Consider This from NPR - The states where abortion is on the ballot in November

Episode Date: May 21, 2024

Since Roe v. Wade was overturned, state laws on abortion have been changing constantly. It will all be part of the picture as voters go to the polls in November.For sponsor-free episodes of Consider This, sign up for Consider This+ via Apple Podcasts or at plus.npr.org. Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Since Roe v. Wade was overturned in June of 2022, the landscape of state laws on abortion has continued to shift, creating difficult choices and consequences for people seeking abortions and for health care providers. where abortion is banned, anyone who performs an abortion can be charged with a felony. Nearly one in four OBGYNs have left the state or retired since the ban took effect a few months after Roe was overturned. Thompson says the law can complicate care and harm patients, including by causing delays while the medical team consults with lawyers. As far as we know, we haven't had a woman die yet as a consequence of this law, but that is really on the top of our worry list of things that could happen because we know that if we watch as death is approaching and we don't intervene quickly enough,

that when we decide finally that we're going to intervene to save her life, it may be too late. This exodus of doctors has led to three maternity wards in her state shutting down. In Florida, the abortion law recently changed. Now most abortions are banned after six weeks of pregnancy before many people learn they're pregnant. Dr. Chelsea Daniels works with Planned Parenthood in Miami. Every day that I'm in clinic and seeing patients and having to inform them about this ban and just watch the panic on their face, it makes you realize just how bans like this are so, so, so targeted and can change the trajectory of someone's life.

The number of abortions has plummeted in the 14 states with bans. And yet, the number of abortions nationally has seen a slight increase. That is driven by the rise of telehealth abortions, where patients receive medication in the mail after consulting with a clinician. These now account for almost one in five abortions. It's affordable, it's convenient, and it feels more private. So most patients will have their medication mailed out that day and can receive it as early as the next day. Jillian Barovic is a midwife in Brooklyn and a co-founder of Juniper Midwifery,

which offers medication abortion via telehealth to patients in six states where abortion is legal. Other organizations even mail medication to people who live six states where abortion is legal. Other organizations even mail medication to people who live in states with abortion bans. Well, abortion rights opponents are fighting back, including with a lawsuit currently before the Supreme Court aimed at restricting the use of the abortion drug mifepristone nationwide. Bans, lawsuits, and ballot measures will all be part of the picture as voters head to the polls in November. Consider this. The right to an abortion is on the ballot in Colorado, Florida, Maryland, and South Dakota, with more states in the process of adding it to the

ballot this fall. Coming up, we learn more from our reporters on the current state of abortion access nationally, the legal gray areas, and the legal and political strategies used by advocates on both sides of the issue. From NPR News, I'm Mary Louise Kelly. It's Consider This from NPR. Nearly two years after the Supreme Court overturned Roe v. Wade, a lot has happened with abortion access. State laws have been changing constantly. New

bans have taken effect. There have been a slew of lawsuits and ballot measures. We're going to take a look at how this issue is motivating voters. And here to give us the state of play on that are NPR's Alyssa Nadwerny, who covers reproductive rights, and NPR's Selena Simmons-Duffin, who covers health policy for us. Hey to you both. Hi, Mary Louise. Alyssa, kick us off. As I say, it has been changing so fast. Where do things stand big picture if we're just trying to picture the map of abortion access in the country right now? they're pregnant. Florida was the most recent place for this to take effect. There are states like Nebraska that ban abortion after 12 weeks. In Arizona, it's 15 weeks. More than half of the states have restrictions. And in those states, the number of abortions has dropped drastically.

And I just want to point out that those laws aren't just affecting the number of abortions happening in these states. They're having a broad impact on how the health care system is working overall. Explain, what does that mean? Okay, so Idaho is an extreme case of how this is playing out. Doctors are leaving the state. Three maternity wards have closed since the abortion ban there took effect. And I talked to Dr. Sarah Thompson. She's an OBGYN in Boise.

We lost 58 obstetricians either to moving out of state or retiring. And in that same time period, only two OBGYNs moved into Idaho. So that is not really a sustainable loss to gain ratio. And it's not just Idaho. A lot of hospital systems in states with abortion bans are having recruiting problems. Okay, so how should we square what you both are telling me, though, with something I just heard you reporting on, Alyssa, that despite all this, abortions are actually increasing nationally? That's right. And it's because more than half of abortions are done with medication. So with the rise of telehealth, patients don't have to take off work and go to a clinic. They can connect with a provider via text message, phone call, or video, no matter where they live. Lauren, who is 33 and lives in Utah, she used a telehealth appointment to access abortion medication last month. She was on birth control. She's already a mother,

which is a demographic most likely to have an abortion. We're not using her last name because she's worried about professional repercussions. In my situation, I felt more at ease than I would in a physician's office and more comfortable, to be honest, especially with a provider within the state of Utah. I feel like there's always a judgmental, like, indication or undertone. So in Utah, where Lauren lives, abortions are allowed up to 18 weeks, but access to them is severely restricted. So as of January, only hospitals can perform abortions. The state also essentially bans

the use of telehealth abortions by requiring an in-person visit to receive a medication abortion. So Lauren used an online company that connected her with a doctor in another state that has protections for doctors and clinics known as shield laws. Well, I have to ask, is that legal, what Lauren is doing and the doctors who are helping her? So it's kind of a legal gray area. States with abortion bans or restrictions hold the provider at fault, not the patient. But there's not a lot of legal precedent on this. I talked with John Segoe, who is the president of Texas Right to Life. He's concerned with the rise of online pills and the shield laws. He told me his group is currently working on how to bring criminal and civil challenges to tamp down on the number of abortions happening.

I'm afraid that we are going to wake up in 20 years and just kind of realize that we won in Dobbs and then we've been losing ever since. He says he sees the rise of overall abortion access as very worrisome. Selena, let me change gears because I want to look at the other side of this. We're paying a lot of attention, as we should, to states that have banned abortion, but some other states are going in the other direction. They're moving to make access easier. Where does that stand? Yeah, so abortion was heavily regulated for years, even while Roe was the law of the land. So some states like Michigan, Colorado, Minnesota, California, and others have made moves to undo some of those regulations. So

to give you an idea, they're getting rid of things like waiting periods and gestational limits. They're allowing more types of providers, like nurse practitioners, for instance, to provide abortions. They're training more providers on abortions. Some states have stockpiled mifepristone, one of the medicines that can be used for abortion in case access is curtailed in the future. And in some places, like New York City, they've made abortion hubs part of the health department. So you can call a number and find out where to get an abortion and how to get funding to cover the costs. Okay, let's go to how all this may play out in the election. Where is abortion actually on the ballot this year?

So far, voters will be weighing in on the right to an abortion in four states, Colorado, Florida, Maryland, and South Dakota. More states are in the process of getting it on the ballot, including Arizona and Missouri. Okay, and for the states where it is on the ballot or may be on the ballot, Alyssa, what are the prospects? How likely are these measures to succeed? Well, nationally, polling shows 6 in 10 Americans say abortion should be legal in all or most cases, but that can vary by state. But since Dobbs, voters in six states have weighed in on constitutional amendments on abortion. Vot voters chose access to abortion each time.

And Selena, to wind us back to where we began, and the Supreme Court, they are not done with this. There are two major decisions on abortion pending right now before the Supreme Court. That's going to come out, what, next month? What's the latest? Right. So the first case is about the abortion pill mifepristone. The court could restrict this drug for the whole country and change access to medication abortion through telemedicine. Court watchers reading the tea leaves think it won't go that way, but obviously no one knows for sure. The second case is about abortion in emergency situations, and it centers on Idaho's medical exception. It's a fight over whether federal or state law should have priority. The oral arguments left analysts really unsure about how this one will go. But the takeaway, as you say, is that

both of these decisions will be coming down in early summer, just a few months before the election. So regardless of what the justices decide, it's going to catapult abortion back into the headlines at a key time for voters. It's NPR's Selena Simmons-Duffin, thanks to you. Thank you. And Alyssa Nadwarny, thank you. Thank you. This episode was produced by Katherine Fink and Mia Venkat. It was edited by Diane Weber, Ashley Brown, and Jeanette Woods.

Our executive producer is Sammy Yinnigan. And one more thing before we go, you can now enjoy the Consider This newsletter. We help you break down a major story of the day, and you will also get to know our producers and hosts and some moments of joy from the All Things Considered team. You can sign up at npr.org slash consider this newsletter. It's Consider This from NPR. I'm Mary Louise Kelly.