Why Recent Supreme Court Rulings Are Status Quo for Deteriorating Abortion Rights

Since the Supreme Court’s decision to overturn Roe v. Wade in 2022, life has become significantly more challenging and risky for many people in the United States who are or may become pregnant, as well as for their loved ones. The Dobbs decision, which struck down Roe, has intensified health disparities, financial challenges, and limitations to health care choices, affecting decisions about whether, when, and under what circumstances a person becomes a parent or grows their family. This decision substantially exacerbates the stress of pregnancy—especially for people with limited resources and health concerns.

Currently, 15 states have total abortion bans, severely restricting the procedure in almost every scenario. Another 27 states impose significant restrictions to access: Seven states restrict abortion before 18 weeks, and 20 states do so at a later point in pregnancy. Texas, for instance, has effectively banned all abortions by prohibiting the procedure after a fetal heartbeat can be detected, usually around five to six weeks, which is around the time when many people find out they’re pregnant. A shocking recent study found this decision has a serious impact on infant mortality—meanwhile, Florida and Georgia also prohibit abortions after six weeks. These obstructions in abortion access disproportionately risk the health, lives, and economic security of those in need of care.

This term, the U.S. Supreme Court was presented with two cases where the rulings could have made things substantially worse. The Court dismissed each without reaching the substantive issues in the case, but these are not wins for reproductive justice. Restrictive laws are on the books, and more challenges to reproductive health care access and bodily autonomy are coming. This means persistent uncertainty, fear, and threats to accessible, life-saving care.

In FDA v. Alliance for Hippocratic Medicine, the first case in which a ruling was released, the Court addressed the legality of FDA rules that allow the abortion medication mifepristone to be available at pharmacies, provided through the mail, and prescribed by medical practitioners beyond just physicians. The Court found the litigants lacked standing due to a lack of demonstrated harm, thereby leaving the FDA’s rules intact—for now. However, the decision outlined a path forward for future challenges to establish standing. Three states—Missouri, Kansas, and Idaho—intervened in the case, and the Supreme Court’s decision on Thursday does not rule out future litigation.

Central to these disputes are FDA regulations from 2016 and 2021 that expanded access to mifepristone, which has been a key component of medication abortion since its FDA approval in 2000. The litigants argued that the FDA overstepped its authority with these regulatory changes.

Medication abortion access is crucial to abortion access, as an estimated 63 percent of abortion-seekers use medication to trigger the end of a pregnancy—this figure likely underestimates usage due to unaccounted mailed prescriptions in states with total abortion bans. Mail-order medication abortion is especially important due to its relative accessibility compared to in-clinic procedures. Approximately 89 percent of U.S. counties do not have abortion clinics, which means that many patients rely on telehealth for prescriptions, often from nurse practitioners rather than physicians, retrieved from pharmacies or delivered by mail. Future litigation challenging these rules—if successful—would mean significant hardship and potentially restrict essential access to abortion care for pregnant people who need it.

When access to abortion is denied, the consequences are profound and far-reaching. What happens when someone can’t get an abortion?

• Financial instability often worsens, leading to heightened economic strain.
• Their physical and mental health may suffer, impacting overall well-being.
• Particularly alarming is the increased maternal mortality risk, which disproportionately affects Black women already grappling with higher rates of pregnancy-related complications.
• Forced birth may limit their future as educational and career opportunities diminish, which can exacerbate economic precarity.
• Tragically, there’s also an increased risk of experiencing domestic and interpersonal violence.

The second case that was before the Court this term was Idaho v. United States, which was consolidated with Moyle v. United States. The Court considered whether the Emergency Medical Treatment and Labor Act (EMTALA) of 1986 conflicts with and overrides an Idaho statute restricting abortions to the narrow circumstance when pregnancy puts a person’s life at risk. EMTALA prohibits hospitals with emergency departments from refusing to examine or treat individuals with an emergency medical condition, including pregnancy complications, necessitating an abortion. Justice Kagan’s concurring opinion highlighted that dilemma: Federal law requires hospitals to provide abortions in cases where a pregnancy jeopardizes a woman’s health—including her future fertility—even if not her life. The plain language of the Idaho law prohibits such emergency care.

The Court determined that it had “improvidently granted review” of the Ninth Circuit Court of Appeals’s decision. The appellate court had allowed Idaho’s law to take effect while a district court reviewed its merits, lifting a district court’s injunction of the Idaho law and forcing Idaho physicians to withhold care for six months, during which patients were regularly airlifted out of state, according to Justice Kagan. With the Supreme Court’s decision to dismiss the case and reinstate the Idaho district court’s injunction, the state law cannot currently be enforced. This temporarily restores access to emergency abortion care for pregnant individuals facing serious medical issues short of those risking death.

However, this is not a victory. Similar legislation from other states is likely, and ongoing litigation in Idaho and Texas suggests the substantive issue about conflicts between EMTALA and state laws will return to the Supreme Court.

Although the Supreme Court’s decisions this term maintain the current state of affairs, we must remember that the status quo is deeply problematic. Abortion access is far too limited, leading to significant health risks, financial hardships, and reduced care for pregnant individuals unable to obtain the abortions they seek, as highlighted by findings from The Turnaway Study, which studied the long-term health and economic effects on women who were denied abortion care.

Tens of millions across the nation reside in states where access to abortion is either banned or significantly restricted. With more than 6.7 million Black women and nearly 6.7 million Latinas aged 15 to 49 living in states that have banned or will ban abortion, Black and brown women face compounded disparities, dating back centuries. People in these states also face above-average maternal mortality rates, a significant concern given that Black women experienced the highest rate of pregnancy-related deaths in 2023 at 49.9 per 100,000 live births, according to recent Centers for Disease Control data.

In states with restrictive abortion laws and bans, pregnant people of all races who must travel more than eight hours out of state for care earn thousands of dollars less annually than those who don’t face such travel requirements. And any future restrictions to medication abortion, especially through telehealth and mail-order services, would only create more challenges. Lack of access to paid sick leave, child care, and other financial barriers further exacerbate pre-existing hardships—potentially rendering travel for abortion care impractical and increasing the likelihood that individuals are forced to carry a pregnancy to term against their preference.

In addition, any future Court decision that limits the reach of EMTALA would be particularly disastrous for women with health complications or heightened risk thereof.

Amidst these challenges, broader societal issues underscore the debate over abortion access: The United States stands alone among most high-income nations in not guaranteeing paid family, medical, and sick leave to workers and in offering too few supports for families. There is not a single state that bans or significantly restricts abortion that also guarantees access to paid leave for new parents in the private-sector workforce, reflecting broader deficiencies in child care subsidies and support.

These policies not only burden families but also hinder economic growth by deterring businesses from states with restrictive abortion laws and inadequate support systems. The Institute for Women’s Policy Research estimates annual losses of $173 billion for the U.S. economy due to restrictions on abortion access alone, driven by reduced female workforce participation, lower earnings, and increased turnover. And this is just part of the estimated $775 billion the United States loses out on by failing to provide investments that support families.

Some states, like Minnesota and Maine, demonstrated an alternative approach by enacting protective abortion laws alongside state-paid leave programs in 2023. Both of these important state policies, along with investments in child care, paid sick time protections, and other policies that support families’ economic security, safeguard and advance reproductive justice.

This election year, voters across the country will cast ballots on abortion rights and paid sick leave and for elected officials at the federal, state, and local levels. Their choices will determine whether conditions improve or worsen for pregnant people and their families. Elected officials wield significant influence by appointing judges who shape decisions impacting millions, particularly those facing multiple harms and with the least means to advocate for themselves and their families. These Supreme Court rulings are the latest reminder of the profound consequences of elections, especially for people in marginalized groups.

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