicine. As of December 1, 2023, 17 states and the District of Columbia have enacted shield laws.
(An explanation of what shield laws are supposed to do, which was drawn from the CRR Report)
In 2023, state supreme courts in Indiana, North Dakota, and Oklahoma found that the state constitutions protect abortion rights when the pregnant person’s life or health is at risk.19 There was one voter-initiated constitutional amendment on a state ballot this year and two amendments were referred by legislators for general elections in 2024.
The report described how the Ohio Reproductive Freedom Amendment came into law and its significance. In 2023, the Center monitored 22 bills in 16 states (Arkansas, Georgia, Hawaii, Illinois, Iowa, Maryland, Mississippi, Nebraska, New York, Nevada, Oklahoma, South Carolina, Texas, Virginia, Washington, and Wisconsin) seeking to amend state constitutions to protect or expand access to abortion. The Maryland and New York legislatures have each referred an amendment to the ballot to appear during the 2024 elections.
In response to federal litigation by anti-abortion advocates seeking to restrict or entirely invalidate the Food and Drug Administration’s approval of mifepristone, the first pill in the two-pill medication abortion regimen, states supportive of abortion moved to specifically protect access to medication abortion through legislation and executive orders. In 2023, 12 states (Arizona, California, Connecticut, Illinois, Indiana, Massachusetts, Michigan, Mississippi, New York, Texas, Vermont, and Washington) and D.C. introduced 26 bills, including provisions protecting or expanding access to medication abortion.
Insofar as the Hyde Amendment, the report indicated that over 18 percent of adults nationwide receive Medicaid, a percentage that rises every year. Despite this, states across the country limit Medicaid coverage and other public funding for abortion, allowing for coverage only in specific circumstances. No states require state Medicaid programs to cover fertility care, and there is a patchwork of coverage for vital maternal health services.
In 2023, 23 states introduced 93 bills to expand state public funding for abortion, including state Medicaid or medical assistance coverage for abortion services, state funding for abortion training and programs, and grants to abortion funds and facilities. While there are no explicit prohibitions concerning Medicaid coverage of fertility care as there are for abortion services, no state includes in vitro fertilization (IVF) in their covered services for Medicaid enrollees.
Medicaid is not the only program that provides support for pregnant people and their families. Temporary Assistance for Needy Families (TANF) provides financial assistance to families for a set period, which varies from state to state.
Unlike Medicaid, TANF has strict work requirements. The program was created as part of the 1996 Welfare Act, which was supposed to lift families out of poverty through work. It’s been heavily criticized by people in the reproductive justice movement as perpetuating racist ideas. TANF benefits are based on family size as of the date someone applies to receive benefits. Family caps, however, deny families incremental increases if they have another child while receiving TANF.
The report also went into the issue of private insurance covering reproductive care. While a lot of focus has been on the abortion aspect, an equally important component missing in many private plans is the financial reimbursement for IVF treatment. A single cycle of IVF can cost an average of $20,000, leaving the procedure out of reach for most people without insurance coverage. Only 14 states and the District of Columbia, however, have insurance mandates that require insurance plans to cover IVF, and some of these existing mandates are not inclusive of single individuals and LGBTQ couples, leaving them unable to access fertility care.
I could describe the whole report, but I’ll attach it here for everyone who wants to know more.
