TO: Interested Parties
FROM: Planned Parenthood Federation of America and Planned Parenthood Action Fund
DATE: June 8, 2023
RE: 2023 State Legislative Session Recap
As we approach the one-year anniversary of Dobbs v. Jackson Women’s Health Organization, many states’ first legislative sessions since the U.S. Supreme allowed states to ban abortion are also wrapping up. Every state in the country has taken action on abortion in some way. Many enacted laws to either ban some or all abortion. Others protected our rights to control our lives, bodies, and futures.
As this memo outlines, the abortion access landscape became even more fractured this year. We continue to face the devastating consequences of abortion bans and restrictions on both patients' health and the greater health care ecosystem. Right now, one in three women — plus trans and nonbinary people — has lost access to abortion in their home states. There is no doubt that this crisis will continue to worsen. Black, Latino, and Indigenous communities, LGBTQ+ people, people with low incomes, people with disabilities, and other groups who face the greatest barriers to health care due to systemic racism and discrimination, will bear the brunt of these attacks.
Not satisfied with banning abortion, lawmakers hostile to sexual and reproductive health care and autonomy aggressively targeted transgender people this session, introducing a record 400+ bills. Twenty states have passed laws to ban some or all gender-affirming care for minors and/or adults: Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Mississippi, Missouri, Montana, Nebraska, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Utah, and West Virginia.
But there is still room for hope. We also saw massive victories this year. States worked to fill critical gaps in care provision and pass legislation to better serve patients seeking care both in and out of state. Even in states dominated by anti-abortion rights politicians who advanced abortion restrictions, advocates for reproductive freedom turned out in record numbers to fight and make their voices heard, fueling our movement to restore, protect, and expand abortion access for generations to come. Amidst ongoing attacks on abortion and in the face of hostile legislatures, pro-sexual and reproductive health champions in several of these states successfully fought to enact bills to expand Medicaid postpartum coverage to 12 months and expand birth control coverage under insurance.
While several states are still in session, here’s a breakdown of what we have seen so far on abortion rights and access during the 2023 state legislative sessions.
Legislation to Protect Abortion Access
In 2023, champions of reproductive health, rights, and justice stepped up to address the ongoing public health crisis head-on. Legislatures enacted more than 35 proactive abortion bills this session. Overall, more than 350 pro-abortion rights bills were filed this year in 48 states — more than double the amount we saw at this time last year. Lawmakers focused on a range of issues, including data privacy protections for personal health information; repealing harmful abortion restrictions; increasing funding and coverage for abortion; enshrining the right to abortion in state laws and state constitutions; and limiting the harm caused by anti-abortion crisis pregnancy centers (CPCs). In total, 25 states and Washington, D.C. have either constitutional or statutory protections for abortion. Here are some key victories this session:
- Colorado: Colorado lawmakers enacted the Safe Access to Protected Health Care package. Among other provisions, it will close gaps in insurance coverage for abortion and sexually transmitted infections, including coverage for travel for abortion. Lawmakers also classified the dissemination of so-called medication abortion “reversal” information as unprofessional conduct.
- Maryland: Lawmakers approved a number of proactive abortion-rights bills including a data privacy law to protect reproductive health information and a law ensuring access to birth control, abortion pills, and emergency contraceptives in or near public college and university campuses in the state. This session, the Maryland General Assembly also approved legislation to codify protections for abortion in the state constitution. Voters will decide on the measure in 2024.
- Michigan: Michigan lawmakers officially repealed the state’s 1931 criminal abortion ban. Although the ban was already nullified by voters’ resounding approval of Proposition 3 in November, which enshrined reproductive rights in the state constitution, the legislative repeal is an important step to permanently protect abortion rights in Michigan.
- Minnesota: With the Protect Reproductive Options (PRO Act), Minnesota lawmakers codified reproductive freedom, ensuring all Minnesotans can make their own reproductive health care decisions, including the right to contraception, the right to fertility treatment, and the right to abortion. Lawmakers also increased reimbursement rates for abortion and family services, expanded abortion coverage under insurance, and ended funding to anti-abortion CPCs.
- New Mexico: New Mexico lawmakers prohibited state interference and discrimination based on reproductive health care choices.
- New York: Lawmakers expanded access to medication abortion on state college and university campuses and made contraceptives accessible over-the-counter.
- Rhode Island: Rhode Island lawmakers enacted the Equality in Abortion Coverage Act, a law to eliminate a discriminatory ban on public funding for abortion and ensure that the nearly 90,000 reproductive-aged Rhode Islanders enrolled in Medicaid or state employee insurance plans have access to abortion coverage.
- Washington: Washington lawmakers enacted several pro-abortion rights laws this session, including legislation to prevent apps and websites from selling, collecting, and sharing people’s health data without their consent and a measure authorizing the Department of Corrections to accommodate the practice of pharmacy or wholesale distribution of mifepristone to provide incarcerated people access to abortion medications.
This session, several states, including Colorado, Hawaii, Maryland, Nevada, New Mexico, New York, Vermont, and Washington, also enacted shield laws aimed at shielding providers of legally-protected reproductive health care services — including abortion and gender-affirming care — from harassing lawsuits and prosecutions brought by out-of-state actors. We continue to keep an eye on states like Oregon, which is still in session and faces hostile opposition as abortion rights champions try to advance legislation to expand reproductive freedom.
This year alone, across 47 states, more than 360 anti-abortion bills were filed and 36 were enacted. State lawmakers opposed to abortion rights who were emboldened by the U.S. Supreme Court allowing states to ban abortion once again worked to pass bans, limit access to medication abortion, bolster so-called “crisis pregnancy centers” (CPCs), increase Targeted Regulations on Abortion Providers (TRAP restrictions), and more. Here is a breakdown of some of the newly-enacted anti-abortion laws:
Currently, bans have eliminated some or all access to abortion in 20 states: Alabama, Arkansas, Arizona, Florida, Georgia, Idaho, Kentucky, Louisiana, Missouri, Mississippi, North Carolina, North Dakota, Nebraska, Oklahoma, South Dakota, Tennessee, Texas, Utah, Wisconsin, and West Virginia. This past legislative session, more than 60 bills banning some or all abortion were introduced in 29 states, including bans at various points in pregnancy or bans based on a person’s reason for seeking an abortion. States that enacted abortion bans this session include:
- Florida: Despite its current 15-week ban, this session Florida lawmakers enacted a six-week abortion ban that will decimate a critical abortion access point for the entire southeast, Caribbean, and Central and South America. The law will not take effect until the Florida Supreme Court takes action on the 15-week ban, which is currently being litigated.
- Montana: Montana lawmakers enacted a viability ban and a law banning D&E procedures — the safest and most common method of abortion after approximately 15 weeks of pregnancy. Both laws, which interfere with medical professionals' ability to offer the best care for their patients, were challenged by abortion providers and are currently blocked along with several other abortion restrictions.
- Nebraska: After initially failing to pass a six-week abortion ban, Nebraska lawmakers passed a 12-week ban during their last few days of the session by adding it as a last-minute amendment tacked on to an existing bill banning gender-affirming care for trans youth. Shortly after the law’s enactment, Planned Parenthood of the Heartland challenged the law in court. The law is currently in effect as litigation proceeds.
- North Carolina: North Carolina lawmakers passed a sweeping 12-week abortion ban after ramming it through the legislature in under 48 hours and subsequently overriding the governor’s veto. The bill also imposes an array of other restrictions that will severely limit abortion access. Parts of the law take effect on July 1, 2023.
- North Dakota: North Dakota lawmakers enacted a near-total abortion ban which would offer only extremely narrow exceptions for the life of a pregnant person and for survivors of rape and incest up until six weeks of pregnancy — before many people even know they are pregnant. This law was passed only a few weeks after the North Dakota Supreme Court blocked the state’s almost identical trigger abortion ban from taking effect. Regardless of the ban, there are currently no providers in the state.
- South Carolina: After failing to pass a total abortion ban during the legislative session, lawmakers reconvened for a special session to pass a six-week ban that substantially mirrors a law previously struck down by the state supreme court. Abortion providers immediately challenged the new law and were granted a preliminary injunction blocking the law while litigation continues. Oral arguments in the case at the South Carolina Supreme Court are scheduled for June 27. Abortion is currently legal in South Carolina.
- Wyoming: Lawmakers passed a total abortion ban to replace the state’s currently blocked trigger ban. The law also removed the limited Medicaid coverage for abortion currently allowed under state law, meaning that even if someone in Wyoming got an abortion to save their life, Medicaid would not cover the costs. After being challenged by abortion providers, the law is currently blocked while litigation continues.
Funding and support for anti-abortion crisis pregnancy centers
This session, legislators introduced nearly 50 bills in 21 states to increase funding or support for anti-abortion crisis pregnancy centers (CPCs). CPCs pose as legitimate health centers but are actually fake clinics set up to spread misinformation and lies about abortion, shame people, and fear-monger to stop patients from getting the care they need. Arkansas, Kansas, North Dakota, and West Virginia all enacted laws to allocate millions of dollars in funding for these fake clinics. Funding for CPCs was also included as part of some laws banning abortion, including Florida’s six-week ban, which gives CPCs $25 million in additional funding.
Licensing Regulations and Targeted Regulations on Abortion Providers (TRAP laws)
TRAP laws place unnecessary and unreasonable requirements on health centers and providers of abortion. They do nothing to improve the health or safety of pregnant people and are intended to strip away people’s access to safe and legal abortion. The proponents of TRAP laws often design the legislation to impose impossible compliance barriers for health care facilities. More than 20 such bills were introduced in 11 states this session. Those enacted include new laws in Arkansas, Montana, and Utah. In Utah, lawmakers passed a law to functionally eliminate access to abortion in the state, even though abortion is currently legal in Utah up until 18 weeks. Utah’s law requires that all abortions be done in hospitals, despite the fact that most Utah hospitals only offer abortion in the most extreme circumstances, and would impose additional restrictions on providers. Abortion providers challenged Utah’s law in court and were granted a preliminary injunction blocking it from taking effect while the case continues.
Laws targeting medication abortion
As a case brought by anti-abortion activists challenging the FDA’s 22-year approval of the safe, effective abortion medicine, mifepristone, continues to work its way through the federal court system, states have continued their attacks on medication abortion. This past session, lawmakers introduced thirty bills in 17 states with provisions that attack medication abortion. These include bans on medication abortion; forcing doctors to lie about medication abortion “reversal”; implementing onerous and burdensome reporting requirements for providers, dispensers, and manufacturers; and more. States that enacted laws targeting medication abortion include:
- Florida: The state’s six-week abortion ban also includes bans on telemedicine for medication abortion and mailing abortion pills.
- Kansas: Lawmakers enacted legislation requiring abortion clinics to have harmful signage about abortion “reversal” — an unproven protocol based on faulty science and advanced by anti-abortion activists. The law, which takes effect on July 1, 2023, has been challenged by abortion providers in the state who are seeking a preliminary injunction.
- Montana: Montana now requires abortion providers to give patients false information about the adverse side effects of medication abortions.
- North Carolina: The state’s 12-week abortion ban also imposes a medically unjustified restriction on the time frame for when medication abortion can be provided: limiting provision to 70 days, rather than 77 days. This law takes effect on July 1, 2023.
- Wyoming: Wyoming banned medication abortion.
Laws targeting minors’ access to abortion
Lawmakers introduced 17 bills in 10 states that target young people’s ability to access abortion care. Idaho lawmakers enacted a law criminalizing adults who help minors access abortion care in particular circumstances. The law only gives an affirmative defense for instances where there is parental consent, meaning helpers could face prosecution even if they have permission from a young person’s parents.
We continue to keep an eye out for anti-abortion legislation moving in states which are still in session.
If you are covering the 2023 state legislative session or have additional questions regarding abortion rights at the state level, please reach out to [email protected].