What comes next for abortion access?

What is the Dobbs v. Jackson Women’s Health Organization case?

Dobbs v. Jackson Women’s Health Organization is a case recently heard by the United States Supreme Court concerning a 2018 Mississippi law banning abortions after 15 weeks, with only narrow exceptions for medical emergencies and severe fetal abnormalities. The Mississippi abortion ban at the center of Dobbs is in direct conflict with the Supreme Court’s holdings in Roe v. Wade and Planned Parenthood v. Casey — two seminal abortion rights cases — because it bans abortion prior to 24 weeks or viability. If the Supreme Court decides in favor of Dobbs this June, it will effectively dismantle 50 years of judicial precedent and overturn federal abortion protections. The battle for abortion access will be a state-by-state fight.

Why should I care about Dobbs v. Jackson Women's Health Organization?

Abortion care is a human right: it is an essential and life-saving medical procedure. And securing access to abortion is a cornerstone of reproductive equity. But abortion care is more than just a medical or “women’s issue.” Abortion is an economic security issue. It’s an educational issue, an immigration issue, a queer justice issue, and a racial justice issue. Attacks on abortion care are attacks on the autonomy of the person.

If Roe v. Wade is ultimately overturned, 26 states are poised to ban or severely restrict abortion care, putting this health care out of reach for upwards of 64 million people of reproductive age. But banning abortion in 26 states is not the anti-abortion movement’s end goal—they want to see a federal abortion ban put in place. A federal abortion ban would ban abortion care in Massachusetts. We cannot let that happen.

And when Dobbs is decided, the right to abortion is not the only right at stake. Many other rights that are founded on the same principles of privacy and equal rights are at risk of being dismantled, including the right to emergency contraception, birth control, gender affirming care, in vitro fertilization, and LGBTQ+ marriage. This decision will have sweeping consequences for bodily autonomy, when and whether people decide to start a family, and reproductive equity.

I thought the Supreme Court already leaked its decision. What is the difference between the leak and the final decision?

The draft opinion that was leaked to the press at the beginning of May was simply that: a draft! The Supreme Court has not yet issued a final decision and nothing has changed about federal abortion protections yet. You can still access abortion care today.

The Supreme Court will continue to release decisions through the month of June, and we can expect to have a final decision on the Dobbs v. Jackson case in the coming weeks.

What will happen to abortion protections when the Dobbs case is decided?

If the holding of the Dobbs decision is similar to the substance of the leaked draft, the decision about whether or not to allow abortion would be left entirely up to states. As it currently stands, 22 states have pre-Roe abortion bans or trigger bans that would automatically take effect upon the court’s decision in Dobbs. Additionally, four more states are likely to ban or severely restrict abortion in the wake of Dobbs, in total impacting upwards of 64 million people of reproductive age. People will be forced to travel far from home to access care, if they can afford to travel at all, and clinics across the South and Midwest will be forced to shutter their doors.

But while abortion rights are protected in Massachusetts, our state will feel a cascading impact from these state bans. They will cause a domino effect in protected states as people cross state borders to receive care – causing abortion providers to experience a demand they’re unable to keep up with. We’re already seeing it in Massachusetts.

People will travel wherever they can get a direct flight, have family or support networks, or feel safe receiving care. New England can and must be a beacon for reproductive equity as these state bans go into effect.

Who will be most impacted by the overturn of Roe?

Black, Brown, low-income, immigrant, disabled, LGBTQ+, and young people will be most impacted by these extremist state abortion bans. Those without the means to travel will have no choice but to carry their pregnancy to term, and those without health insurance that covers abortion will be forced to pay exorbitant out-of-pocket costs for routine health care.

Which states are poised to ban abortion?

There are 26 states that will likely ban abortion if Roe falls, though not all bans will happen instantaneously. 22 states have pre-Roe abortion or trigger bans that would automatically take effect and ban abortion if Dobbs removes federal constitutional protections.

• Alabama, Arizona, Arkansas, Idaho, Kentucky, Louisiana, Michigan, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, Wyoming have a pre-Roe ban or a trigger ban on the books that would go into effect as soon as the decision is released;

• Georgia, Idaho, Iowa, Kentucky, Louisiana, Mississippi, North Dakota, Ohio, Oklahoma, South Carolina, Tennessee, Texas have a six-week ban that would take effect;

• Missouri has an eight-week ban that would take effect.

Additionally, based on recent legislative activity, four more states are likely to ban or severely restrict abortion in the wake of Dobbs: Florida, Montana, Indiana, and Nebraska.

Will people in New England still be able to access abortion?

Yes! In most New England states—Connecticut, Maine, Massachusetts, Rhode Island, and Vermont—abortion is codified into state law. To find out about abortion clinics and availability near you, please visit Reproductive Equity Now’s New England Abortion Care Guide, available here. You can also find state-by-state laws governing abortion access here.

What barriers to abortion care exist in Massachusetts?

Because Massachusetts passed the ROE Act in 2020, abortion will remain legal regardless of what happens at the Supreme Court this June. But while legal, access is not guaranteed. Barriers to care—including exorbitant costs, complicated insurance coverage, and under-resourced providers—still exist, especially for low-income communities, communities of color, immigrant communities, and young people.

The total cost of abortion varies based on a number of factors including how far along in the pregnancy a patient is, what type of procedure the patient needs, and what type of insurance the patient carries. A Massachusetts study found that the cost of medication abortion can range from $420 to $920 and surgical or aspiration abortion could range from $420 to $3,450. In addition to the cost of the procedure, travel, lodging, child care, doula, and translation services can also add to the cost and present barriers to patients obtaining abortion care.

For individuals younger than 16, they must receive parental consent or judicial bypass in order to access abortion care. However, Massachusetts has instituted a telephonic judicial bypass system so that youth do not have to miss school or physically appear in the courtroom to seek permission for an abortion. Still, this can pose especially challenging for youth in the Department of Children and Families (DCF) custody or care.

Crisis Pregnancy Clinics, also known as Fake Women’s Health Centers, can also pose a barrier to patients seeking abortion care. These clinics present themselves as resources for people facing unplanned pregnancies, yet are intended to manipulate and dissuade pregnant people from accessing abortion. They are often deliberately located near reproductive health clinics and create websites that appear in online searches for legitimate abortion clinics. Fake Women’s Health Centers are typically managed and funded by organizations—often religions organizations—that oppose abortion in any and all circumstances. Find the dangerous crisis pregnancy centers near you at abortioncarenewengland.com.

Is New Hampshire going to outlaw abortion?

New Hampshire is the only state in New England that has not codified the right to abortion access in state law, making it vulnerable to more restrictive abortion bans. However, New Hampshire does not have a "trigger law" that would immediately ban abortion if Roe is overturned. Last year, the New Hampshire legislature passed legislation to ban abortion after 24 weeks. The law has recently been updated to include some exceptions for fatal fetal diagnoses and the life of the pregnant person. Even so, New Hampshire clinics frequently only provide abortion up to 15 weeks, while hospitals may provide care later in pregnancy.

How can I get an abortion in New England?

To find out about abortion clinics and availability near you, please visit Reproductive Equity Now’s New England Abortion Care Guide, available here.

If you need assistance paying for abortion care, there are nonprofit organizations that may provide direct financial aid in the form of grants. Visit the National Network of Abortion Funds to find a fund in your area.

Are Massachusetts providers protected for providing abortion care?

The right to an abortion is affirmatively codified in Massachusetts law. Abortion up to 24 weeks may be performed by any physician, physician assistant, nurse practitioner or nurse midwife consistent with the scope of their practice and license. The Dobbs decision will not change this: Massachusetts providers will still be able to perform, and Massachusetts patients will still be able to obtain, abortions.

But we can't rely on other states to protect our providers; Massachusetts must do what we can to strengthen legal protections for abortion providers in our state who look to provide care to those from states with hostile bans. We need to do all we can to try to insulate Massachusetts providers from harmful consequences for providing care that is legal in Massachusetts. That’s why we are excited to see an amendment with provider protections included in the Massachusetts Senate budget.

For more information on our recommendations to protect providers, read our agenda here.

What is the path forward for abortion rights and access if Roe v. Wade is overturned or dismantled?

With the Supreme Court’s decision, the fight for abortion access will become a state-by-state, grassroots battle. New England can and should be at the forefront of the fight to assert the right of all people to make private, personal decisions about their reproductive destiny. We envision a regional block of states paving the way forward on reproductive equity and demonstrating to the nation what true reproductive equity looks like. 

Massachusetts can take meaningful action today to promote reproductive freedom in the Commonwealth. Reproductive Equity Now has outlined a 21-point plan—consisting of legislative actions, budget investments, and regulatory solutions—that leaders and policy makers should adopt to expand access to abortion care in Massachusetts. We are poised to lead the way with a model that emphasizes local and state leadership to secure national change. 

You can read and co-sign our agenda at massbeyondroe.com.

How can I get involved in the fight for abortion care here in New England?

1. Sign up to volunteer with groups like Reproductive Equity Now! We are doing the electoral and policy work on the ground in Massachusetts to expand access to care and keep our state as a beacon for reproductive freedom.

2. Donate to abortion funds! Abortion funds are grassroots organizations that are working on-the-ground to help pregnant people finance their abortion care. They help with everything from travel to accommodations to child care, to the procedure itself so that people can afford to travel for abortion care when Roe falls. Go to abortionfunds.org to find a local abortion fund to give to.

3. We can show what is possible when we have leaders and advocates that are committed to smart, forward thinking policy to support reproductive equity. Support pro-reproductive freedom candidates up and down the ballot!