REPRODUCTIVE HEALTH DIGEST (5/28/26)

Developments in Abortion, Autonomy, and Access:

This week’s Digest covers the latest decision from the Supreme Court on access to medication abortion, litigation developments out of Arkansas and Indiana, a new lawsuit challenging the VA’s abortion ban, Texas’s continued legal pursuit of a New York shield provider, Iowa’s new law restricting medication abortion access, and ongoing policy developments impacting reproductive health and bodily autonomy. As always, please read on to the end for the news that you need to know. 

Legislation & Litigation:

• Overview:

• The Supreme Court issued a ruling allowing mifepristone to continue to be available by mail while litigation challenging the removal of in-person dispensing requirements plays out in the lower courts; 

• A previously-dismissed challenge to Arkansas’ total abortion ban has been revived; 

• A veterans rights advocacy group is suing the Trump Administration over the VA’s rescission of abortion coverage; 

• Indiana’s total abortion ban will remain in place, following a state supreme court order; 

• Iowa Governor Kim Reynolds has signed a law restricting access to medication abortion; 

• Texas is continuing its lawsuit against New York shield provider Dr. Maggie Carpenter; it has appealed an October ruling by a New York court that affirmed protections under the state’s shield law. 

• Supreme Court Issues Order Allowing Mifepristone by Mail to Continue for Now:

• Shortly after publication of our last Digest, the Supreme Court issued an Order allowing mifepristone to continue to be prescribed and dispensed through telehealth. As a reminder, Louisiana initiated this litigation against the FDA in order to challenge the 2023 removal of in-person dispensing requirements for the commonly used medication abortion drug. On May 1, 2026, a panel of Republican-appointed Judges from the 5th Circuit Court of Appeals granted Louisiana’s request to reinstate in-person dispensing requirements during the pendency of litigation. Danco and GenBioPro, the manufacturers of the medication, appealed the 5th Circuit’s decision to the Supreme Court. After a brief extension, Justice Alito, who oversees emergency appeals out of the Fifth Circuit, issued an Order preserving the status quo and allowing mifepristone to continue to be sent by mail while the litigation makes its way through the lower courts. Notably, Justice Thomas penned a dissent in which he called out the Comstock Act - an 1873 anti-vice law - as a legitimate basis for ruling in Louisiana’s favor on the merits of the case. Despite courts being clear that Comstock is dead law in the context of lawful abortion, anti-abortion activists have responded to the growing availability of telehealth abortion care by calling for its enforcement - a move that could lead to a de-facto nationwide abortion ban. Some legal experts have speculated that the Trump administration has made a strategic decision not to take a strong stance on the question of mifepristone until after the midterm elections.

• Lawsuit Challenging Arkansas’ Abortion Ban Revived After Previous Dismissal:

• As we have previously reported, a group of Arkansas women who were denied abortion care in their home and an Arkansas ob-gyn are suing to overturn the state’s total abortion ban on constitutional grounds. The ban only permits abortion in circumstances where the patient's life is at risk. On April 30th, Pulaski County Circuit Judge Cara Conners issued a decision dismissing the case pursuant to a recently-passed Arkansas law requiring certain constitutional challenges to go before the Arkansas Court of Appeals. However, shortly before Judge Conners issued her decision, the Arkansas Supreme Court found that the law that she had based her ruling on is unconstitutional. Upon the plaintiffs’ motion, Judge Conners agreed that the case should be revived in her court. 

• As reported by the Arkansas Advocate, five of the six women involved in the lawsuit were forced to travel to Kansas or Illinois to obtain care; of those women, three had nonviable pregnancies, one had been the victim of sexual assault, and one did not want children - the final plaintiff had to carry her pregnancy for nearly two months after learning it was nonviable as a result of the state’s abortion ban. The case is being litigated by Molly Duane of Amplify Legal, the litigation arm of Abortion in America. 

• Veterans Advocacy Organization Sues Trump Administration Over Rescission of Abortion Coverage:

• A veterans advocacy group - Minority Veterans of America - has filed a lawsuit against the Trump Administration challenging its policy rescinding abortion coverage and counseling for service members. The memo announcing the change in policy was issued late last year and authored by anti-abortion Deputy Attorney General Joshua Craddock. It asserted that the Biden-era policy of coverage for veterans was invalid. Under the new policy, abortion coverage is only permitted when the life of the pregnant person is endangered. Reportedly, many of Minority Veterans of America’s members live in states with abortion bans, leaving them to rely on the VA for access to care. The Organization’s lawsuit argues that the VA violated the Administrative Procedure Act by enacting restrictions on abortion coverage in cases where the patient’s health is in danger or where the pregnancy resulted from rape or incest.

• Indiana’s Abortion Ban Remains in Place After State Supreme Court Upholds Lower Court Decisions:

• Indiana’s near-total abortion ban will remain in place following an Indiana Supreme Court Order declining to review lower court rulings. The ban prohibits abortion at all gestational ages and includes exceptions only for the life or health of the patient, and for cases involving rape or incest or fatal fetal anomalies within a certain gestational age. Following its passage, Planned Parenthood and others filed suit arguing that it violated Indiana constitutional protections. In August of last year, the Indiana Court of Appeals found that there were no circumstances identified wherein the “limited” constitutional right to an abortion to save a patient’s life or preserve their health would be implicated and the state’s abortion ban would prohibit care. The ACLU acknowledged that the Indiana Supreme Court’s decision ends the legal challenge and lamented the impact that the ban’s continued enforcement will have on patient safety. This case does not impact a separate case challenging the state’s abortion ban on religious freedom grounds. 

• Iowa Passes Restrictions on Medication Abortion:

• On May 19th, Iowa Governor Kim Reynolds signed House File 2788, a bill restricting access to medication abortions through telehealth and mail-order prescription services. The bill also creates a new civil cause of action against any person who dispenses medication abortion in violation of the law. Effectively, the law reinstates in-person dispensing requirements and incentivizes lawsuits against individuals who provide or facilitate access through other methods. The law will not take effect until July 1, but it comes during a time of national conversation and scrutiny about access to medication abortion and intense pressure from anti-abortion activists to curtail telehealth abortion care. 

• Texas Appeals in Case Challenging New York’s Shield Law:

• Texas is continuing to pursue a judgment against New York shield provider Dr. Maggie Carpenter for allegedly prescribing medication abortion into Texas. Last October, a New York judge dismissed a claim against Ulster County Clerk Taylor Bruck for refusing to file the Texas state court judgment. The court found that Bruck’s conduct was proper in light of New York’s shield law for providers and patients involved in reproductive healthcare. Earlier this month, Texas appealed the October ruling, seeking to enforce its six-figure judgment against Dr. Carpenter, alleging that she acted in violation of the state’s total abortion ban. Bruck is standing by his actions, stating that “in rejecting the Texas filing, I was simply following the law of this State,” and that “the issues in this case . . . are legal in nature; I trust the courts to decide them.” This case is one of multiple pitting state abortion bans against protective shield laws. 

Trend and Policy Watch:

• Texas Attorney General Requires Texas Children’s Hospital to Open a “Detransition Clinic” as Part of Settlement:

• Texas Attorney General Ken Paxton and the Department of Justice have entered into a settlement agreement with Texas Children’s Hospital (TCH) that requires TCH to pay the state $10 million, terminate and revoke medical privileges for five clinicians, and establish the nation’s first “detransition clinic.” This settlement agreement followed a three-year investigation, initiated by AG Paxton’s office, into allegations related to gender-affirming care for minors. During this time, TCH was forced to turn over millions of documents. It is not yet clear what services will be provided at the so-called “detransition clinic.” As the Texas Tribune reports, experts point out that - for the small percentage of individuals who choose to detransition - the resources already exist, and it is unlikely that a clinic created out of a legal battle initiated by a viciously anti-trans politician will have the best intentions of the transgender community at heart. TCH maintains that “all reviews and investigations continue to support” that it has “been compliant with all laws;” the hospital clarified that it is “settling to protect [its] resources from endless and costly litigation,” and that it remains committed to putting its “purpose over politics.”

• Research from the National Abortion Federation Shows that Violence Against Providers and Clinics is On the Rise:

• Research published in the National Abortion Federation’s 2025 Violence and Disruption Report found that violence and threats against abortion clinics and providers significantly increased between 2024 and 2025. The Trump Administration has severely curtailed enforcement of the FACE act,  the federal law seeking to prohibit interference with access to reproductive health clinics. The current DOJ has indicated that it won’t enforce the FACE act, except in extraordinary circumstances, and it has disparaged previous FACE Act enforcement as political weaponization. Trump has also pardoned 23 individuals convicted of FACE Act violations. The administration’s clear message that it does not take threats of anti-abortion violence seriously has clear consequences. As reported by NAF, death threats and stalking incidents against abortion providers more than doubled between 2024 and 2025, and clinic blockades rose from 1 in 2024 to 6 in 2025. Assault and battery, arson, vandalism, and theft also increased. 

• NAF has joined other organizations in a lawsuit challenging the Trump Administration's recently created $1.776 billion  “Anti-Weaponization Fund” on the grounds that it incentivizes and facilitates continued violence against NAF members and their affiliates.

• Missouri Aims to Make Citizen-Led Ballot Initiatives More Difficult to Pass:

• Missouri lawmakers are attempting to make it more difficult for voters to successfully utilize the ballot initiative process. In recent years, Missourians have successfully used the process to legalize marijuana, raise the minimum wage, and reinstate abortion rights. Frustrated by these victories, Governor Mike Kehoe has placed an amendment aimed at making direct democracy more difficult on the August ballot. If passed, Amendment 4 would raise the threshold for passing a citizen-led ballot measure from a simple statewide majority to a majority in every congressional district, allowing a single district veto power. The placement of Amendment 4 on the August ballot, rather than the November ballot has also raised questions. The August ballot draws a traditionally more conservative electorate, and the top races on this August ballot are for competitive Republican primaries. Notably, Amendment 4 would only apply its more stringent passage standard to citizen-initiated measures - it would require constitutional amendments proposed by lawmakers to only receive a simple majority.

• Planned Parenthood Great Northwest to Begin Providing ‘Just in Case’ Abortion Pills to Patients in Hawaii and Washington State:

• Planned Parenthood Great Northwest, Hawai’i, Alaska, Indiana, Kentucky (PPGNHAIK) has announced that it will start offering advance provision of abortion pills to people over the age of 18 in Hawaii and Washington. The new service - called Just In Case Abortion Pills - will allow people to obtain pills before they become pregnant, giving them increased options and access. Although other organizations and providers follow a similar model and allow for advance orders of medication abortion, having a provider as established as Planned Parenthood choose to do so sends an important message about the safety of self-managing abortion and the importance of being prepared for a future where medication abortion access may be limited. According to Planned Parenthood, “medications come with clear instructions, and PPGNHAIK clinicians are available by phone every day to answer questions before and after use.

REPRODUCTIVE HEALTH DIGEST (5/14/26)

Developments in Abortion, Autonomy, and Access:

We thank you for your patience while we switched up the Digest schedule to accommodate the needs of our staff in the past several weeks, and we hope that you enjoyed last week’s joint edition of the repro digest and the trans rights digest. We are excited to now be back on our regular schedule, delivering critical repro news directly to your inbox every two weeks. This week’s Digest walks through developments in access to mifepristone, legislation restricting or criminalizing care, the overturn of Michigan’s pregnancy exclusion law for end of life care, and updates in the Tennessee case challenging the state’s abortion ban. We also discuss developments in abortion politics, the future of Planned Parenthood funding, and the Trump Administration’s latest moves with respect to reproductive health. As always, please read on to the end for the news that you need to know. 

Reproductive Rights and Health Equity News

This Week’s Must-Read: 

This week’s must-read tells the story of Tiffany McElroy, an Alabama woman who went into early labor shortly after being booked in an Alabama jail and was forced to give birth on the prison floor while guards reportedly watched and ignored her pleas for help. Other detained women helped her to give birth and revived the baby, who was not breathing when she was born. Pregnancy Justice has filed a federal civil rights lawsuit on Ms. McElroy’s behalf, seeking justice for her and her baby. 

Legislation & Litigation:

• Overview:

  • In-person dispensing requirements for mifepristone remain on hold until 5:00 EDT on Thursday, May 14th, while the Supreme Court continues to consider the matter; 

  • Tennessee is using a newly enacted procedural law to delay trial and testimony  in a case challenging the state’s abortion ban; 

  • South Carolina lawmakers and advocates continue to battle over a proposed total abortion ban that would see providers, patients, and helpers penalized; 

  • Oklahoma Governor Kevin Stitt has signed a law criminalizing medication abortion; 

  • A Michigan court struck down the state’s pregnancy exclusion for end of life directives; and 

  • A bill strengthening so-called ‘conscience protections’ for healthcare providers, institutions, and entities awaits Iowa Governor Kim Reynolds’ signature.

• Medication Abortion Still Available In the Mail Until At Least Thursday, May 14th:

• As reported in our last Digest, on May 1, 2026, a panel of Republican-appointed judges from the 5th Circuit Court of Appeals granted Louisiana’s request to pause a 2023 FDA policy removing in-person dispensing requirements for mifepristone during the pendency of litigation. Danco and GenBioPro, the manufacturers of the medication, appealed the 5th Circuit’s grant to the Supreme Court, and the Supreme Court issued a temporary stay, requiring the parties to submit briefing by Thursday, May 7th. You can read a detailed analysis of this procedural history in this piece published by L4GG legal fellow Zane McNeill. 

• On Monday, May 11th, Justice Alito extended the pause until Thursday, May 14th. Louisiana submitted its brief last week, arguing that in-person dispensing requirements should be reinstated nationwide while the case makes its way through the lower courts. Notably, the Department of Justice, which represents FDA, the actual defendants in this matter, did not file a brief. Both sides reportedly took the administration’s silence as approval of the Fifth Circuit’s decision to re-impose restrictions on access.

• Tennessee Delays Trial in Case Challenging the State’s  Abortion Ban:

• Tennessee has taken procedural action to delay progress in the trial challenging the state’s total abortion ban. The case was originally filed in 2023 by women who had  been denied care in the face of severe medical complications. The law was temporarily paused for circumstances involving medical emergencies, but attorneys  in the case argue that it remains insufficiently clear and that patients will continue to suffer as a result. Trial in the case was set to begin last month; however, the state used a recently passed law allowing for automatic appeals in certain cases to halt the trial at the last minute. This move delays the  plaintiffs’ opportunity to be heard and to tell their stories in a court of law. Notably, the plaintiffs in the case are merely asking for the state to clarify that a patient’s health is sufficient grounds for medical intervention, and that the patient need not be facing an imminent threat to their life - they are not asking the court to overturn the ban altogether. Regardless, the state has attempted to have the case dismissed four times.

• South Carolina Legislature Battles Over Total Abortion Ban:

• South Carolina lawmakers are continuing consideration of a total abortion ban with an exception only for the life of the patient. Currently, South Carolina is enforcing a ban on abortion after detection of fetal cardiac activity - around 6 weeks gestational age - with exceptions for the life of the patient, fatal fetal anomalies, and certain cases of rape or incest. If passed, Senate Bill 1095 would not only make South Carolina a total ban state, but would also take the first-of-its kind step of allowing punishment of the patient themselves. The bill makes it a felony for someone to perform an abortion or provide medication to terminate a pregnancy and a misdemeanor for a person to have an abortion. It would also further limit the rights of minors to obtain abortions, both in and out of state. At this time, the bill still faces a long road and substantial opposition, but the Senate Medical Affairs Committee recently voted to give a favorable report on the bill, advancing it one step closer to passage. 

• Oklahoma Passes Law Restricting Abortion Medications:

• On May 5th, Oklahoma Governor Kevin Stitt signed a new law criminalizing medication abortion, despite the state already enforcing a total abortion ban. House Bill 1168 creates a felony charge for knowingly providing abortion-inducing medication to a pregnant person to terminate their pregnancy, with narrow exceptions for ectopic pregnancies and miscarriage management. Penalties include prison time and up to $100,000 in fines - even for friends or family members who assist someone in obtaining care. According to Senate Minority Leader Julia Kirt, the bill was intended as a political talking point for Republicans on the campaign trail. Regardless, its impact will be to intimidate patients out of seeking care (including lawful care), increase obstacles to clinicians providing care, and interfere with the doctor-patient relationship. The measure will go into effect 90 days after the end of Oklahoma’s legislative session.

• Michigan Court Strikes Down Pregnancy Exclusion for End of Life Directives:

• A Michigan court has struck down provisions of state law that restricted end of life directives for incapacitated pregnant people. Judge Sima Patel wrote that the laws - known as the “pregnancy exclusion” - “infringe on the fundamental right to reproductive freedom as was enshrined in the Michigan Constitution in 2022.” The lawsuit was filed by Michigan women, physicians and patient advocates challenging the state’s denial of incapacitated pregnant people’s right to have their end of life wishes honored. Under the law, patient advocates could not refuse life-sustaining treatment for pregnant people. According to a report by Pregnancy Justice, 29 states have laws invalidating advance directives for pregnant people.

• Iowa Considers Increased ‘Conscience Protections’ as the State’s Abortion Ban Harms Patients:

• A bill to strengthen so-called ‘conscience protections’ for healthcare providers awaits Iowa Governor Kim Reynolds signature. House Bill 571 would empower medical providers and institutions to decline to provide care that they allege conflicts with their moral or religious beliefs - oftentimes, this involves care related to abortion, contraception, or the LGBTQ+ community. Conscience laws generally allow healthcare providers to opt out of caring for a patient when the care required in some way conflicts with their belief system. Proponents of these laws say that they are crucial for protecting religious and individual liberties, but critics say that they conflict with clinicians' ethical obligations to care for all patients equally and threaten to worsen already dire physician shortages. Federal conscience protections already exist for healthcare providers, but many states have passed their own provisions. Iowa’s proposed law would strengthen providers and payors’ rights to refuse to participate in certain care, create additional ‘anti-discrimination’ regulations for objectors, and implement whistleblower and first amendment ‘protections.’ 

Trend and Policy Watch:

• Idahoans Gather Enough Signatures to Put Abortion on the Ballot:

  • Idahoans have officially gathered enough signatures to qualify for the November ballot. The Reproductive Freedom and Privacy Act, championed by Idahoans United for Women and Families, would functionally restore Idaho’s abortion laws to their pre-Dobbs status. Idahoans have suffered under one of the most draconian abortion bans in the country in the years since the Supreme Court overturned Roe, and despite repeated calls for change and clarification, the state has failed to take any action to relieve the healthcare crisis unfolding in the state. As Executive Director of Idahoans United stated, the “hope is that this is one significant step back towards stabilizing  [Idaho’s] healthcare system in asserting that people deserve dignity and privacy as it relates to their medical care.”

• Advocates and Politicians on Both Sides Look to Whether Planned Parenthood will Remain “Defunded”:

• Last year, President Trump effectively defunded Planned Parenthood as a part of the “One Big Beautiful Bill Act.” The defund provision was set to last a year, and as that deadline approaches, politicians on both sides of the aisle are looking to shape the future of reproductive healthcare funding. During reconciliation bill talks, rifts have emerged between Republicans who want to focus solely on funding for immigration enforcement, and those who want to ensure that Planned Parenthood remains defunded. Senator Josh Hawley (R-Mo.) unsuccessfully attempted to pass an amendment to extend the defund provision, and other lawmakers like Texas Senator John Cornyn have called for the permanent defunding of Planned Parenthood through a third reconciliation bill. As Republicans weigh their current legislative priorities, they are grappling with the very real possibility that they may lose the House in the November midterms and, with it, the political power to pass certain hardline conservative policies. 

• Trump Administration Meets with Anti-Abortion Officials:

• The Trump Administration reportedly met with anti-abortion officials last Friday, at a time when prominent anti-abortion groups have vocally criticized Trump’s handling of abortion policy. The Administration has found itself in a difficult position with respect to abortion rights in a midterm year – while taking bolder action to oppose abortion may appease the religious right, it has proven to be a politically challenging or damaging stance with broad swaths of the electorate. The administration’s recent meeting came days before FDA Commissioner Marty Makary resigned from the role, reportedly over moral opposition to the administration’s handling of flavored e-cigarettes. Makary was in charge of the FDA’s “review” of mifepristone’s safety record and had faced calls for his removal from anti-abortion groups that viewed him as not taking sufficiently aggressive action to curb access to medication abortion. 

• Trump Administration Launches Moms.gov, a Government Website Riddled with Anti-Abortion ‘Resources’:

• On Mothers Day, the Trump Administration launched “Moms.gov,” a website that purports to address “the needs of mothers and fathers who face difficult or unexpected pregnancies” and ensure “the wellbeing of mothers and the health of American families.” The website conspicuously features a link to Option Line’s crisis pregnancy center finder - notably, Option Line is a project of Heartbeat International and is touted as a helpline for “Rescuing Lives from Abortion.” The new moms.gov website features no information about abortion or hormonal contraception, and instead highlights “fertility awareness based methods.” During the press conference about this new “resource”, Dr. Mehmet Oz stated that “one in three Americans are ‘under-babied’”, and Trump - not for the first time - confusingly referred to himself as the father of fertility.  The launch comes after a year that saw devastating cuts to healthcare for Americans across the country and widespread defunding of reproductive health clinics and resources.

SPECIAL EDITION: Repro Health x Trans Rights Digest

Written by: Allison Chapman & Alyssa Morrison

Developments in Transgender & Reproductive Rights:

Welcome to this special omnibus edition of the Transgender Rights Digest & Reproductive Health Digest. Last week, we celebrated Law Day of Action with 75 coordinated events taking place across 65 cities in 25 states with 3,000+ participants representing state and local bar associations, national legal advocacy organizations, law schools, and affinity bar groups. We are back at our desks, packing two intense weeks of bodily autonomy news and legal updates into one special issue. We hope you get tremendous benefit from it – please let us know what you think! 

Want access to a detailed analysis of the transgender rights law in every U.S. state and territory? Please view our free Policy Resource Hub for Transgender Rights, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Top Line News Stories

• Trump Administration Has Major Impact on Transgender Mental Health:

• New reports from the Trevor Project and Williams Institute reveal the deep psychological harm caused by the Trump administration's policies targeting the transgender community.

• The Trevor Project report showed the devastating results of anti-LGBTQ+ policies on the lives of young people within the United States – especially those who are transgender and nonbinary. The Trevor Project found that 40% of transgender and nonbinary people have seriously considered attempting suicide in the past year. Young people who lack access to gender-affirming hormones are twice as likely to attempt suicide as those with such access.

• The Williams Institute’s April report included findings that 66% of transgender or nonbinary parents reported that their children had become more fearful under the Trump administration, and 73% of transgender or nonbinary parents reported that they were pursuing or considering pursuing self-defense classes to better protect themselves and their families.

• Read more analysis of these reports on our website.
  
  

• 2023 FDA Policy On Mifepristone Back In Effect After SCOTUS Pauses 5th Circuit Ruling:

• On May 1, 2026, a panel of Republican-appointed judges on the 5th Circuit Court of Appeals granted Louisiana’s request to pause a 2023 Food and Drug Administration (FDA) policy allowing the abortion medication mifepristone to be prescribed online and sent by mail. This created widespread confusion about what care was still legally permissible. 

• Intervenor pharmaceutical companies that produce mifepristone quickly appealed the 5th Circuit’s grant, and on May 4, 2026, the Supreme Court issued a temporary stay, allowing the telehealth provision of mifepristone until at least May 11, 2026. The briefing in the case was due on Thursday, May 7th.

• Read more analysis from L4GG legal fellow Zane McNeill on our website.

Legislation & Litigation Developments

• Federal Agencies Continue To Target Transgender Rights:

• The animus against transgender people continues to spread across all governmental agencies. The Federal Trade Commission (FTC) and Federal Communications Commission (FCC) are the latest federal agencies to target transgender people, signaling their willingness to fall in line with r the president’s agenda.

• Over the past few months, the FTC has begun targeting transgender healthcare under the guise of consumer protections. In February, the organization sent civil investigative demands (CIDs) to the American Academy of Pediatrics, World Professional Association for Transgender Health, and the Endocrine Society. A former FTC employee has flagged multiple unusual happenings within the department, from the targeting of nonprofit organizations to hiring lawyers specifically for investigating gender affirming healthcare. 

• The FCC has requested public comment on the current TV rating system and whether  programs should be rated differently or contain descriptions flagging transgender or gender nonconforming content. The request for comments states that the FCC believes that the lack of warnings undermin[e] the ability of parents to make informed choices for their families.” If changes are implemented, it could result in LGBTQ+ people being censored in the media.
  

• Pennsylvania Court Strikes Down Ban on Medicaid Coverage of Abortion:

• In late April, a Pennsylvania court struck the state’s ban on using state Medicaid funds for abortion coverage and found that the Pennsylvania Constitution includes a right to abortion. The case, Allegheny Reproductive Health Center v. Pennsylvania Dep’t. of Human Services was first filed in 2019 and has gone through a winding procedural history centering on the question of whether and to what extent equal protection considerations require state coverage of reproductive healthcare. In 2024, the Pennsylvania Supreme Court overturned state precedent holding that the Medicaid ban did not violate the constitution and instead found that it constituted a form of sex-based discrimination by allowing healthcare coverage for men’s reproductive healthcare without covering women’s. The court further found that the ban should be subject to strict scrutiny - the most rigorous test for a state to pass in examining the constitutionality of a statute. The ruling is a huge victory for reproductive health in Pennsylvania and provides a vital reprieve as healthcare faces massive defunding at the federal level.  It also places Pennsylvania among the ranks of states whose courts, legislature, or voters have determined that their state constitution protects abortion rights. The state may appeal the ruling.

• Wyoming Court Blocks State’s Fetal Heartbeat Ban:

• On April 27th, a Wyoming court blocked the state’s recently passed ban on abortion after detection of fetal cardiac activity, which occurs around 6 weeks of gestational age. The so-called “heartbeat ban” was rushed through the state legislature after the Wyoming Supreme Court ruled in January that the state constitution protects a right to choose abortion and struck down a previously passed total abortion ban. The Supreme Court based its ruling on a 2012 amendment to the state constitution that was passed in response to the Affordable Care Act and guarantees Wyoming citizens the right to make their own healthcare decisions. In the April 27th order, the judge found that the plaintiffs challenging the new 6-week ban had shown a likelihood of success and demonstrated irreparable harm if the ban stays in place during the pendency of litigation. The state will continue to fight to enforce the ban. In the meantime, Governor Mark Gordon has signed an alternate provision banning abortion after viability.

• Indiana Case Challenging Abortion Ban On Religious Grounds Will Go Directly to the State Supreme Court: 

• As we reported on in the Repro Health Digest in March, an Indiana court recently blocked the state’s abortion ban for cases in which it conflicts with a person’s sincerely held religious beliefs. Although Indiana is currently enforcing a total abortion ban, the plaintiffs argued in their complaint that Jewish beliefs around when life begins, and Jewish laws’ requirement of prioritizing the mother’s physical and mental health prior to birth, mean that their faith would, in certain circumstances, dictate pregnancy termination as the proper course of action. A Marion County Court agreed, but the state appealed. Now, the case will go directly to the Indiana Supreme Court, bypassing the state’s court of appeals. Oral arguments will be held on September 10th.
  

• Six Transgender Iowians Challenge State Bathroom Ban:

• On April 29, 2026, six transgender Iowa residents filed a class action lawsuit in federal court challenging the restroom provision of H.B. 752. The lawsuit argues that the law violates the plaintiffs’ constitutional rights to due process, equal protection, and informational privacy.  
  

• Ninth Circuit Stays Removal of Surgery Prerequisite For Arizona Gender Marker Changes

• On April 28, 2026, the Ninth Circuit issued a stay pending appeal of a preliminary injunction in Roe v. Johnston that would have required Arizona to remove its surgery prerequisite for gender marker changes on birth certificates beginning on April 30, 2026.

Trend and Policy Watch

• Gun Control: But Only If You Are Transgender:

• Experts have warned that a new rule from the U.S. Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF) could deter trans people from buying guns due to a mandatory requirement to report their sex assigned at birth when purchasing a firearm. 

• This could give the ATF the ability to create a list of transgender gun owners. In a statement to The Independent, Patrick G. Eddington, a senior fellow in homeland security and civil liberties at the Cato Institute and ex-CIA analyst said that "it's pretty clear that [Trump's team] want to try to collect data on individuals who don't fit the regime's idea of who is male and female... [creating] a de facto registry of people by gender identity."

• Last fall, the Department of Justice reportedly weighed options to ban transgender people from obtaining firearms in response to the assassination of right-wing activist Charlie Kirk. For years, right-wing figures have repeatedly fearmongered that transgender people are likely to carry out acts of mass violence. Despite the accusations, transgender shooters are statistically inconsequential with the majority of attacks being carried out by cisgender men. 

• Texas Is Still Texas:

• Texas is oftentimes a testing ground for right-wing policies and strategies. Lawmakers nationwide take note of what works and fails to then implement similar theories and policies at both the state and federal levels. In a prescient article by Legal Fellow Zane McNeill in The New Republic on December 9, 2024, Project Fellow, Allison Chapman was quoted, warning about potential FTC investigations into gender affirming care after Texas utilized a similar strategy. “The ultimate goal of these attacks is to have transgender people disappear from public life. Attacking the basic right to privacy would help create those conditions. So I think it’s absolutely possible this will be a continual issue and we’ll continue to see regulations and legislation to make this happen.”
  

• Next Texas Attorney General May Take Aim at Marriage Equality: 

• In November, Texans will vote for a new attorney general (AG), ending Ken Paxton’s 10+ year tenure in the role. Right-wing groups are hopeful that the next AG will be even more aggressive than Paxton in advancing a regressive agenda that would seek to overturn key Supreme Court precedents and roll back civil rights. 

• U.S. Rep. Chip Roy (R) has signaled that overturning a Supreme Court case that prohibited Texas from excluding undocumented students from public school is one of his “foremost priorities in running for attorney general.” He has also expressed his desire to see marriage equality overturned, referring to it as “a war raging against our souls as Texans.” 

• has taken similar positions. 

• Attorneys general have not always acted as agents of public policy change at a national level. However, since the 1990s that has gradually changed, and state authorities have increasingly viewed themselves as key players in shaping (and fighting) federal law and policy. Georgetown Law professor and constitutional scholar Steve Vladeck explains, [t]he notion that the attorney general of any one state, even Texas, should be leading the charge in defining what the Constitution means on a nationwide basis, is, to me, the epitome of hubris.”
  

• Texas Therapists Unsure About How to Proceed with Counseling LGBTQ+ Minors: 

• Last month, the Supreme Court issued an 8-1 ruling finding that Colorado’s ban on conversion therapy violated Christian counselor Kaley Chiles’ First Amendment rights by censoring the kinds of speech that she could engage in with her patients. Although many have rightly criticized the ruling for prohibiting states from banning a demonstrably harmful, discredited, and clinically unsupported form of ‘therapy,’ others have also pointed out that the ruling could make it more difficult for states to prohibit gender-affirming talk therapy. This is at odds with an opinion issued by AG Ken Paxton that purported to apply Texas’s ban on gender-affirming care for minors to mental health providers and prohibit them from  “transitioning” youth. Although the Supreme Court’s reasoning in Chiles should apply to protect affirming therapy, experts have expressed concern that courts will adhere to it and apply it equally in the context of transgender healthcare.
  

• Texas Medical Board Sanctions Physicians in Connection with Pregnant Patients Deaths: 

• Three Texas doctors who had been previously investigated by ProPublica following their patients’ deaths after improper or delayed care under the state’s total abortion ban have been disciplined by the Texas Medical Board.

• Two of the doctors were found to have failed to provide proper medical care to a teenager who was suffering from a life-threatening pregnancy complication. The teen ultimately died after seeking emergency medical care on three separate occasions within 12 hours.

• The third doctor was disciplined due to failing to administer a D&E to a patient with severe bleeding after a miscarriage. The doctor gave the patient misoprostol as an alternative, which should have been contraindicated due to excessive bleeding. The patient ultimately bled to death.

• Texas’s abortion ban prohibits abortion at all gestational ages, with only a narrow exception for the life of the patient. And, physicians face a potential life sentence if they are found to have violated the law. When physicians are forced to make emergency decisions under threat of severe legal penalty, patient care suffers.
  

• Texas’s Total Abortion Ban Falls Heavily on the Shoulders of Immigrant Communities:

• In the Rio Grande Valley (RGV) in southern Texas, Texas’s total abortion ban has had devastating effects. The geographic isolation of the RGV makes it extremely difficult to access care. “People in my community are having to travel more than 12 hours to drive out of state,” said Zaena Zamora, executive director of Frontera Fund. “If they’re taking a bus, that’s a 24-hour bus ride. If they’re taking a flight, it’s a two- or three-hour flight to get their care.”

• Immigration crackdowns have only exacerbated this problem. Immigration checkpoints are located approximately 100 miles from the border, requiring those seeking an abortion to be interrogated about their citizenship status and subjecting them to warrantless searches. These restrictions can leave people in impossible and sometimes life-threatening situations.

Take Action!

• Tell HUD: Protect LGBTQ Housing

• On April 28, the Trump administration announced a proposal to rescind the Equal Access Rule (EAR), which guarantees equal access to programs and services funded by the U.S. Department of Housing and Urban Development (HUD) regardless of sexual orientation, gender identity, or marital status.

• The Equal Access Rule benefits all people seeking access to housing and homeless services, but its impact is vital for transgender and nonbinary people seeking the services of homeless shelters.  HUD officials are proposing to eliminate the EAR and replace it with a new rule that would force recipients of federal funding to discriminate against the trans community.  

• Please submit your comment with our partners at A4TE, and if you need support drafting a substantive comment, stay tuned for an L4GG comment training!

REPRODUCTIVE HEALTH DIGEST (4/16/26)

Developments in Abortion, Autonomy, and Access:

This week’s Digest details two lawsuits against strict anti-abortion and anti-midwifery regulations in Georgia and Arkansas (states with some of the highest maternal mortality rates); Mississippi Governor Tate Reeves  signing a bill criminalizing medication abortion;  the Kansas legislature overriding the Governor Laura Kelly’s veto of two abortion regulation bills; a federal judge dismissing state officials from a Texas woman’s lawsuit alleging false arrest and malicious prosecution after she was wrongfully arrested for self-administering abortion medication; the Trump administration shifting Title X from a contraception program into a tool to push pro-natalism; and a federal judge pausing Louisiana’s legal challenge to the FDA’s regulation of abortion medication until the agency finalizes a review of the medication that abortion advocates are saying is based on “junk science.” As always - please read on to the end for the news that you need to know. 

🎥 Zurawski v. Texas, Documentary Screening: Join L4GG tonight for a virtual screening of Zurawski v. Texas — a documentary about the Texas women who sued their state after being denied critical reproductive healthcare — The film screening will be followed by a live conversation with two of the plaintiffs, Amanda Zurawski and Dr. Austin Dennard. The film runs 98 minutes. It will be available starting at 5pm ET; we recommend watching at 6pm so the discussion is fresh. Click "Pre-register for Free" to reserve your spot.

✍️ Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

Reproductive Rights and Health Equity News:

This Week’s Must-Read: 

Earlier this month, our legal fellow Zane McNeill published an article exploring the intersections between reproductive justice and transgender liberation. He explains that both movements are grounded in the principles of bodily autonomy, self-determination, and freedom from discrimination and state violence. Today, these principles are under attack by the far-right, which seeks to control our bodies and undermine our safety and dignity. Because of these shared threats—and the strong overlap between these movements—he argues that it is imperative that we do not operate in siloes and work together to protect our communities and our democracy.

Legislation & Litigation:

• Overview:

  • Three midwives are challenging Georgia’s laws that criminalize the practice of direct-entry midwifery and strictly regulate certified nurse-midwives;

  • A federal judge ruled that state officials are protected by qualified immunity in a case brought by a Texas woman who was wrongfully arrested in 2022 after taking abortion medication; 

  • Mississippi’s governor signed a bill into law that will make it illegal to manufacture, distribute, dispense, or prescribe abortion medication;

  • The Department of Health and Human Services posted a guidance for Title X clinics that only mentions “contraception” once and pushes pro-natalist “natural family planning methods;”

  • A federal court  has granted the FDA’s request to pause Louisiana’s legal challenge to the agency's abortion medication regulations until after the FDA finishes its “junk science” review of the medication.

  • The Kansas legislature overrode the governor’s veto of abortion regulation bills, which will now go into effect July 1; 

  • Two more women have joined a lawsuit challenging Arkansas’ abortion ban after they were unable to access abortion care in the state; and 

  • The Virginia Governor signed the ‘Right to Contraception Act’ into law, barring  state and local governments from restricting or banning the sale, provision, or use of contraceptives, including birth control, emergency contraception, and intrauterine devices (IUDs).

• Georgia Midwives File Lawsuit Challenging Strict Midwifery Regulations:

• Three midwives, represented by the Center for Reproductive Rights, have brought a legal challenge to Georgia’s restrictive laws governing midwifery. The laws criminalize the practice of direct-entry midwives (midwives trained outside of the nursing profession who specialize in out-of-hospital births) and impose significant burdens on certified nurse-midwives (who are advanced practice nurses also trained in midwifery). 

• The complaint alleges that these restrictions lack a demonstrated connection to health and safety and, in fact, endanger patient welfare. The complaint notes that this is particularly concerning given Georgia’s ongoing maternal health crisis and research showing that maternal and infant outcomes improve when midwives are allowed to practice to the full extent of their training. In states like Georgia with  significant rural counties, birth workers like midwives and doulas fill critical gaps. 

• The plaintiffs are asserting multiple legal claims, including violations of due process and equal protection, as well as claims based on nondelegation, ultra vires actions, the anti-competition clause, and vagueness. They are seeking a permanent injunction to prevent the state from enforcing the challenged midwifery restrictions while the lawsuit advances.

• Federal Judge Dismisses Texas Prosecutors, Sheriff From Lawsuit Brought By Woman Who Was Arrested After Taking Abortion Medication in 2022:

• A federal judge has dismissed Texas prosecutors and law enforcement officials from a lawsuit filed by Texas woman Lizelle Gonzalez, who was arrested and briefly jailed in 2022 when she sought hospital care after taking medication to induce an abortion. Following her visit, hospital staff contacted the district attorney’s office, which, along with the sheriff’s office, secured a grand jury indictment. Although Texas bans the performance of non-emergency abortions, Texas law did not, and still does not, permit charges against a pregnant person for seeking or obtaining an abortion.

• Gonzalez sued Starr County District Attorney Gocha Allen Ramirez, Assistant District Attorney Alexandria Lynn Barrera, and Starr County itself in 2024 under Section 1983, alleging false arrest, malicious prosecution, and conspiracy. Ramirez was disciplined by the Texas State Bar and briefly suspended from practicing law in 2024 over the prosecution. Gonzalez later also added Starr County Sheriff Rene Fuentes as a defendant.

• On April 1, 2026, U.S. District Judge Drew B. Tipton, a Trump appointee, ruled that the Starr County officials were protected by qualified immunity—granting their motions for summary judgment and dismissing them from the case. The lawsuit will proceed against Starr County as the sole remaining defendant.

• Mississippi Governor Signs Bill Criminalizing Medication Abortion:

• On April 8, Mississippi Governor Tate Reeves (R) signed HB 1613 into law. The legislation makes it unlawful to manufacture, distribute, dispense, or prescribe abortion medication. Anyone who violates the law may face civil liability and up to 10 years in prison. The law is set to take effect on July 1, 2026.

• This law could make it more difficult for doctors to provide appropriate care—especially in emergency situations—and may worsen Mississippi’s maternal mortality rate, which is already among the highest in the country. Research shows that a similar law enacted in Louisiana in 2024 disrupted pregnancy and fertility care, as well as other treatments relying on mifepristone and misoprostol.

• The American Civil Liberties Union (ACLU) has noted that while called “abortion medication,” mifepristone and misoprostol are both used to treat a wide range of conditions, both related and unrelated to pregnancy termination. These include postpartum hemorrhage, miscarriage management, Cushing’s syndrome, uterine fibroids, ovarian cancer, and gastric ulcers.

• HHS Title X Guidance Instructs Clinics to End DEI and “Protect Parent’s Rights:” 

• The Department of Health and Human Services (HHS) posted new Title X guidance for reproductive healthcare clinics that critics say reimagines the Title X program, shifting it from “a contraception program into a pronatalist machine.” The HHS guidance was posted just hours after the White House released its 2027 budget proposing the wholesome elimination of the program. 

• The HHS guidance mentions “contraception” only once and only to say that fewer people are using hormonal birth control because of “side effects.” Instead of focusing on contraception, the guidance instead touts practices like “fertility-awareness based methods,” “natural family planning methods,” and “preconception health services.” 

• The guidance also instructs clinics to “[e]nd diversity, equity, and inclusion (DEI) policies,” “ensure that federal resources are not used to facilitate or incentivize illegal immigration” “[p]rotect parental rights to direct the religious upbringing of their children,” and “[e]nforce the Hyde Amendment,” a prohibition on the use of federal funds for abortion.

• The guidance seems to have been drafted by Trump appointees to placate anti-abortion groups who have recently criticized the administration for not cracking down on medication abortion access or going far enough in targeting Title X funding to Planned Parenthood clinics. 

• Anti-abortion groups have increasingly strategized on how to help crisis pregnancy centers (CPCs), or facilities that pretend to be reproductive health clinics but whose true purpose is to dissuade patients from accessing abortion care, access Title X funding. Abortion rights advocates believe this guidance is part of this attempt to “reroute” Title X funding to CPCs.

• Federal Judge Grants Government’s Motion to Stay in Louisiana v. FDA:

• On April 7, 2026, a federal court granted a request by the Food and Drug Administration (FDA) to pause Louisiana’s legal challenge to the agency’s 2023 decision to remove the in-person dispensing requirement for the abortion medication mifepristone. The pause will remain in effect while the FDA completes its ongoing review of the medication– a review that has been widely criticized for being politically motivated and inconsistent with the mifepristone’s well-established safety record

• While the ruling allows telehealth prescribing of mifepristone to continue for now, abortion rights organizations cautioned that it is not an absolute victory. The judge, David C. Joseph, a Trump appointee, appeared sympathetic to Louisiana’s arguments. He urged the FDA to complete its review promptly and ordered the agency to provide a status update to the court within six months.

• Mifepristone currently accounts for 63 percent of abortions and roughly one in four abortions are provided via telehealth. The availability of telehealth abortion medication has become a lifeline for people who live in states that ban abortion care.

• Kansas Legislature Overrides Governor’s Veto of  Abortion Regulation Bills:  

• On April 9, 2026, the Kansas legislature overrode Gov. Laura Kelly’s (D) vetoes of two abortion regulation bills. HB 2729 requires the Kansas Department of Health and Environment to produce a standardized informed consent form for people seeking abortion care in accordance with the state’s biased counseling requirements. HB 2727 allows people who file lawsuits alleging violations of the state’s informed consent requirements to bypass medical malpractice screening panels if they agree to limit damages to $5,000.

• Kelly has said that HB 2729 “requires the state to put false medical information out that has no scientific basis and only serves to mislead women,” and HB 2727 “is another attempt by politicians to involve themselves in these private decisions, this time by trying to intimidate health care providers.”

• These laws will take effect July 1.

• Two Women Denied Abortion Care in Arkansas JoinLawsuit Challenging Ban:

• Two additional women have joined a lawsuit challenging Arkansas’ near-total abortion ban after they were unable to access abortion care in the state. Arkansas’ abortion ban makes the provision of abortion a felony punishable by up to a $100,000 fine and a 10-year prison sentence. The plaintiffs—who now include 6 patients and one physician—are arguing that the state's abortion ban should be struck down in its entirety based on various constitutional grounds. In March, the defendants filed a motion to dismiss the complaint, asserting that the state has sovereign immunity from the suit.

• Virginia Governor Signs Right to  Contraception Act:

• On April 8, 2026 Virginia Governor Abigail Spanberger (D) signed the Right to Contraception Act into law. The law bars state and local governments from restricting or banning the sale, provision, or use of contraceptives, including birth control, emergency contraception, and intrauterine devices (IUDs).

• Abortion rights advocates have praised the measure, arguing that protections for contraception are increasingly important amid ongoing Republican efforts to undermine reproductive healthcare. Officials in the Trump administration have repeatedly (incorrectly) called birth control like the Pill and IUDs “abortifacients” and Trump himself has said that he wants to be remembered as the “fertilization president.”

Trend and Policy Watch:

• Research Finds that Abortion Medication Is Safe Enough to Be Provided Over-the-Counter:

• A recently published study in JAMA Internal Medicine found that abortion medications such as mifepristone and misoprostol “likely meet the FDA’s criteria for over-the-counter sale.”

• In the study, researchers recruited people seeking abortion medication at five abortion-providing facilities across three states. Participants were shown a prototype package for an over-the-counter abortion medication and asked to determine whether they were good candidates for its use based on the package instructions. Researchers then compared participants’ self-assessments with evaluations made by clinicians. The results showed that 88% of participants reached the same conclusion as their clinician.

• Although over-the-counter abortion medication is not yet available, researchers noted that the path to over-the-counter sale could be similar to that of birth control pills, which also faced a “long road” before the first oral contraceptive received FDA approval for over-the-counter use in 2023.

• Planned Parenthood Takes Aim At Anti-Abortion Republicans:  

• On April 9, 2026 Planned Parenthood Action Fund, the advocacy arm of Planned Parenthood Federation of America, launched a new $1.5 million campaign to fight back against Republicans's efforts to ‘defund’ Planned Parenthood health centers and deprive countless Americans of basic reproductive healthcare.

• The campaign specifically identifies five House Republicans–Juan Ciscomani (AZ), Gabe Evans (CO), Brian Fitzpatrick (PA), Mike Lawler (NY), and Mariannette Miller-Meeks (IA)—as “key targets.” As part of the effort, the Action Fund plans to spend nearly $900,000 on advertisements in these districts, “encouraging their constituents to ask them to oppose any legislation that attempts to ‘defund’ Planned Parenthood.”

• Reproductive Rights Wins Contribute to Republican Crackdown on Direct Democracy: 

• In 2024, voters in seven states approved measures affirming that their state constitutions protected the right to abortion care. In response to the success of these citizen-led ballot initiatives, legislatures in North Dakota, Utah, and South Dakota are advancing measures for the November ballot that would raise the approval threshold for citizen-led amendments from a simple majority to 60 percent. 

• In Missouri, the legislature is trying to make it even more difficult for voters to successfully pass citizen-sponsored amendments by requiring them to win in each of the state’s eight U.S. House districts. Under this rule, a measure could receive 95 percent of the statewide vote and still fail if it loses in just one district.  

• Meanwhile, in Florida, Governor Ron DeSantis signed a bill that increases requirements, fees, and criminal penalties related to collecting petition signatures for ballot initiatives. As a result, all 22 citizen-proposed initiatives this year failed to qualify for the ballot.

REPRODUCTIVE HEALTH DIGEST (4/2/26)

Developments in Abortion, Autonomy, and Access:

This week’s Digest goes discusses the politics and ethical concerns surrounding crisis pregnancy centers, anti-abortion legislation and ballot initiatives out of Mississippi, Ohio, Missouri, and South Dakota, the story of a woman being charged with murder for allegedly taking abortion pills, and new information about how and where people are accessing abortion care. As always - please read on to the end for the news that you need to know. Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

Reproductive Rights and Health Equity News:

This Week’s Must-Read: 

This week’s must-read comes from the Dallas Morning News and tells the story of a pregnant Texas woman who underwent emergency surgery for an ectopic pregnancy after a crisis pregnancy center assured her that her ultrasound and pregnancy were normal. Crisis pregnancy centers - anti-abortion centers that often misleadingly present themselves as medical clinics - have been accused for decades of providing substandard care and inaccurate information to the people who walk through their doors. They raise serious questions about the ethics of facilities that purport to offer certain medical and diagnostic services while actually centering a mission of dissuading people from deciding to have an abortion. Although anti-abortion activists view these centers as the “front line” of their movement, experts warn that they provide a woefully inadequate alternative to comprehensive prenatal and reproductive healthcare. 

Legislation & Litigation:

• Overview:

  • Mississippi legislators are advancing legislation that would criminalize “abortion-inducing drugs” under the state’s drug trafficking laws; 

  • Despite Ohioans passing an abortion rights constitutional amendment in 2023, Ohio lawmakers are pressing forward with bills to limit and surveil care; 

  • South Dakota has passed a series of anti-abortion laws, including one which targets ‘advertising’ related to abortion; 

  • The Kansas Legislature overrode the governor’s veto of a bill de-regulating crisis pregnancy centers; and

  • A Georgia woman is facing unprecedented murder charges for allegedly taking abortion pills.

• Mississippi Legislators Aim to Criminalize Medication Abortion:

• Mississippi lawmakers are advancing a bill to criminalize “abortion-inducing drugs” such as mifepristone and misoprostol under state drug trafficking laws. HB 1613 was introduced by Republican Representative Celeste Hurst as an amendment to a pre-existing drug  trafficking bill. It prohibits, among other things, creating, distributing, prescribing or possessing these drugs and subjects alleged violators to up to ten years in prison. Rep. Hurst’s stated purpose is to stop the flow of abortion pills to patients in Mississippi - a state currently enforcing a total abortion ban. Although the amendment includes an exception for circumstances where these drugs are prescribed for purposes other than abortion, experts warn about the confusion and chilling effect that bills like HB 1613 create. 

• HB 1613 is one of many proposed state laws aiming to stop patients in ban states from accessing care. Other states have passed medication abortion bans, reclassified abortion drugs as controlled substances, introduced legislation to create causes of action against abortion pill manufacturers, limited access to telehealth, and moved to enshrine fetal personhood in state law. This crackdown comes as telehealth abortions continue to rise in states enforcing total bans, largely as a result of access to care through shield providers and online distributors in protective states.

• Ohio Lawmakers Move Forward with Abortion Restrictions, Despite Constitutional Protections:

  • Despite Ohioans passing an abortion rights constitutional amendment in 2023, Ohio lawmakers are continuing to press for restrictions on care and abortion surveillance. The Republican-led Ohio House is pushing forward legislation implementing a mandatory 24-hour waiting period, despite there being no medically indicated reason supporting such delays in care. Although a court previously struck a similar waiting period on the grounds that it violated the amended state constitution, proponents of the new law argue that it does not contravene constitutional protections and instead provides “women with the full protection of informed medical consent when making a stressful, life-altering decision.” Far from improving quality of patient care, waiting periods actually delay and deter care, particularly for patients who are forced to travel long distances and obtain childcare and work coverage - a fact that anti-abortion lawmakers are well aware of. . 

  • In addition to the waiting period bill, Republican lawmakers have also introduced a “Certificate of Life” bill that would require physicians to file a certificate with the state government within 10 days of detection of fetal cardiac activity and to register all fetal deaths, regardless of age or manner of death. In other words, it would effectively create a registry of all pregnant people in the state and all pregnancy terminations and losses. The bill’s sponsor openly stated that its purpose is to "acknowledge the sanctity of life beginning in the womb.” 

• South Dakota Passes Law Targeting Abortion Information:

• In late March, South Dakota Governor Larry Rhoden signed several anti-abortion bills into law. The first - and perhaps most alarming - is HB 1274. Although South Dakota is already enforcing a total abortion ban, HB 1274 creates a new felony for any person who dispenses, distributes, sells, or advertises anything intended to be used to produce an abortion. The law allows the attorney general to pursue monetary penalties for alleged violators. South Dakota’s targeting of abortion advertising comes as Attorney General Marty Jackley is attempting to block Mayday Health - an abortion rights nonprofit - from providing abortion information in the state. Jackley stated that the new law would give prosecutors another tool for blocking out-of-state abortion providers and advertisers. 

• In addition to the anti-advertising law, Governor Rhoden also signed an abortion “clarification” law, which excepts specific treatments from the state’s abortion ban - namely, miscarriage treatment, ectopic pregnancy treatment, removal of a deceased fetus and procedures that are intended to preserve the pregnancy or that unintentionally result in pregnancy loss. These kinds of clarification laws do little to actually inform providers of when they are able to intercede to help their patients and fail to account for even a fraction of the complications and risks inherent to pregnancy. 

• The final abortion-related law targets public school education on human reproduction and requires South Dakota schools to show students a video depicting fetal development from fertilization to birth. By law, the video cannot be provided by an organization affiliated with abortion. Critics are concerned that the video provided to students will be created by anti-abortion groups or biased towards anti-abortion sentiment and will not show a scientifically accurate portrayal of fetal development.

• Kansas Governor Vetoes Legislation De-regulating Crisis Pregnancy Centers:

  • Kansas lawmakers successfully overrode Democratic Governor Laura Kelly’s veto of a law that prohibits regulation of crisis pregnancy centers in order to “protect [their] ability to provide life-affirming care.” Although Governor Kelly explained that Kansans have made clear that they do not want their tax dollars going towards regulating private medical decisionmaking, the House and Senate both easily defeated her veto. The now-passed law aims to block the state from regulating or limiting what kinds of information and resources can be provided by CPCs, despite the anti-abortion centers’ long history of presenting biased,  inaccurate, and medically contradicted information to pregnant people while prioritizing discouraging abortion over patient care. The law also creates a private right of action for individuals to sue and allows the state legislators to join in such cases. Reportedly, the state has given over $7 million to CPCs since 2022, and they outnumber abortion clinics 44 to 7. 

• A Georgia Woman has Been Charged with Murder After Taking Abortion Pills:

• Georgia prosecutors have brought murder charges against 31-year-old Georgia woman Alexia Moore after she allegedly took abortion pills and delivered a premature fetus. Although Georgia bans abortion after detection of fetal cardiac activity (around 6 weeks gestational age), it - along with other abortion ban states - bars the state from prosecuting the pregnant person themselves and instead targets the person performing the abortion. In a bond hearing, both the DA and Moore’s defense attorney pointed out this fact, and the judge agreed. The DA also reportedly stated that the Kingsland Police Department did not seek his office’s support before bringing the murder charge, but he was nonetheless not yet prepared to drop it. Moore’s case represents one of the first times that a person has been charged with a crime like murder for self-managing an abortion, and experts on pregnancy criminalization have spoken out to condemn the charges. At this time, Moore has been released on bond, with the Superior Court Judge setting a symbolic $1 dollar bond for the murder charge and expressing doubt about the state’s ability to succeed in the charges. 

Trend and Policy Watch:

• New Data from Guttmacher Shows how Abortion Rates and Methods Changed in 2025:

  • Guttmacher’s 2025 abortion reporting data demonstrates how, nearly four years after the Dobbs decision, overall abortion numbers remain roughly steady, while the ways in which people are accessing care have shifted. Despite vigorous efforts from anti-abortion advocates and lawmakers, things like shield laws and telehealth have allowed people to continue to obtain abortions - even while living in states that ban such care. Guttmacher’s latest reporting shows that, in states without total bans, abortion numbers “declined slightly from 1,049,000 to 1,036,000,” while in states with total abortion bans in place, telehealth provision increased from 74,000 to 91,000 between 2024 and 2025. Additionally, the number of people crossing state lines to obtain care declined slightly from 154,000 in 2024 to 142,000 in 2025. What this tells us is that people are increasingly turning to telehealth and self managed abortion to obtain care - rather than traveling to other states in person.

• Anti-Abortion Groups in Missouri Aim to Overturn Abortion Rights Constitutional Amendment:

  • This November, anti-abortion groups in Missouri hope to overturn the abortion rights constitutional amendment passed by citizen-led ballot initiative in 2024. Reportedly, they are hoping that increased coordination, funding, and support from Republican lawmakers will help them succeed in 2026 where they failed in 2024. The anti-abortion campaign - misleadingly called “Her Health, Her Future” - aims to reinstate a total abortion ban, with narrow exceptions for rape, incest, or medical emergencies. Although they have the benefit of time and increased public awareness this time around, they are still being outspent by the opposition “Stop the Ban” campaign.  The 2024 win was a somewhat narrow one, with abortion rights supporters garnering only 52% of the vote, and access to abortion in the state has remained in flux as arguments over the constitutionality of remaining abortion restrictions play out in state courts. This election cycle, the anti-abortion amendment also includes a ban on gender-affirming care for minors, which recent polling shows may increase Missourians likelihood of supporting the measure.

• HHS Investigating States for Alleged Violations of “Conscience” Laws:

• The Department of Health and Human Services is reportedly opening investigations into 13 blue states over alleged violations of the Weldon Amendment. The Weldon Amendment, which was first implemented in 2005, is a refusal of care policy that prohibits federally funded healthcare entities from ‘discriminating’ against healthcare institutions, providers and insurers who decline to provide, cover, or refer for abortions. HHS alleges that the targeted states have unlawfully ‘coerced’ healthcare entities into providing care over conscience objections. Notably, officials involved disclosed that the investigations were not prompted by any actual complaints from individuals or entities who allege they were subject to coercion. This investigation reflects a broader move by the current administration to restrict and defund abortion coverage.

REPRODUCTIVE HEALTH DIGEST (3/19/26)

Developments in Abortion, Autonomy, and Access:

This week’s Digest covers Wyoming’s new 6-week abortion ban, an Indiana court’s ruling on abortion and religious freedom, Senator Josh Hawley’s attempts to rescind FDA approval for mifepristone, legislative and policy developments related to fetal personhood, and new research about how abortion bans impact where people choose to live and work. As always, please read on to the end for the news that you need to know. 

🚨If you find the Repro Digest to be a valuable resource, we are so excited to share with you the upcoming launch of a second Digest - the Transgender Rights Digest. The Transgender Rights Digest is a bi-weekly newsletter that distills the most important state and federal developments affecting transgender rights — drawn directly from our continuously updated Policy Resource Hub for Transgender Rights. In addition to the bi-weekly national newsletter, subscribers can opt into state-specific email alerts for developments that directly impact any state they’re monitoring. It will launch on March 31, Trans Day of Visibility! Pre-Register for the Digest here. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s must-read comes from ProPublica and details how pregnant patients have been forced by court order to undergo unwanted c-sections. The practice of court intervention in birthing dates back to the 1980s and is rooted in the idea that the state’s interest in unborn life gives it authority to override a pregnant patient’s medical decisions, even if that means operating on a patient without their consent. As fetal personhood arguments like this gain traction in the mainstream and more and more states pass laws granting fetuses and embryos legal rights, concerns over the erosion of the patient’s rights are growing. 

Legislation & Litigation:

• Overview:

• An Indiana court has issued a ruling blocking the state’s abortion ban for patients whose sincerely held religious beliefs dictate that pregnancy termination is the proper course of action; 

• Wyoming Governor Mark Gordon has signed a new fetal “heartbeat” bill into law, restricting abortion after 6-weeks gestational age; a group of abortion rights advocates have already challenged it in court; 

• Republican Senator Josh Hawley has introduced legislation to rescind FDA approval of mifepristone; and 

• Arizona lawmakers are considering a fetal personhood bill that would define embryos and fetuses as pre-born children and allow child support from the moment a person realizes they are pregnant.

• Indiana Court Partially Blocks Abortion Ban on Religious Freedom Ban:

• In early March, an Indiana judge issued a ruling permanently preventing the state from enforcing its total abortion ban against individuals who say it violates their sincerely held religious beliefs. The state’s abortion laws ban care at all gestational ages, except in cases where the patient’s life or health are at serious risk, and certain cases involving rape, incest, or fetal anomalies. The law does not allow abortions for reasons related to mental health. Over three years ago, Hoosier Jews for Choice and a number of individual plaintiffs sued the state, arguing that the ban violated the state’s Religious Freedom Restoration Act (RFRA). 

  In their complaint, the plaintiffs argue that Jewish beliefs around when life begins and Jewish laws’ requirement of prioritizing the mother’s physical and mental health prior to birth mean that their faith would, in certain circumstances, dictate pregnancy termination as the proper course of action. However, under Indiana law, they would be prohibited from seeking that course of treatment. Indiana’s RFRA prohibits the state from substantially burdening a person’s religious practice, absent a compelling state interest. In issuing a permanent injunction, Judge Christina Klineman sided with the plaintiffs’ religious freedom arguments and wrote that “[p]enalizing providers to avoid the violation of RFRA is an untenable end-run around the conflict in these laws.” Her ruling applies to any person in Indiana whose religious beliefs require them to seek an abortion otherwise banned by state law. The Attorney General has  appealed that ruling. 

• Wyoming Governor Signs Fetal “Heartbeat” Bill into Law:

• In January, the Wyoming Supreme Court struck down the state’s abortion bans on the grounds that they violate the Wyoming Constitution’s guarantee of individuals’ rights to healthcare decisionmaking. In response, the legislature swiftly introduced and passed a “heartbeat” ban, which prohibits abortion at approximately 6-weeks gestational age - a point at which many people do not yet know that they are pregnant. Republican Governor Mark Gordon signed the bill into law on March 9th, despite previously expressed reservations about its lack of exceptions for victims of rape or incest. The day after Governor Gordon signed the bill, a group of abortion rights advocates filed a motion asking the court to block it. In their motion, they requested to add their challenge to the 6-week ban to an ongoing lawsuit challenging other abortion restrictions in the state. Whether the court will find that the law has the same constitutional deficiencies as the previously-struck total ban remains to be seen; however, for the time being, the one remaining abortion clinic in the state has canceled appointments for patients past 6 weeks. 

• Senator Josh Hawley Introduces Legislation to Rescind FDA Approval of Mifepristone:

• Republican Senator Josh Hawley of Missouri has introduced federal legislation to withdraw FDA approval for mifepristone. Medication abortion now accounts for over 60% of abortions performed in the U.S. and access to abortion pills via telehealth has served as a lifeline for patients living in abortion ban states. In recent months, anti-abortion groups and activists have become vocally frustrated with the Trump Administration’s failure to take aggressive action to curtail access. Although mifepristone has been approved for over 25 years and has an excellent safety record, Hawley claims that “the science” shows that “the chemical abortion drug is inherently dangerous to women and prone to abuse.” His bill would not only strip mifepristone of its FDA approval but would also create a private right of action for patients to sue its manufacturers. Thus far, the bill has received little support from fellow Republican lawmakers - many of whom are likely weighing the politics of opposing abortion in a midterm year. President Trump, who has been relatively quiet on the issue of abortion in his second term, is now caught in a bind between dissatisfied anti-abortion groups threatening to withhold support in the midterms and the reality that opposing abortion is deeply politically unpopular. 

• Arizona Considers Fetal Personhood Legislation:

  • While we cannot possibly report on all of the pieces of anti-abortion legislation being introduced around the country, it is important to highlight those that are representative of broader anti-abortion trends and strategies. Arizona HB 2144 falls into that category. The proposed law would allow pregnant people to seek child support from the moment they realize they are pregnant. It would also define “pre-born child” under state law as embryos and fetuses from conception to birth. Although proponents of the bill insist that they are merely trying to provide more support for pregnant people, critics point to its obvious fetal personhood implications. The law’s definition of “pre-born child” and attachment of child support obligations that traditionally do not apply until a child is born create a legal framework for granting embryos and fetuses the same kinds of rights that born persons have. This kind of fetal personhood structure paves the way for abortion opponents to further entrench abortion restrictions and argue that abortion violates state law.

Trend and Policy Watch:

• Texas Attorney General Threatens Mental Health Providers:

• Texas Attorney General Ken Paxton has threatened mental health providers who treat transgender or gender non-conforming minors. Although Texas already bans gender-affirming care for minors, AG Paxton issued an opinion on February 27th, declaring that mental healthcare providers are similarly prohibited from “transitioning” minors - though it is unclear what conduct would fall under this asserted prohibition. In his published statement on the opinion, he stated that “[a]ny radical facilitating the ‘transitioning’ of our kids is committing child abuse,” and that the opinion “should send a clear warning there will be consequences for any medical professional, whether a doctor or therapist, who is illegally ‘transitioning’ Texas kids.” The opinion will inevitably have its intended effect: chilling the speech and therapeutic efforts of mental health professionals treating minors for issues related to gender. 

• Virginia Towns Using Zoning Laws to Restrict Abortion:

• Although abortion is legal in Virginia - making it a singular stronghold of access in the South - certain towns have begun weaponizing zoning laws to enact restrictions. For example, in Lynchburg, the City Council recently enacted a zoning ordinance prohibiting clinics that provide abortion services from operating near certain locations, such as schools, parks and churches. The ordinance renders nearly all of Lynchburg off-limits, highlighting the ways in which laws seemingly unrelated to healthcare can be used to choke off access. Similarly, in Roanoke County, the Board of Supervisors passed a resolution in February instructing the planning commission to examine how it could limit the locations of abortion clinics. Reportedly, the resolution “was included on the board’s consent agenda, usually reserved for routine, procedural items that all parties have previously agreed on.” Individuals in both Lynchburg and Roanoke County have criticized the political maneuvering for lacking transparency.

• Abortion Absent From State of the Union Address:

  • President Trump’s State of the Union Address, delivered on February 24th, conspicuously skirted the issue of abortion, with the word not being mentioned a single time. Although President Trump has previously referred to himself as “the most pro-life president in history” and proudly touted his administration’s anti-abortion agenda, he has been remarkably quiet on the subject in the past several months. Notably, multiple anti-abortion groups and leaders have publicly expressed discontent with the President’s failure to take more aggressive action to ban abortion at the federal level in his second term and called on the administration to restrict access to mifepristone, following medication abortion’s post-Roe rise in popularity. The administration’s silence likely reflects a calculation that aggressively taking on abortion would hurt the President and his allies politically in an already-contentious  midterm year. 

• Surgeon General Candidate Espouses Anti-Birth Control Views:

  • President Trump’s nominee for surgeon general, wellness influencer Dr. Casey Means, faced intense scrutiny during her confirmation hearing before the Senate. Dr. Means, who would act as the top doctor in the country, was asked to answer for her history of anti-vaccine and anti-birth control statements and positions. She was specifically pressed on issues related to whether parents should have their children vaccinated, the efficacy of the flu vaccine, and debunked links between autism and vaccines. She was also questioned about her history of statements criticizing birth control, including referring to birth control pills as disrespectful to human life. At this time, it is unclear whether Means will garner the votes necessary to secure the position.

REPRODUCTIVE HEALTH DIGEST (3/5/26)

Developments in Abortion, Autonomy, and Access:

This week’s Reproductive Health Digest covers escalating attempts to criminalize reproductive healthcare providers, litigation challenging access to medication abortion, proposed legislation restricting abortion in Wyoming and Arizona, a new draconian anti-trans law out of Kansas, and multiple stories around the politics of abortion access in the run-up to the midterm elections. As always, please read on to the end for the news that you need to know.

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

Legislation & Litigation:

• Overview:

  • In late February, a Louisiana federal court heard arguments over the question of whether the FDA erred in removing in-person dispensing requirements for medication abortion; 

  • Texas Attorney General Ken Paxton has brought another suit against a California shield provider and a telehealth organization in his ongoing effort to block access to abortion options for Texans; 

  • Last month, a Texas court heard arguments in its case against a midwife for allegedly providing illegal abortions, but the defense argues that the state’s case is exceedingly weak;

  • Wyoming lawmakers are moving forward with legislation to ban abortion after detection of fetal cardiac activity; 

  • Kansas has begun enforcing one of the most draconian anti-trans bills in the country; and 

  • Arizona lawmakers have proposed a slew of abortion restrictions, despite Arizonans voting to constitutionally protect access to care.

• Federal Court Hears Argument About Access to Mifepristone:

• Late last month, the Western District of Louisiana heard arguments in a case seeking to limit access to the common abortion pill mifepristone. The lawsuit, brought by Louisiana Attorney General Liz Murrill, is one of multiple cases challenging the legality of the drug. 

  During the Covid-19 pandemic, in-person dispensing requirements for mifepristone were temporarily lifted. That change was later made permanent based on a finding that allowing telehealth eased access to care and posed no significant safety risks to patients. Louisiana is now asking the court to reinstate in-person dispensing requirements. If successful, this would severely limit telehealth access to care even in states where abortion is legal and protected. 

  During arguments, Louisiana asserted that removal of in-person requirements increases risks of harm to patients and allows for the medication to flow into states that ban abortion, circumventing those states’ laws. When forced to take a position in the case last month, the FDA under the Trump Administration asked for the judge to temporarily halt the case’s progress while the agency undertakes a review of mifepristone’s safety record - a review that has been heavily criticized for being politically motivated and ignoring mifepristone’s sound scientific record. Manufacturers GenBioPro and Danco Laboratories intervened in the case, affirmatively arguing for continued telehealth access to mifepristone. The companies point the court to the drug’s excellent safety record and the lack of evidence that in-person dispensing is medically necessary. They also cautioned against allowing Louisiana to reshape the national regulatory landscape for an FDA-approved drug - a move that could open the doors to increased non-expert scrutiny of other long-approved medications. The court did not indicate when it will make its ruling, but the outcome of the case will significantly impact ongoing fights over medication abortion in and out of the courtroom. 

• Texas Attorney General Sues California Shield Provider and Medication Abortion Organization:

• In our last Digest, we reported on the first lawsuit filed under HB7, Texas’s newly enforced medication abortion ban. In that case, a Texas man amended his prior lawsuit alleging that California shield provider Dr. Remy Coeytaux sent medication abortion pills into the state to add a count under HB7. Texas Attorney General Ken Paxton has now filed an additional lawsuit against Dr, Coeytaux and Aid Access and its founder, alleging violations of HB7 and Texas’s abortion ban. AG Paxton has lodged separate but similar lawsuits against Delaware and New York providers. Texas now asks the court to prohibit Dr. Coeytaux and Aid Access from shipping medication abortion across state lines and into Texas. Lawsuits like this one, Louisiana’s litigation against the FDA, described above, and individual lawsuits against shield providers, are a part of a multi-faceted and coordinated effort to severely restrict or wholly withdraw access to medication abortion - particularly for individuals living in ban states.

• Texas Hears Arguments in Case Charging Midwife with Providing Illegal Abortions:

  • On February 19th, the Fifteenth Court of Appeals in Texas heard arguments in a case accusing a Houston-area midwife of performing abortions in violation of Texas law. Last year, Maria Rojas and several of her associates were indicted on felony charges, in what appears to be the first attempted prosecution of a healthcare provider for allegedly violating a state’s abortion ban post-Roe. The state has brought both a civil and criminal case against Rojas, and she faces a sentence of up to life in prison if she is found guilty. 

    Rojas’s attorneys, however, argue that the state’s case is exceedingly weak. They point to the lack of any credible eyewitness or documentary evidence indicating that illegal abortions were performed at Rojas’s clinics, and explain that a statement by a person identified as “E.G.” who claimed to have been given abortion pills lacks any concrete corroborating evidence and amounts to hearsay. Further, although a bottle of misoprostol was found on the premises, this does not necessarily indicate that abortions were being performed. Misoprostol is routinely used in miscarriage management, and Rojas was legally allowed to prescribe it under supervision of a physician. And, investigators have not put forth any evidence that they found mifepristone, the drug that typically accompanies misoprostol in a medication abortion, or surgical abortion tools. Despite the lack of evidence proving the State’s case, AG Paxton has aggressively smeared Rojas and her affiliates, using inflammatory and racially charged language. Rojas’s clinics are currently closed, and she is out on a $1.4 million bond.

• Wyoming Takes Steps to Ban Abortion After Fetal Cardiac Activity:

  • In January, the Wyoming Supreme Court struck down the state’s abortion bans on the grounds that they violate the Wyoming Constitution’s guarantee of individuals’ rights to healthcare decisionmaking. In response, the legislature is now attempting to pass a “heartbeat” ban, which would prohibit abortion at approximately 6-weeks gestational age - a point at which many people do not even know they are pregnant. HB 126, championed by fetal personhood proponent Chip Neiman, only includes an exception for medical emergencies. It would not allow abortion in cases involving fatal fetal abnormalities or circumstances of rape or incest.

    The bill has passed through the legislature with relative ease and now only requires one more vote in the House. It will then go before Republican Governor Mark Gordon. Although the law would almost certainly be subject to swift legal challenge, it is unclear how the state’s courts would rule on a 6-week gestational ban, as opposed to the previously struck total abortion ban.

• Kansas Begins Enforcing Draconian Anti-Trans Law:

  • Last month, Kansas passed one of the most draconian anti-trans laws in the country. SB 244, passed over the veto of Governor Laura Kelly, bars trans people from using restrooms consistent with their gender identity, and implements a bounty hunter-style provision allowing individuals who believe they have encountered a trans person in a public restroom to bring a lawsuit for monetary damages. Additionally, the law prohibits changing gender markers on a person’s driver’s license and invalidates driver’s licenses that have already been updated to reflect a person’s gender identity, effective immediately. 

    Kansans who had legally changed the gender markers on their licenses have received letters informing them of this change in the law and stating that “the Legislature did not include a grace period for updating credentials. That means that once the law is officially enacted, your current credentials will be invalid immediately, and you may be subject to additional penalties if you are operating a vehicle without a valid credential.” In other words, Kansas is restricting the ability of transgender Kansans to drive, without providing any justification or explanation of how the state is harmed by individuals using validly issued licenses with accurate gender markers. The law was swiftly challenged  by the ACLU on multiple constitutional grounds.

• Arizona Republicans Move Forward with Abortion Restrictions, Despite Recent Court Ruling:

  • In early February, an Arizona court issued a ruling striking down a number of medically unnecessary restrictions on abortion. These included 1) a law requiring patients to make two separate trips to their healthcare provider and wait at least 24 hours before receiving care; 2) laws banning abortions sought as a result of certain fetal diagnoses; and 3) a ban on the use of telemedicine for abortion services. The court found that the struck provisions were unconstitutional in light of the constitutional amendment protecting reproductive rights that Arizonans passed in November 2024. 

    The clear expression of the people’s will, and the court’s recent ruling have not deterred anti-abortion lawmakers in the state, however. Republican legislators have filed a notice of appeal challenging the February ruling and introduced a wave of abortion-restrictive legislation. The Arizona Center for Investigative Reporting found “16 [proposed bills] in play this session, including proposals seeking to advance fetal personhood and impose new limits on medication abortion, among other restrictions affecting public universities, schools and state health programs.” This move by lawmakers to restrict the efficacy and scope of the 2024 reproductive rights amendment is a strategy mirrored in states across the country. For example, despite having passed an abortion-rights measure in 2023, Ohioans are still battling in court over restrictions on care. And, in Missouri, anti-abortion lawmakers are asking voters to repeal an abortion rights amendment that they passed in 2024.

Trend and Policy Watch:

• Texas Attorney General Threatens Mental Health Providers:

• Texas Attorney General Ken Paxton has threatened mental health providers who treat transgender or gender non-conforming minors. Although Texas already bans gender-affirming care for minors, AG Paxton issued an opinion on February 27th, declaring that mental healthcare providers are similarly prohibited from “transitioning” minors - though it is unclear what conduct would fall under this asserted prohibition. In his published statement on the opinion, he stated that “[a]ny radical facilitating the ‘transitioning’ of our kids is committing child abuse,” and that the opinion “should send a clear warning there will be consequences for any medical professional, whether a doctor or therapist, who is illegally ‘transitioning’ Texas kids.” The opinion will inevitably have its intended effect: chilling the speech and therapeutic efforts of mental health professionals treating minors for issues related to gender. 

• Virginia Towns Using Zoning Laws to Restrict Abortion:

• Although abortion is legal in Virginia - making it a singular stronghold of access in the South - certain towns have begun weaponizing zoning laws to enact restrictions. For example, in Lynchburg, the City Council recently enacted a zoning ordinance prohibiting clinics that provide abortion services from operating near certain locations, such as schools, parks and churches. The ordinance renders nearly all of Lynchburg off-limits, highlighting the ways in which laws seemingly unrelated to healthcare can be used to choke off access. Similarly, in Roanoke County, the Board of Supervisors passed a resolution in February instructing the planning commission to examine how it could limit the locations of abortion clinics. Reportedly, the resolution “was included on the board’s consent agenda, usually reserved for routine, procedural items that all parties have previously agreed on.” Individuals in both Lynchburg and Roanoke County have criticized the political maneuvering for lacking transparency.

• Abortion Absent From State of the Union Address:

  • President Trump’s State of the Union Address, delivered on February 24th, conspicuously skirted the issue of abortion, with the word not being mentioned a single time. Although President Trump has previously referred to himself as “the most pro-life president in history” and proudly touted his administration’s anti-abortion agenda, he has been remarkably quiet on the subject in the past several months. Notably, multiple anti-abortion groups and leaders have publicly expressed discontent with the President’s failure to take more aggressive action to ban abortion at the federal level in his second term and called on the administration to restrict access to mifepristone, following medication abortion’s post-Roe rise in popularity. The administration’s silence likely reflects a calculation that aggressively taking on abortion would hurt the President and his allies politically in an already-contentious  midterm year. 

• Surgeon General Candidate Espouses Anti-Birth Control Views:

  • President Trump’s nominee for surgeon general, wellness influencer Dr. Casey Means, faced intense scrutiny during her confirmation hearing before the Senate. Dr. Means, who would act as the top doctor in the country, was asked to answer for her history of anti-vaccine and anti-birth control statements and positions. She was specifically pressed on issues related to whether parents should have their children vaccinated, the efficacy of the flu vaccine, and debunked links between autism and vaccines. She was also questioned about her history of statements criticizing birth control, including referring to birth control pills as disrespectful to human life. At this time, it is unclear whether Means will garner the votes necessary to secure the position.

REPRODUCTIVE HEALTH DIGEST (2/12/26)

Developments in Abortion, Autonomy, and Access:

This week’s Reproductive Health Digest walks through litigation developments in a Texas case challenging medication abortion access, a ruling striking down Arizona restrictions on abortion, key examples of anti-abortion legislation being introduced at the state level, and continued legal battles over the right to gender-affirming care. We also discuss policy developments around veterans’ coverage for abortion, the FDA’s study of mifepristone’s safety record, and the Texas Medical Board’s new course for physicians about the state’s abortion laws. As always, please read on to the end for the news that you need to know.  

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

If you’d rather not receive the bi-weekly Reproductive Health Digest but still want to get other L4GG emails, you can opt out of just this newsletter here.

Legislation & Litigation:

• Overview:

  • A Texas man who is suing California Dr. Remy Coeytaux for mailing abortion pills to his ex-partner has amended his lawsuit to add the first claims brought under Texas’s new medication abortion ban; 

  • An Arizona court has struck down several medically unnecessary abortion restrictions, including a ban on telehealth, as unconstitutional in light of the state’s abortion rights amendment; 

  • Iowa lawmakers have introduced a slate of anti-abortion legislation, including two total abortion bans; and 

  • California has filed a lawsuit against a hospital for its decision to cease providing gender-affirming care services to patients under 19.

• Texan Man Files First Lawsuit Under New Texas Medication Abortion Ban:

  • In December of last year, Texas’ medication abortion ban, HB7, went into effect. The law uses a ‘bounty hunter’ mechanism that financially incentivizes private citizens to sue anyone who provides abortion pills to Texans without a valid prescription. Texas is already enforcing a total abortion ban; however, abortion pills prescribed via telehealth have acted as a lifeline for individuals in need of care - HB 7 was passed as an attempt to block that route to access. 

  • Last year, Texas man Jerry Rodriguez filed a lawsuit against Californa Dr. Remy Coeytaux for allegedly sending Rodriguez’s former partner abortion pills, and earlier this month, he amended that lawsuit to add a claim under HB7. This appears to be the first lawsuit brought pursuant to the new law.  Rodriguez is seeking both financial damages and an order blocking Dr. Coeytaux from continuing to mail medication abortion into Texas. Dr. Coeytaux is operating under protection of California’s shield law, and California has thus far refused to comply with the lawsuit, with Governor Newsom stating that California “will not allow extremist politicians from other states to reach into California and try to punish doctors based on allegations that they provided reproductive health care services. Not today. Not ever.” Battles over the enforceability of shield laws are playing out in multiple legal forums, and whether these protective laws can ultimately withstand judicial scrutiny will play a fundamental role in the abortion access landscape moving forward.

• Arizona Strikes Down Abortion Restrictions:

• Earlier this month, Arizona Judge Gregory Como issued a ruling permanently striking down several medically unnecessary abortion restrictions in the state. In November 2024, Arizonans voted to amend their constitution to add protections for the right to pre-viability abortion care. However, the constitutional amendment did not automatically undo the many restrictive abortion laws that remained on the books and functionally blocked patients from accessing care.  Like other states that have passed constitutional amendments, Arizonans have had to fight in court to see their rights fully realized. The restrictions struck by Judge Como this month include 1) a law requiring patients to make two separate trips to their health care provider and wait at least 24 hours before receiving care; 2) laws banning abortions sought as a result of certain fetal diagnoses; and 3) a ban on the use of telemedicine for abortion services. The rescission of the 24-hour waiting period and the prohibition on telehealth in particular remove significant barriers to accessing care – particularly for patients who live in rural areas, or do not have the resources to travel and take time away from work, family, and other obligations. A spokesperson for the Arizona Senate President stated that they would appeal the ruling.

• Iowa Lawmakers Introduce Anti-Abortion Legislation:

• Less than a month into Iowa’s legislative session, lawmakers have introduced a number of bills that would significantly roll back access to abortion in the state. Iowa is currently enforcing a so-called ‘heartbeat ban’ that prohibits abortion after approximately 6 weeks gestational age. Although it is not yet clear how much traction each of the measures has in the general assembly, it is important to note that both houses of Iowa’s legislature are Republican controlled, and the state is run by a Republican governor adamantly opposed to abortion. 

• The first bill, HF 2332, would enact a total abortion ban and define the intentional ending of a pregnancy as “feticide”, punishable as a class A felony. A second proposed total abortion ban, HF 2316, goes even further and would punish abortion at all gestational ages as homicide and apply all of Iowa’s criminal and civil laws to a fetus from the time of fertilization. In other words, it would be a full realization of fetal personhood in state law. A third bill, SSB 3115 would tighten up on access to medication abortion by requiring an in-person visit prior to prescription. It would also add new informed consent requirements to Iowa law, including requiring prescribing physicians to screen for abuse or coercion. A similar proposed screening requirement was recently shot down by the Nebraska legislature on the grounds that it would place an additional burden on providers and was unnecessary in light of existing state protections against trafficking and abuse.

• California Brings Suit Against Hospital for Ceasing Providing Gender-Affirming Care:

  • On January 30th, Attorney General Rob Bonta filed a lawsuit against Rady Children’s Health after the hospital announced that it would cease providing gender-affirming care for patients under the age of 19. Rady is only the latest in a large number of healthcare systems and hospitals ceasing care in light of the Trump Administration’s attacks on trans health. AG Bonta’s lawsuit alleged that Rady violated a binding merger agreement that required it to continue to provide all existing levels of healthcare, including gender-affirming care, until 2034. On Wednesday, a judge issued a ruling temporarily requiring Rady to continue providing care. Although many Californians have lauded the lawsuit as an important step taken by the state to protect care, others have questioned why - in a state that protects gender-affirming care and has strong anti-discrimination laws - the suit was brought on narrow contract-based grounds, rather than resting on California civil rights law. 

Trend and Policy Watch:

• Texas Medical Board Rolls Out Training on When Doctors Can Provide Abortions:

  • As ProPublica reports, the Texas Medical Board has started training its doctors on when they can legally provide care under the state’s multiple abortion bans. For years, providers and medical groups in the state have requested meaningful guidance on how to navigate the law - and for years, the Texas Medical Board has failed or declined to provide it. Last year, Texas passed SB 31, the ‘Life of the Mother Act,’ which sought to clarify the state’s exception for the life of the pregnant person. SB 31 also put in place requirements for the Texas Medical Board to create an educational course for providers around what state law prohibits and permits. That course is now available to physicians in the state. SB 31 was passed, in large part, in response to outcry from the medical community about the exceedingly dangerous uncertainty created by Texas’s vague and highly punitive bans.  Since the implementation of its abortion bans, Texas has faced soaring sepsis rates and multiple cases of patients dying after failing to receive abortion care.

• Democrats Are Fighting Back on Abortion Access for Veterans:

• Last year, the Trump Administration rescinded abortion access for veterans and their dependents - including for cases involving threats to the patients health or instances of rape and incest. The new policy, which was implemented immediately by the VA, rolled back Biden-era guidance permitting abortion coverage in limited cases where the pregnant person’s life or health was threatened or where the pregnancy was a result of sexual assault. This coverage was particularly important in light of the disproportionate rates of sexual assault faced by servicemembers. Democratic lawmakers are now using the Congressional Review Act to push back on the new policy. As Planned Parenthood reports, “Sen. Blumenthal introduced the CRA resolution in the Senate along with Sen. Patty Murray (D-WA) and Senate Democratic Leader Chuck Schumer (D-NY), and Rep. Julia Brownley (D-CA) and Rep. Mark Takano (D-CA) are leading the charge in the House.” Other lawmakers have since joined the effort.

• California Passes Legislation Giving $90 Million to Reproductive Health Clinics:

  • California Governor Gavin Newsom has signed a measure giving $90 million in emergency grant funding to Planned Parenthood and other reproductive health clinics. The funding was passed in response to the Trump Administration’s slashes to Medicaid and rescission of federal funding for Planned Parenthood and other clinics. The defunding of Planned Parenthood is currently being challenged in court, and multiple states have stepped up in similar ways as California to fill the gaps, but the loss of funding has already devastated access to affordable reproductive healthcare.

• Republican Lawmaker Reportedly ‘Fuming’ at FDA’s Failure to Expedite its Review of Mifepristone’s Safety:

• As we have reported on previously, the FDA, under the leadership of Commissioner Dr. Marty Makary, has committed to taking steps to review the safety of common abortion drug mifepristone. Mifepristone has been the subject of an onslaught of anti-abortion attacks because of its role in the continued availability of abortion post-Roe.  Recently, anti-abortion lawmakers and groups have expressed frustration and anger at the Trump Administration for not taking more aggressive action to curb abortion access nationwide. Now, Sen. Josh Hawley is reportedly “fuming” after a meeting with Dr. Makary that left him with the impression that Dr. Makary is “not serious” about the review and that it may take the FDA years to complete it. Major policy changes to restrict access to abortion have proven to be extremely politically unpopular, and the Trump Administration is likely factoring the impact of such a move on the midterm elections into its calculus on the question.
  

REPRODUCTIVE HEALTH DIGEST (1/15/26)

Developments in Abortion, Autonomy, and Access:

Happy New Year and welcome back to the Reproductive Health Digest. We appreciate your patience while our staff was on break for the holidays. 2026 has started with no shortage of reproductive health news, and in this Digest we discuss the Wyoming Supreme Court’s decision overturning the state’s abortion ban, attempts to criminalize abortion providers and patients, continued attacks on the LGBTQ+ community, abortion restrictions on trial in Missouri, and developments in reproductive health policy. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

Legislation & Litigation:

• Overview:

• The Wyoming Supreme Court has struck down the state’s total abortion ban, affirming a constitutional right to make healthcare decisions;  

• Louisiana is seeking to extradite and criminally charge a California doctor for allegedly providing medication abortion across state lines; 

• A group of federal employees have filed suit against the federal government over the cessation of gender-affirming care coverage; 

• A Kentucky woman is facing criminal charges over an alleged abortion; 

• Abortion laws in Missouri are on trial this week, as advocates seek to vindicate MIssourians ability to access care; and 

• The Supreme Court heard oral arguments this week over the rights of transgender people to participate in sports. 

• Wyoming Supreme Court Strikes Total Abortion Ban and Affirms a  Constitutional Right to Abortion:

• On January 6th, the Wyoming Supreme Court issued a decision affirming that abortion is a constitutionally protected right in the state. Following the overturn of Roe, Wyoming passed the “Life is a Human Right Act,” a total abortion ban, as well as a medication abortion ban and a series of other restrictions on care. A group of Wyoming citizens and medical providers brought suit, arguing that the abortion ban violates Wyoming’s constitutional guarantee that every adult has the right to “make his or her own health care decisions.” 

• The constitutional amendment enshrining that right was ironically passed in 2012 in response to concerns about the passage of the Affordable Care Act and its impact on individual healthcare decisionmaking. Last week, following a years long legal battle, the Wyoming Supreme Court affirmed that, although the state has an “interest in protecting the life than an abortion would end,” it failed to “meet its burden of justifying the abortion statutes’ restrictions on a woman’s right to make her own health care decisions, as expressly protected by the Wyoming Constitution.” The decision is the first in the nation to uphold abortion rights on the basis of a constitutional right to autonomy in healthcare. 

• Louisiana Seeks to Extradite and Charge California Abortion Provider:

• Louisiana is seeking to extradite and criminally charge California Doctor Remy Coeytaux  over allegations that he provided abortion medication into the state. This is the second doctor that Louisiana has targeted - the first being New York Doctor Maggie Carpenter. Both New  York and California have robust shield laws in place that protect physicians who prescribe abortion medication across state lines. These laws have allowed pregnant people in ban states and maternity care deserts to access medication abortion safely and securely. Louisiana’s efforts set up a legal stress test over the as-yet unanswered question of how courts will weigh one state’s shield law against another’s abortion ban. How that question is answered will significantly shape the nation’s abortion rights landscape and define the future of access to telehealth abortion care. Dr. Coeytaux and Dr. Carpenter are both facing separate lawsuits out of Texas, and thus far California and New York have stood behind their shield laws and refused to extradite their providers. 

• Federal Employees Sue the Government Over Cessation of Gender-Affirming Care Coverage:

• The Trump Administration has announced a new policy that eliminates coverage for gender-affirming care for federal employees, continuing its  onslaught of attacks on the LGBTQ+ community and our nation’s civil rights structures. Human Rights Campaign has filed a class action challenging the policy and arguing that it unjustifiably discriminates on the basis of sex. This attempt to strip coverage from federal employees comes at the same time that CMS has proposed new rules that would bar Medicaid and CHIP coverage from entities that provide gender-affirming care to minors. If implemented, these rules would force countless providers to choose between losing funding and having to close their doors or discontinuing evidence-based care for trans youth. This kind of governmental intrusion into the healthcare decisions of transgender people and their families furthers the same ideological agenda of control and conformity that underlies abortion bans and restrictions. 

• Kentucky Woman Facing Criminal Charges Over Alleged Abortion:

• A Kentucky woman is facing criminal charges following an alleged medication abortion. Law enforcement arrested Melinda Spencer at her home on New Year’s Day after a healthcare provider contacted them to report her for inducing an abortion. She was initially charged with fetal homicide, abuse of a corpse, and tampering with physical evidence, despite the fact that Kentucky’s laws explicitly prohibit charging a pregnant person with homicide for an abortion or miscarriage.  The fetal homicide charge was subsequently dropped after the prosecuting attorney acknowledged that the charge could not be supported; however, Spencer still faces the remaining charges. We will continue to report on this story as it develops. 

• Research from Pregnancy Justice shows that there have been over 400 post-Dobbs prosecutions for pregnancy-related conduct. In many instances, healthcare providers were responsible for involving law enforcement, even where no law was broken. States across the country have investigated or prosecuted women for their handling of miscarriages, decisions to have abortions, conduct while pregnant, and other pregnancy-related outcomes. 

• Abortion Laws in Missouri Go to Trial:

• As we have reported on extensively in this Digest, Missouri passed an abortion rights constitutional amendment and overturned a total abortion ban in the 2024 elections. However, since that vote, the state has successfully done everything in its power to block Missourians from actually accessing care. This week, the state went to trial to defend a host of abortion restrictions and regulations, commonly referred to as Targeted Restrictions on Abortion Providers, or “TRAP”, laws. Although the state argues that these laws are medically necessary and ensure patient safety, abortion rights advocates argue that they violate the Missouri Constitution and are merely a way for the state to maintain a tight grip on individuals' reproductive choices. 

• The regulations at issue in trial include, among other things: a near-total abortion ban that remains on the books, a 72-hour waiting period, burdensome informed consent requirements, a telehealth ban, strict facility licensing requirements, and state-approved complication plans. If these TRAP laws are overturned, Missourians will be able to actually access their constitutionally protected right to care in their state. 

• Supreme Court Hears Arguments in Cases About the Rights of Trans People to Participate in Sports:

• This Tuesday, the U.S. Supreme Court heard oral arguments in Little v. Hecox and West Virginia v. B.P.J., two cases challenging state bans on transgender girls and women participating in sports that align with their gender identity. The rights of trans people to participate in sports has become a hot button issue as the Trump Administration and state-level Republicans work relentlessly to rollback the rights of trans people in all aspects of public life. 

• Lawyers in the case argued that Idaho and West Virginia’s sports bans violate both the equal protection clause and Title IX. But, depending on the breadth of the Court’s ruling, it could have implications for individual rights far beyond participation in sports. Specifically, the question of what burden of proof the government must carry in order to discriminate on the basis of a person’s transgender status is on the line – a question that the Court has skirted in previous trans rights cases. If the court rules that the states only have to meet the lowest burden of proof (known as rational basis review), it will open the floodgates for states to pass and enforce openly discriminatory legislation with little accountability or recourse for the impacted individuals. During arguments, the conservative majority appeared sympathetic to the states’ arguments that their bans could pass constitutional muster. Justice Alito specifically (and unsurprisingly) honed in on the questions of what it means to be a “boy or girl” and whether trans participation in sports threatened the rights of women and girls. Meanwhile, the liberal justices inquired about how they could craft a narrow ruling that respects conflicting laws in red and blue states. Throughout the arguments, multiple justices wrestled with questions about the multitude of contexts and competition levels involved in youth sports and how individual abilities line up with sweeping bans. The Court will likely not issue a decision for several months, and we will report closely on the ruling once it is published. 

Trend and Policy Watch:

• Veterans Lose Access to Abortion Coverage:

• The Trump Administration has issued a legal opinion rescinding nearly all abortion coverage for veterans. Previously, the VA provided abortion counseling and care in cases where there was a threat to the life or health of the pregnant person or in cases of rape or incest. Now,  veterans will only be able to access coverage if their life is at risk. The VA has reportedly announced internally that it will begin complying with the new opinion immediately, without going through the formal regulatory process for finalizing agency rules. This prohibition on coverage applies to all VA facilities, including those that serve the 51% of veterans that, according to the Center for Reproductive Rights, live in states that permit or protect abortion rights. 

• Abortion May Not Be As Motivating in the 2026 Midterms as in Elections Past:

• In the elections immediately following the overturn of Roe, abortion was a highly motivating issue for voters. Recent polling, however, shows that that may not be the case in the 2026 midterms. The Public Religion Research Institute found that the percentage of Democrats who stated that abortion was important to their voting choice dropped from 55% to 36% between 2024 and late 2025. Abortion importance among Republican voters stayed steady, seemingly showing that the electorate most motivated by the issue at this time is the group who would see abortion banned. With Democrats seeking to take back power and several states set to vote directly on abortion rights, it is important that reproductive autonomy is a central part of the conversation in the run up to the midterms. 

• The City of San Antonio Shuts Down its Abortion Travel Fund:

• Last year, the San Antonio City Council approved $100,000 to support abortion patients needing to travel. Texas Attorney General Ken Paxton brought suit almost immediately, arguing that the allocation of the funds conflicted with state policy banning abortion, and a Texas court agreed with him and temporarily blocked the funds. In August, the state passed SB 33, which bars the use of public funds for any logistical support related to abortion. As a result, San Antonio’s city attorney’s office determined that state law no longer permitted the allocation of funding to support abortion travel, and the case was non-suited. Paxton’s office issued a statement referring to San Antonio’s actions as attempted funding for “abortion tourism” and claiming that he will do everything possible “to prevent radicals from manipulating the system to murder innocent babies.” 

• Senate Health Committee Holds Hearing Over Safety of Mifepristone:

• On Wednesday, the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing purportedly to examine the safety of medication abortion. This hearing comes as FDA Commissioner Marty Makary and the Department of Health and Human Services under RFK Jr. have committed to reviewing the safety of mifepristone. Mifepristone has been used safely and effectively for abortion care and miscarriage management for decades; however, as medication abortion rises in popularity, anti-abortion groups have escalated their calls to restrict access to the drug. Throughout the Senate hearing, Republican lawmakers repeated debunked talking points about the purported dangers of medication abortion, while Democrats and their witness attempted to redirect the conversation towards the settled science around the safety of the drug. Continued access to mifepristone - particularly through telehealth - has acted as a post-Roe lifeline for individuals in need of care. 

REPRODUCTIVE HEALTH DIGEST (12/18/2025)

Developments in Abortion, Autonomy, and Access:

As we near the close of 2025 and publish our final Digest of the year, I want to open with a sincere thank you. This has been a challenging year for everyone in our community, and your presence here and engagement with these critical  issues matters. This space exists because of a shared belief in the importance of bodily autonomy, reproductive freedom, and equity and dignity for all people, and I am so grateful for the community that we have built. Thank you for sticking with us this year, and we look forward to continuing this work in 2026. 

This week’s Digest discusses the new lawsuit brought by Texas and Florida challenging access to mifepristone, an update in the Trump Administration’s efforts to defund Planned Parenthood, new details about the ongoing attacks against the transgender community, ballot initiative news, and more. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s Must-Read comes from Ms. Magazine and outlines the 2026 policy priorities that the Heritage Foundation – the group behind Project 2025 – released to the public this week. As Ms. Magazine reports, the new document “picks up where Project 2025 left off: banning abortion pills, weaponizing the 150-year old Comstock Act to criminalize medication by mail, embedding fetal personhood across federal agencies, and stripping every federal safeguard protecting reproductive freedom.” The Heritage Foundation has already been exceedingly successful in implementing its Project 2025 agenda, but many conservatives have been frustrated with what they perceive as a lack of effort to restrict abortion on the Trump Administration’s part. Going into 2026, it is critical that we are prepared for attacks on all aspects of reproductive freedom and autonomy to escalate. 

Legislation & Litigation:

• Overview:

• Texas and Florida have filed a new lawsuit in the Northern District of Texas challenging the FDA’s approval of mifepristone and two subsequent generic versions and the FDA’s relaxation of certain regulations for the medication’s use, including removing in-person dispensing requirements; 

• A federal appeals court has sided with the Trump Administration in its ongoing efforts to defund Planned Parenthood, placing over a million Americans access to healthcare at risk; 

• Texas Attorney General Ken Paxton has expanded his lawsuits against Texas clinicians who he alleges violated the state’s ban on gender-affirming care for minors; and 

• A Missouri appeals court rewrote ballot measure language for an initiative that will go before voters next year, finding that the state’s proposed language failed to inform voters of the fact that the new initiative would put a total abortion ban back in place. 

• Texas and Florida File a New Lawsuit Challenging Mifepristone Access:

• Florida and Texas have filed a new lawsuit in the Northern District of Texas seeking to restrict access to medication abortion. The suit challenges 1) the FDA’s original approval of mifepristone in 2000 (a claim that the Fifth Circuit has previously found to be untimely); 2) changes made in 2016 to relax mifepristone’s regulations for use; 3) the removal of in-person dispensing requirements; and 4) the FDA’s approval of generic versions of mifepristone in 2019 and 2025. 

The case closely mirrors and expands upon the Alliance for Hippocratic Medicine v. FDA case that the Supreme Court dismissed for lack of standing in 2024. Following the Supreme Court’s dismissal, Missouri, Kansas and Idaho intervened in that case, and Texas and Florida attempted to do so as well. However, the case was transferred to Missouri, and Florida and Texas’s request was found to be moot. The new case is the latest in a series of aggressive attacks on access to medication abortion, including a campaign to discredit the drug’s safety record, attempts to link it to water safety issues, and calls by anti-abortion groups for FDA Commissioner Marty Makary to be fired for failing to take swift action to limit access to the drug. 

• Appeals Court Sides with Trump Administration in Attempt to Defund Planned Parenthood: 

• The First Circuit Court of Appeals has issued a ruling allowing the Trump Administration to move forward in its attempt to defund Planned Parenthood. The court found that the challenged provision does not constitute an unconstitutional bill of attainder and overturned a district court injunction temporarily blocking it. A separate lawsuit brought by 22 states and D.C. is ongoing in the district court, and the defund provision is currently blocked for those states. If the law takes full effect, entities that provide abortions and received more than $800,000 in Medicaid funds in 2023 will be stripped of Medicaid funding for a year. 

Although certain states may attempt to use state funds to mitigate the harm and keep clinics open, the reality is that this is not sustainable and Americans will lose critical access to services like cancer screenings, pregnancy testing, contraception, prenatal care, and STI testing. As we have reported on before, despite the fact that federal funds are already prohibited from paying for abortion care, ‘defunding’ Planned Parenthood has long been a key part of the anti-abortion right’s strategy. Already in 2025, nearly 50 Planned Parenthood clinics have closed their doors as a result of losing Medicaid and Title X funding, and 1.1 million Planned Parenthood patients are on the brink of losing basic healthcare. 

• Texas Attorney General Continues to Pursue Healthcare Providers: 

• Texas Attorney General Ken Paxton is continuing to aggressively target gender-affirming care in the state, announcing on December 10 that his office has expanded its lawsuits against two physicians who he claims unlawfully provided care to minors after the state banned it. Initial suits were brought against the providers in October and November; however, he now claims that “[n]ew evidence gathered by the Office of the Attorney General shows that there were deliberate efforts to conceal illegal activity by falsifying records, altering diagnosis codes, and submitting deceptive billing information.” He described the defendants’ alleged conduct as “evil” and “cruel child abuse.” According to the Texas Newsroom, an attorney for one of the doctors said that Paxton’s allegations were “false in every material aspect,” and that she “did not force any treatment on any of her patients and her care complied with Texas and federal law in every respect.” Notably, Paxton’s office brought a similar lawsuit against another provider last year and ultimately dropped the case after finding no evidence of wrongdoing. 

• Missouri Appeals Court Rejects Biased Ballot Initiative Language 

• Missouri is continuing its battle to overturn a citizen-passed constitutional amendment protecting pre-viability abortion rights and reinstate a total abortion ban. Earlier this month, a Missouri appeals court found that the state’s proposed ballot language and summary statement failed to adequately inform voters of the impact of the proposed abortion ban amendment. The now-rejected language stated that the proposed amendment would “Repeal Article I, section 36, approved in 2024; allow abortions for medical emergencies, fetal anomalies, rape, and incest.” It failed to directly inform voters that it would reinstate a near-total abortion ban and constitutionally enshrine a ban on gender-affirming care for minors. The state may appeal to the Missouri Supreme Court. The Appeals Court’s revised language now asks voters whether the Missouri Constitution should be amended to: 

• “Repeal the 2024 voter-approved Amendment providing reproductive healthcare rights, including abortion through fetal viability;

• Allow abortions for rape and incest (under twelve-weeks’ gestation), emergencies, and fetal anomalies;

• Allow legislation regulating abortion;

• Ensure parental consent for minors’ abortions;

• Prohibit gender transition procedures for minors?”

Trend and Policy Watch:

• Telehealth Abortions are on the Rise: 

• Post-Dobbs, telehealth abortion has taken on new significance, as pregnant people in ban states struggle to access care and rely on telemedicine services. New data from the Society of Family Planning shows that telehealth abortion has increased substantially – from 5% in 2022 to 27% in 2025, with more than half of those abortions provided through shield laws. The rise in telehealth abortion and the access that it allows people is exactly why anti-abortion activists are aggressively pushing to limit medication abortion access through every available avenue, including prolific litigation challenging mifepristone’s availability and the recent calls for the firing of FDA Commissioner Marty Makary, as discussed above. In 2026, it is critical that states do everything in their power to continue to protect and expand access to telehealth and medication abortion. Without it, countless people in states where abortion is banned or severely limited will be left with no viable options for care. 

• South Dakota Issues Cease and Desist Against Telehealth Provider: 

• South Dakota is also working to restrict access to information about abortion pills and telehealth. Last week, the state’s Attorney General issued a cease and desist to Mayday Health, a nonprofit that assists with the provision of contraception and abortion medications. Mayday had launched a campaign placing advertisements that read “Pregnant? Don’t want to be?” at gas stations around the state. In response, the state is threatening a lawsuit under consumer protection laws. Mayday provided the South Dakota Searchlight with the following statement: “Mayday Health spreads awareness that abortion pills are safe, effective, and have been FDA approved for over 20 years…[t]his is First-Amendment protected free speech. Mayday is an education nonprofit. We don’t sell abortion pills, we just believe people should know their options.” 

• Missourians Still Struggle to Access Care, Despite Passing Constitutional Protections: 

• Despite having passed a citizen-led ballot measure last year legalizing pre-viability abortion, Missourians are still struggling to access care. Reportedly, between January and October, only 80 procedures were performed in clinics across the state, with another 79 abortions performed in hospitals as a result of medical emergencies. Following the passage of the abortion rights amendment, the state began the process of aggressively defending remaining abortion restrictions, including a restriction on telehealth. Those battles are continuing to play out in court. Compounding challenges to access is the fact that Planned Parenthood is currently the only operating abortion provider in the state as a result of Missouri’s long track record of instituting anti-abortion policies. As discussed above, the state is now attempting to nullify abortion rights altogether once again by putting an anti-abortion ballot measure before voters in 2026. 

• IVF Coverage for Military Members Remains Limited: 

• On Wednesday, the Senate passed the 2026 National Defense Authorization Act (NDAA), which provides for $900 Billion in defense spending. IVF coverage for service members was a subject of significant debate throughout the process, with Speaker Mike Johnson reportedly working to remove coverage from the bill due to his opposition to abortion. At present, TRICARE - the military healthcare program – only covers IVF in instances where infertility was caused by an active duty injury or illness. A bipartisan provision would have expanded TRICARE’s coverage to all enrollees; however, that expansion failed to make it to the finish line, despite President Trump’s campaign promises to expand access to IVF. The bill now goes to the President’s desk for his signature. 

• Anti-Abortion Lawmaker Josh Hawley Starts New Dark-Money Group: 

• Missouri Senator Josh Hawley and his wife Erin Hawley, an attorney who argued in favor of restricting access to mifepristone at the Supreme Court, have launched a new ‘dark money’ group to fund anti-abortion campaigns, advertising, and candidates. According to reports, the group, called “Love Life Initiative” will focus both on opposing abortion and promoting families. Senator Hawley is ardently anti-abortion and has been a vocal member of the coalition calling for the FDA to review mifepristone’s safety record. Hawley’s creation of the new organization has stirred up disagreements in the Trump Administration, which has appeared reluctant to make abortion a key agenda item in the President’s second term. 

REPRODUCTIVE HEALTH DIGEST (12/4/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Digest discusses the federal government’s attempts to defund Planned Parenthood, the reinstatement of North Dakota’s abortion ban, continued attacks on access to medication abortion, rulings and policy decisions limiting the rights of trans people, some important flags for the 2026 elections, and more. We thank you for your patience while we took a break last week for the Thanksgiving holiday. We will publish one final 2025 Digest on December 18th, prior to our office’s winter closure, and we will back in the New Year with all of the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s must-read comes from ProPublica and details the story of 37-year old Tierra Walker – yet another Texas woman who has died as a result of being denied an abortion. When she became pregnant, Walker was dealing with multiple health conditions, including seizures, hypertension, and diabetes, that put her at an extremely high risk for severe pregnancy complications like preeclampsia. She inquired about whether it would be safe for her to continue her pregnancy, but she was repeatedly told that there was no emergency - the only circumstance under which abortion is legal in Texas. At 20-weeks pregnant, her teenage son found her lifeless in bed. She had died of preeclampsia. Had Walker been given the choice to decide what care was best for her, experts agree that she would be alive today.  

Legislation & Litigation:

• Overview:

• A federal judge has once again ruled against the Trump Administration’s attempt to defund Planned Parenthood; 

• The North Dakota Supreme Court has ruled that the state can enforce its total abortion ban, reversing a lower court ruling blocking the law from taking effect. 

• The Supreme Court will allow the Trump Administration to enforce its new policy blocking people from changing their gender markers on their passports, even in cases where their gender markers have been legally changed on other documents; 

• The ACLU has filed a lawsuit seeking information about the scope of Congress’s reported review of the safety record of mifepristone, a common medication abortion drug; 

• A draconian South Carolina anti-abortion bill has hit a roadblock and is unlikely to pass; and 

• Three states have launched a challenge to the FDA’s recent approval of another generic version of mifepristone.

• Federal Judge Rules Against Trump Administration’s Attempt to Defund Planned Parenthood:

• The spending bill passed by Congress in July - known as the “One Big Beautiful Bill Act’ - included a provision that effectively defunded Planned Parenthood. As we have reported on previously, that provision was immediately subject to litigation and partially blocked by a federal judge on constitutional grounds.

This week, U.S. District Judge Indira Talwani once again ruled in favor of Planned Parenthood. In a lawsuit brought by 22 Democratic states, she found, among other deficiencies, that the provision attached conditions to state funding without providing clear notice of how and to whom those conditions apply. She also found that the plaintiff states could be irreparably harmed by the defund provision, as Planned Parenthood is a critical source of general healthcare in many states. The fight over Planned Parenthood’s funding is likely to be a lengthy one as multiple cases wind their way through federal courts. 

• North Dakota Abortion Ban Reinstated:

• On November 21, the North Dakota Supreme Court issued a ruling allowing the state’s total abortion ban to take effect. Last year, a lower court had blocked the ban, finding that it was unconstitutionally vague. The State appealed that ruling. Although three of the five North Dakota Supreme Court justices agreed with the lower court that the ban is unconstitutional, North Dakota law requires a supermajority of four out of five justices in order to declare a law unconstitutional. 

For the moment, the ruling does not functionally change access to abortion in the state, as the state’s only abortion clinic moved to Minnesota shortly after the Dobbs decision. However, it does not bode well for the future of reproductive rights in the state and will increase fear and uncertainty around when physicians are able to intervene to provide emergency terminations. 

• The Supreme Court Allows Anti-Trans Passport Policy to Take Effect:

• The U.S. Supreme Court ruled in early November that the Trump Administration can enforce its discriminatory passport policy, which prohibits individuals from changing the gender marker on their passports. The policy stems from a January Executive Order that effectively denied trans existence by declaring that there are only two sexes and that they are unchangeable. 

A Massachusetts federal court had previously blocked the policy, but the Supreme Court’s conservative majority overturned that order. Justices Kagan, Jackson, and Sotomayor dissented, with Justice Jackson calling out the Administration’s failure to explain how it can claim to face urgent harm when it intends to allow people whose gender markers have been changed to continue to use those documents until expiration. She described the Court’s actions as “an abdication of [its] duty to ensure that equitable standards apply equally to all litigants—to transgender people and the Government alike.” The new passport policy fails to plausibly justify itself or explain why the harm that it will cause to the dignity and privacy of Americans is somehow necessary for the wellbeing of the country. It will additionally create significant challenges for individuals who have already changed their gender markers on other legal documentation, like their drivers license and birth certificate. 

• The ACLU is Seeking Information About Congress’s Review of Mifepristone: 

• The ACLU has filed a Freedom of Information Act (FOIA) lawsuit seeking information about the FDA’s planned review of mifepristone, a medication commonly used for medication abortions. In August, the ACLU sent a FOIA request to the FDA seeking details about the scope of the intended review and communications that the agency has had with anti-abortion groups and lawmakers. The FDA failed to respond to that FOIA request. Of particular concern is the FDA’s seeming reliance on a widely criticized paper, publicized by an anti-abortion group that attempts to cast doubt on mifepristone’s well-established safety and efficacy record. This lawsuit follows on the heels of a similar case brought by the Center for Reproductive Rights. Although the case will likely take a while to yield any concrete outcomes, it will hopefully shed light on the current Administration’s decision making framework  around abortion access. 

• Draconian South Carolina Anti-Abortion Bill Hits Roadblocks: 

• A South Carolina bill that would have outlawed nearly all abortion care has failed to advance in the state Senate. The bill, which the ACLU of South Carolina called “an egregious attack on our autonomy, privacy, speech, and safety,” would have removed exceptions for rape, incest, and fatal fetal anomalies, and punished pregnant people and anyone who helped them access  abortion care with up to 30 years in prison. 

The bill also appeared to ban any form of contraception that prevents a fertilized egg from implanting, which would have effectively prohibited intrauterine devices (IUDs) and could have limited access to in vitro fertilization. The proposal also included language that would have made it illegal for doctors to provide patients with information about abortion, which critics of the bill said raised significant First Amendment concerns.

After four of the six Republicans on the Senate subcommittee declined to vote on the bill, the three Democrats on the subcommittee were able to block the measure from advancing. Notably, one of the bill’s own sponsors abstained from the vote, citing his concerns about the bill penalizing mothers. Although the bill is not officially dead, it is unlikely to move forward and become law.

• States Challenge FDA’s Approval of Generic Mifepristone:

• A group of anti-abortion states have moved to challenge the federal government’s recent decision to approve another generic form of mifepristone. Idaho, Missouri, and Kansas have filed an amended complaint in the pre-existing case challenging the FDA’s RIsk Evaluation and Mitigation Strategies (REMS) for mifepristone. 

The original lawsuit, formerly known as Alliance for Hippocratic Medicine vs. FDA, was filed in 2022  by anti-abortion doctors and organizations seeking to wholly undo the FDA’s approval of mifepristone. Following the Supreme Court’s dismissal of the case on standing grounds, the three states took up the charge, arguing that the FDA’s relaxation of conditions for mifepristone’s use was unlawful and posed a threat of harm to the states and their citizens.

The FDA has asserted that, because federal law requires approval of a generic version when it is identical to an already-approved drug, its approval of another generic version was merely a procedural matter. Medication abortion, which accounts for  two thirds of all abortions in the U.S., has been under relentless attack since the Dobbs decision overturned Roe. States like Texas and Louisiana have passed laws to curtail and criminalize possession of mifepristone. Anti-abortion state lawmakers and leaders have urged Congress to reevalute mifepristone’s safety and launched multiple lawsuits challenging its approval. And, the federal government has indicated that it is reviewing mifepristone’s safety record.

Trend and Policy Watch:

• Anti-Abortion Group to Invest $80 Million in 2026 Midterm: 

• In the runup to the 2026 midterm elections, anti-abortion groups are mobilizing to elect pro-life candidates. As reported by Politico, Susan B. Anthony Pro-Life America and its Super PAC have announced that they will invest $80 million into anti-abortion candidates in battleground states. Their multi-pronged campaign includes door-knocking, digital advertising, and extensive canvassing. This push comes after the Post-Roe success of pro-choice candidates and ballot measures highlights the salience of abortion access as an issue within the American electorate.

• U.S. Bishops Vote to Ban Gender Affirming Care at Catholic Hospitals: 

• In another attack on access to healthcare, U.S. Catholic Bishops have voted to ban gender-affirming care at Catholic hospitals nationwide. Catholic hospitals have been expanding for years, and the Associated Press reports that more than one in seven patients treated in America every day are treated at Catholic hospitals. Although the Church had already made its stance on the issue of gender-affirming care clear, the new vote solidifies that policy at a time when both federal and state governments are taking aggressive actions to limit access to healthcare for trans people.

• Wisconsin Introduces Bill that Would Require Miscarriage and Abortion ‘Catch-Kits’:

• A group of Wisconsin Republicans has introduced the “Clean Water for All Life Act,” a bill that would require patients who use medication abortion drugs to be issued ‘catch kits’ to collect blood and tissue and return it to their provider for disposal. The Republicans leading the bill claim - without evidence - that it is a water safety issue and that endocrine disruptors from the medications pose a danger to public health. This echoes an argument championed by Students for Life. In addition to the obvious surveillance and privacy concerns created by this bill, it raises concerns about patients experiencing miscarriages, who often are prescribed the same medications targeted by the bill. The bill also singles out medication abortion for particular treatment while ignoring wholesale all other medications that individuals take on a daily basis that may  enter the state’s wastewater.

• Ballot Measure to Overturn Idaho Abortion Ban Makes Progress:

• We have reported in the past on the overwhelming success of citizen-led ballot initiatives for constitutionally protecting reproductive rights at the state level. Reproductive rights have gone before voters in 16 states since the Dobbs decision, and they have succeeded in 13 of those instances. Voters in several states, including Idaho, are now gearing up for the 2026 elections. The group spearheading the efforts reports that it has amassed more than 50,000 of the 71,000 signatures needed to qualify for the ballot. If passed, the measure would override one of the strictest abortion bans in the country and enshrine pre-viability abortion rights into the state constitution. 

• Research Shows How Texas Abortion Ban Adversely Impacted Minors:

• New research from the American Journal of Public Health shows how Texas’s abortion bans have disproportionately impacted minors. As summarized by KUT News, researchers compared statistics from the two-year period after Texas enacted its initial 6-week abortion ban to the two years prior. They found that “facility-based abortions” received by minors decreased by almost 60%. Factoring in patients traveling out of state for care, minors overall received 26% fewer abortions than during the pre-ban time period. The stark impact is likely attributable to factors like minors’ access to a car or other transportation, financial resources, ability to miss school, and the logistical challenges of making an out-of-state medical appointment. Every state bordering Texas, with the exception of New Mexico, is now enforcing a total abortion ban, compounding barriers to care. 

REPRODUCTIVE HEALTH DIGEST (11/13/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Reproductive Health Digest covers a preliminary injunction hearing in Arizona; a federal ruling that the FDA violated the law by maintaining restrictions on the abortion medication mifepristone in 2023; a New York judge blocking Texas Attorney General Ken Paxton’s attempt to force a county clerk to enforce a Texas default judgment against provider Margaret Carpenter; Florida’s Attorney General using consumer protection laws to target Planned Parenthood in efforts to restrict access to mifepristone; and other policy and access developments across the states. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day– so you’re always up to speed. 

Also, check out our Repro Blog of the Month, which explores how authoritarian governments manufacture public anxiety around gender and sexuality– and then weaponize those fears to undermine democratic institutions.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s Must-Read comes from Politico; this exclusive report details how a major anti-abortion group, the Susan B. Anthony Pro-Life America along with its affiliated super PAC, is planning on  investing $80 million to back anti-abortion candidates in key battleground states ahead of the 2026 election. Abortion rights remain highly popular– evidenced by what Politico describes as a “string of post-Roe defeats at the ballot box.” In response, the anti-abortion group is using the millions in funding to launch an outreach campaign aimed at winning over swing voters.

Legislation & Litigation:

• Overview:

• Arizona called anti-abortion witnesses who have never performed an abortion during a preliminary injunction hearing challenging state laws that require women to wait 24 hours and undergo an ultrasound before an abortion.

• A federal judge in Hawaii ruled that the Food and Drug Administration (FDA) violated the Administrative Procedure Act (APA) when it maintained access restrictions on abortion medication in 2023.

• A New York judge dismissed a petition by Texas Attorney General Ken Paxton that sought to force a New York court clerk to enforce a Texas judgment against a New York doctor who allegedly prescribed abortion medication to a patient in Texas. 

• Florida Attorney General James Uthmeier has brought a $350 million lawsuit against Planned Parenthood for “deceptive marketing practices.” The complaint cites multiple anti-abortion sources, including the anti-abortion group Live Action and a non-peer reviewed report from the conservative think tank, Ethics and Public Policy Center (EPPC). 

• Arizona GOP Relies on Vocal Anti-Abortion Witnesses to Defend Abortion Restrictions 

• Earlier this month, Arizona Senate President Warren Petersen and House Speaker Steve Montenegro defended state laws that require women to wait 24 hours and have an ultrasound before getting an abortion, despite voters approving a constitutional right to abortion in 2024. To support their claim that the abortion restrictions do not offend this constitutional right, they called anti-abortion witnesses, none of whom have performed abortions. One witness, Maureen Curley, testified that she has made at least $22,000 for her anti-abortion testimony in other anti-abortion cases in North Dakota and Missouri. 

• Meanwhile, the reproductive rights attorneys who brought the legal challenge in May, relied on testimony from local abortion providers and medical experts to support their argument that the court should at least temporarily pause enforcement of the laws while the lawsuit proceeds.  

• Federal Judge Rules that the FDA Violated Law by Restricting Abortion Medication

• In October, a federal judge in Hawaii ruled that the FDA violated the Administrative Procedure Act “by failing to provide a reasoned explanation for its restrictive treatment of the drug” when it maintained restrictions on access to the abortion medication mifepristone in 2023. The court has ordered the FDA to review evidence it allegedly overlooked, including “the wealth of peer-reviewed evidence proving mifepristone’s safety, including when delivered by telemedicine, as well as how FDA’s restrictions burden patient access.”

• While the restrictions on access remain in effect for now, Julia Kaye, senior staff attorney with the ACLU Reproductive Freedom Project said in a statement that the court’s “decision is a victory for everyone who believes that our access to safe and essential medicines should be dictated by science, not politics.”

• New York Judge Blocks Texas Attempt to Enforce Abortion-Pill Judgment

• A New York trial court dismissed Texas’s petition seeking to compel a county clerk to enforce a Texas judgment against Dr. Margaret Carpenter, who allegedly prescribed abortion pills to a Texas woman. 

• In December 2024, Texas Attorney General Ken Paxton sued Carpenter, and after she declined to respond, a Texas judge entered a default judgment in February 2025, ordering her to pay a $113,000 fine. Paxton attempted to collect the fine in Ulster County, New York  but a county clerk refused, citing New York’s shield law, which bars state officials from enforcing out-of-state penalties against protected healthcare providers. In July, Paxton sued Bruck, arguing the shield law violates the Constitution’s Full Faith and Credit Clause, and in September, New York Attorney General Letitia James intervened to defend the law. 

• On October 31, Ulster County Supreme Court Judge David Gandin dismissed the case, ruling that Carpenter’s services are legal in New York and fall “squarely within the definition of ‘legally protected health activity’” under the shield law. The state has not yet confirmed whether it is planning on appealing the ruling. 

• Florida Goes After Planned Parenthood 

• In the latest move by anti-abortion Republicans targeting abortion medication, Florida Attorney General James Uthmeier brought a $350 million lawsuit alleging that Planned Parenthood misrepresented that abortion medication mifepristone is safer than Tylenol. According to Mother Jones, the lawsuit is “riddled with familiar anti-abortion arguments and misinformation” and cites openly anti-abortion sources. While UC Davis School of Law Professor Mary Ziegler wrote for MSNBC that Florida Judges may see this lawsuit as a “mere smokescreen for suppressing” reproductive rights in the state, she also warned that this lawsuit represents a new tactic anti-abortion Republicans are using in their “efforts to eliminate mifepristone.”

Trend and Policy Watch:

• Pro-abortion Candidates Win Big on Election Day 

• Reproductive rights scored major victories in New Jersey, Pennsylvania, and Virginia on November 4. 

• In New Jersey, reproductive rights supporter Mikie Sherrill was elected governor. Sherill has vowed to protect abortion access during her tenure as governor. 

• In Pennsylvania, three liberal justices secured new 10-year terms on the Pennsylvania Supreme Court, allowing Democrats to keep their 5-2 majority on a court that could play a crucial role in future rulings on abortion rights in the state. 

• In Virginia, voters elected “reproductive freedom champion” Abigail Spanberger to be the state’s first female governor. Democrats also secured control of both chambers of the Virginia legislature, helping to protect abortion access for both state residents and for people from neighboring states with strict abortion bans.

• The GOP Accused of Trying to Sneak Abortion Ban into Funding Bill

• Sen. Ron Wyden (D-Ore.), the top Democrat on the Senate Finance Committee, warned on November 8 that “Republicans said they might vote to lower Americans’ health care costs, but only if we agree to include a backdoor national abortion ban.” While Republicans reportedly had demanded that any extension of Affordable Care Act (ACA) subsidies include a provision preventing the tax credits from being applied to plans that cover abortion, Wyden noted that “[z]ero federal dollars [currently] pay for this care in ACA plans.” 

• Subsidies under the ACA were at the center of the government shutdown. Earlier this week, a handful of Senate Democrats broke ranks to pass a stopgap funding bill, which does not include an immediate extension of certain healthcare subsidies and will likely exponentially increase healthcare costs for millions of Americans.  

• FDA to Remove Black Box Warnings from Women’s Estrogen HRT Products

• Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. announced on November 10th, that the black box warning on women’s estrogen-based hormone replacement therapy (HRT) products will be removed. Women’s health celebrated the move and the American College of Obstetricians & Gynecologists has said that the label change will “increase access to hormone therapy.” 

• At the same time, the Trump administration has made restricting HRT access for transgender youth a central policy priority.

• Oklahoma Health Care Authority rejects abortion attestation rule

• In July, Oklahoma Gov. Kevin Stitt signed an executive order directing the Oklahoma Health Care Authority (OHCA) to stop funding any individual or organization connected to prohibited abortion providers. The order also required Oklahoma Medicaid, or SoonerCare, providers to submit a signed attestation confirming whether they, or any associated entities, “[p]erforms, refers for, or is affiliated with the performance of abortions not permitted under state law.” 

• At a special meeting on November 9, the  OHCA board declined to approve the emergency rule, citing concerns over its legality and potential impacts on providers. The board unanimously voted to request an opinion from the attorney general on the rule and asked OHCA CEO Clay Bullard and board chair Marc Nuttle to consult with Gov. Stitt to clarify the executive order and delay enforcement of the attestation requirement until formal rules are established.

REPRODUCTIVE HEALTH DIGEST (10/23/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Reproductive Health Digest discusses a new lawsuit out of Louisiana that challenges the FDA’s handling of mifepristone, the continued fight over abortion access in Missouri, abortion-related prosecutions in Texas, an ongoing case in Tennessee, and policy and practical-access developments in the states. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s Must-Read comes from Rewire News; it describes how increased restrictions on reproductive freedom and choice are a hallmark and warning sign of growing authoritarianism. Looking to international examples, the piece makes the case that “reproductive rights . . . are an essential element of democracy.”

Legislation & Litigation:

• Overview:

• Louisiana filed a lawsuit challenging the FDA’s regulations for mifepristone’s use and seeking to reinstate in-person distribution requirements; the state argues that telehealth is allowing Louisianians to continue to have abortions, despite the state’s ban; 

• A Missouri court has affirmed a lower court's decision pausing medically unnecessary requirements for care, allowing abortions to continue consistent with the state’s recently passed constitutional protections; 

• Texas Attorney General Ken Paxton announced that eight more individuals have been arrested in connection with the state’s first prosecution under its abortion ban; counsel for those arrested deny the charges that they engaged in illegal activity; and 

• A Tennessee court has ruled to allow a lawsuit challenging the state’s extremely narrow life and health exceptions to move forward. 

• Louisiana Brings a Lawsuit Challenging FDA’s Mifepristone Regulations:

• If you have read this Digest for a while, you are well aware that anti-abortion groups and states have been using every tool available to attack access to medication abortion post-Dobbs. As we discussed in the last issue, Texas Judge Matthew Kacsmaryk recently transferred a case challenging FDA’s approval and subsequent relaxations of regulations for use of mifepristone to the Eastern District of Missouri, where it is likely to be allowed to progress. Now, Louisiana Attorney General Liz Murrill has filed a separate lawsuit against FDA, challenging its approval of the use of telehealth for distribution of mifepristone. 

• In the Complaint, Louisiana alleges that telehealth has allowed “pro-abortion activists … to blanket pro-life states with mifepristone – with impunity and without any fear of liability” and that “hundreds of unlawful abortions occur every month in Louisiana.” The state argues that the FDA’s actions are a violation of both the Administrative Procedure Act and the Comstock Act. This direct invocation of the Comstock Act is particularly significant. The 1873 anti-vice law, by its language, bans the mailing of any materials involved in abortions; however, it has been largely treated as a dead law for decades. Anti-abortion activists are now attempting to revive it in order to block telehealth abortions, or – if read and enforced broadly – to halt the mailing of materials used for any type of abortion, including in-clinic procedural care. 

• Missouri Court Affirms Decision Allowing Abortions to Continue:

• Since last November’s passage of a constitutional amendment protecting reproductive healthcare in the state, Missouri has been locked in a battle to restrict access and block the implementation of that amendment by any legally available means. On paper, Missourians have a constitutional right to abortion pre-viability; however, the state has argued to enforce a number of practical barriers to access that have effectively halted care at multiple points in the past year. These include licensing requirements for clinics, state approval of complication plans, a 72-hour waiting period, and restrictions on telemedicine. Litigation challenging these restrictions has been making its way through Missouri courts, including the state supreme court. On October 14th, a panel of three judges in a Missouri appeals court affirmed a lower court's ruling that temporarily blocked many of the challenged restrictions, allowing care to continue in the state. While the state’s battle to restrict access plays out in the courts, anti-abortion lawmakers have also put forth a second constitutional amendment that, if passed, would undo the first and reinstate a total abortion ban, with limited exceptions. The proposed constitutional amendment will go before voters next November. 

• Texas Has Arrested Eight More People In Connection with an Investigation Into Alleged Unlawful Abortions:

• Texas has reportedly arrested eight more people in connection with a prosecution for the alleged provision of unlawful abortions. In March, a Houston-area midwife was arrested on charges of practicing medicine without a license and performing abortions in violation of state law.  Her attorneys vigorously deny these claims, arguing that the state relied heavily on circumstantial evidence that did not prove any of its allegations. Now, Texas Attorney General Ken Paxton has announced that the state is bringing felony-level charges against eight additional people associated with the previously-arrested midwife and her clinics. This case appears to be the first prosecution brought directly under Texas’s abortion ban. Paxton’s press release announcing the arrests was rife with inflammatory language, including labeling several of the individuals involved “foreign nationals,” despite that having no apparent relevance to the case. He also referred to the arrestees as a “cabal of abortion-loving radicals” and “dens of fake doctors” engaged in conduct that he described as “evil.” 

• Tennessee Chancery Court Allows Lawsuit Challenging State’s Ban to Move Forward:

• A three-judge panel in a Tennessee Chancery Court has ruled that a 2023 lawsuit challenging Tennessee’s extremely narrow life and health exceptions to its otherwise total abortion ban can move forward. The original lawsuit was brought by a group of Tennessee physicians and patients who had suffered medical harm as a result of the law’s vagueness and extremely punitive nature.  A court previously partially sided with those plaintiffs, temporarily blocking doctors from facing professional discipline for emergency abortion care. In 2025, Tennessee amended its ban to allow abortions in cases of previable preterm premature rupture of the membranes (PPROM), inevitable abortion, and fatal fetal diagnoses that lead to severe maternal health conditions or infections causing uterine rupture or loss of fertility. The state argued that this amendment rendered the plaintiffs’ case moot.  The court disagreed, writing that the “changes made by the 2025 amendment do not significantly alter the status” of the case, and plaintiffs “have sufficiently alleged that the defects in the Medical Necessity Exception place their lives at risk.” 

Trend and Policy Watch:

• Republican Senators Ask HHS and FDA to Restrict Access to Medication Abortion:

• In yet another attack on mifepristone, every Republican senator aside from Susan Collins (ME) and Lisa Murkowski (AK), has signed a letter published to FDA and HHS calling for restrictions on access to the safe, effective medication. Relying on anti-abortion talking points and slanted ‘studies,’ the senators ask the agencies to, among other things, conduct a new REMS safety review, suspend approval of any new generic versions of mifepristone, reinstate in-person dispensing requirements, “suspend the distribution of mifepristone” as an “imminent hazard under Section 505(e) of the Federal Food, Drug and Cosmetic Act (FDCA),” and withdraw permissions for pharmacy distribution of mifepristone. Earlier this year, 22 Attorneys General sent a similar letter urging FDA and HHS to reevaluate mifepristone’s regulations. The Administration has indicated that it is currently undertaking a review of the drug’s safety and efficacy, despite decades of reliable science supporting its use for early abortion care. 

• Virginia’s Upcoming Election May Determine the Future of Reproductive Rights in the State:

• Although Virginia remains a bastion of abortion access in an otherwise restricted South, that could change with the state’s upcoming election. This November, voters will choose their next governor (and the state’s first woman governor) and determine control of the Virginia House of Delegates. The outcome will be substantially determinative of the state’s reproductive rights policy moving forward. Current Republican Governor Glenn Youngkin has repeatedly vetoed pro-choice bills passed by the state legislature; however, if Virginians elect Democratic Candidate Abigail Spanberger and hold control of the house and senate, they could see expanded reproductive freedoms and rollbacks on medically unnecessary restrictions. Virginia’s elections will serve as an important signal of where abortion sentiment sits in the state and how powerful of a factor reproductive rights are in electoral decisions three years post-Roe. 

• Planned Parenthood Southeast Launched an Investigation into Anti-Abortion Sentiment From New Leadership:

• The Board of Directors at Planned Parenthood Southeast has reportedly hired a law firm to conduct an investigation into “troubling allegations” made about its Executive Leadership team and Board. A petition circulated earlier this year described a culture in which new leadership had systematically de-emphasized abortion policy and removed public policy and organizing staff. Reportedly, newly hired leadership included an executive director who once referred to herself as pro-life in an interview, and a VP for external affairs who raised the question of working with Students for Life. Former leadership also alleged that support for the LGBTQ+ community had waned. This internal investigation comes as Planned Parenthood nationwide faces attempts by the federal and some state governments to defund its operations. 

• Clinic Closures Continue Following Passage of the So-Called “Big Beautiful Bill”: 

• Maine Family Planning, a network of 19 clinics that serve primarily low-income Medicaid patients across the state, will cease providing primary care at the end of this month. As we reported on in our last Digest, clinics across the country are closing their doors or ceasing care following the federal administration’s rescission of Medicaid funding for clinics that provide abortions and received more than $800,000 in Medicaid funding in 2023. This is the case even for clinics where abortion is only one of many services offered. Clinics like Maine Family Planning are unable to absorb the cost of that loss, and thousands of state residents will lose critical primary healthcare services as a result. Although Maine Family Planning is attempting to fight the funding cuts in court, it has thus far been unsuccessful. 

REPRODUCTIVE HEALTH DIGEST (10/09/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Digest goes through legal developments in state ballot measures, access to medication abortion, minors’ ability to access care, and a potential total abortion ban in South Carolina. We also discuss trends in abortion rates, student activists filling a gap in need for contraception, and how abortion bans impact crime. As always, please read on to the end for the news that you need to know. 

We also invite you to read two blog posts published by L4GG this week. The first covers the politics around mifepristone, and the second calls on New York Governor Kathy Hochul to sign a slate of critical health laws.

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read: This week’s Must-Read comes from the Guardian and details a new Report from Pregnancy Justice finding that over 400 pregnant people have been charged with pregnancy-related crimes post-Roe. The majority of these cases involve allegations of substance abuse, and the cases are highly concentrated in the South, where abortion bans are in place in nearly every state. The kinds of charges described in the Report raise concerns about pregnancy surveillance, fetal personhood, and criminalization over care. 

Legislation & Litigation:

• Overview:

• A Nevada court has ruled to allow the state’s parental notification law to go into effect, requiring minors to involve their parents or obtain a court order prior to obtaining care; 

• Planned Parenthood clinics in Louisiana have closed their doors after over 40 years, resulting in thousands of residents losing access to cost-effective reproductive healthcare; 

• After a protracted legal battle, Missouri has settled on ballot summary language for a measure that would reinstate a total abortion ban; 

• Judge Matthew Kacsmaryk transferred the case challenging the FDA’s approval of mifepristone out of his court and to the Eastern District of Missouri, finding that the state-plaintiffs lacked venue in Texas. 

• Last week, South Carolina lawmakers heard testimony on a proposed total abortion ban that would be the most severe in the nation if enacted; and 

• A California doctor is facing criminal charges for mailing abortion medication into Louisiana; the same doctor faces a civil claim out of Texas. 

• Nevada’s Parental Notification Law Allowed to Stand:

• In late September, Nevada District Court Judge Erika Mendoza denied Planned Parenthood’s request to pause the state’s parental notification requirement. The law in question requires either notification to a parent or guardian prior to a minor receiving an abortion, or a court order finding that the minor is sufficiently mature and parental involvement is not in their best interest. The law was passed in 1985, and it has never been enforced; however, following the overturn of Roe, a federal court lifted the injunction blocking it. Planned Parenthood sued, alleging a number of constitutional arguments. In declining to pause the law, Judge Mendoza found that the plaintiffs had failed to establish a likelihood of success on the merits. Planned Parenthood has appealed this ruling. 

• Although the majority of pregnant minors do choose to involve a parent, advocates for reproductive rights argue that laws requiring such involvement create medically unnecessary barriers to minors making decisions about their own care – particularly for individuals who cannot safely involve a parent or guardian. Judicial bypass procedures also create obstacles by requiring a minor to navigate an intimidating and confusing legal process in a short window of time. The logic underlying the judicial bypass system has also been called into question, as it creates a paradox wherein a court that finds that a minor lacks the maturity to choose abortion has effectively decided that the minor possesses the maturity to parent a child. 

• Planned Parenthood Clinics Close Their Doors and Stop Offering Care:

• Planned Parenthood’s two Louisiana clinics have been forced to shut their doors following a federal court ruling allowing the government’s efforts to defund the organization to move forward. The President of Planned Parenthood Gulf Coast stated that the decision to close the clinics came about because of “compounding political attacks that have dismantled public health infrastructure, [and] blocked patients from care.” The clinics were in operation for over 40 years. Louisiana is already enforcing a total abortion ban, and federal funding is blocked from going towards abortions. Instead, the services most commonly accessed included “STI testing and treatment, birth control and HIV prevention,” as well as cancer screening and hormone replacement therapy. Thousands of primarily low-income patients will now lose access to cost-effective reproductive healthcare. Planned Parenthood Gulf Coast is also closing two of Houston’s six clinics. 

• Clinics operating in states where abortion is legal and protected are also having to make difficult decisions about continuing care. Earlier this month, Planned Parenthood in Wisconsin announced that it would stop providing abortions while it attempts to navigate the federal funding landscape. If the federal funding prohibitions stand, Planned Parenthood estimates that it will have to close 200 clinics, the majority of which operate in healthcare deserts. 

• Missouri Politicians Continue to Fight Over Anti-Abortion Ballot Measure Language:  

• In Missouri, where lawmakers are attempting to reinstate a total abortion ban via ballot initiative, a Cole County judge has approved summary ballot language. Previously, Judge Daniel Green had twice rejected proposed language that failed to directly inform voters that the measure would repeal the abortion rights constitutional amendment that they passed last year. The summary language now states the following: 

• “Shall the Missouri Constitution be amended to:

• Guarantee women’s medical care for emergencies, ectopic pregnancies, and miscarriages; 

• Ensure women’s safety during abortions; 

• Ensure parental consent for minors; 

• Repeal Article I, section 36, approved in 2024; allow abortions for medical emergencies, fetal anomalies, rape, and incest;

• and Prohibit sex-change procedures for children?”

Although the summary language now explains that the prior amendment would be repealed, advocates for abortion rights in the state argue that it is still insufficient and fails to fully notify voters of the consequences of a ‘yes’ vote. 

• The Case Challenging FDA’s Approval of Mifepristone Has Been Transferred to Missouri:

• The case challenging FDA’s approval of mifepristone and regulations for its use has been transferred from a Texas court to Missouri. As a reminder, the lawsuit was originally filed in notoriously anti-abortion Judge Matthew Kacsmaryk’s court in the Northern District of Texas by a group of anti-abortion doctors and organizations. Last year, the Supreme Court dismissed the case for lack of standing. Following that dismissal, Idaho, Missouri and Kansas joined as plaintiffs in an attempt to keep the dispute alive, and Texas, Florida and Louisiana all recently sought to intervene. Earlier this year, the Trump Administration argued that the case should once again be dismissed on the grounds that Missouri, Idaho and Kansas do not have standing in a Texas federal court. 

• Last week, rather than allow the states to move forward in his court, Judge Kacsmaryk transferred the case to the Eastern District of Missouri, finding that the state-plaintiffs lack proper venue in Texas and cannot piggyback on the original plaintiffs’ venue arguments. His Order was explicit in its disagreement with the Supreme Court’s finding that the original plaintiffs lacked standing, but conceded that the lower court was bound to follow that decision. As Mother Jones points out in its reporting on the case, Judge Kacsmaryk’s selection of the Eastern District of Missouri was likely an intentional move to stack the odds in favor of the anti-abortion plaintiff states. Of the nine judges presiding over the Eastern District of Missouri, 8 are Republicans, and 4 are Trump appointees. 

• South Carolina Lawmakers Heard Testimony Last Week on a Draconian Total Abortion Ban: 

• Last Wednesday, the South Carolina legislature heard hours of public testimony on SB 323, the “Unborn Child Protection Act.” If passed, the draconian abortion ban would be the strictest in the nation. It would ban abortion at all gestational ages and eliminate exceptions for rape, incest and lethal fetal anomalies. It would also criminalize aiding and abetting in unlawful abortions and levy severe criminal penalties on the abortion patient themselves. During testimony, South Carolina lawmakers heard impassioned pleas from both sides of the issue. Testimony in favor of the bill tended to rely on religious interpretations of when life begins, with several individuals arguing that the bill does not go far enough because it caps potential prison time at 30 years. Conversely, testimony in opposition focused on framing abortion as a part of reproductive health care and included arguments from advocates for reproductive rights and stories from women who had suffered miscarriages, faced agonizing fetal diagnoses, or encountered medical emergencies during pregnancy. Notably, the Senate Medical Affairs subcommittee–the body hearing testimony–was composed entirely of men. South Carolina’s legislative session will convene again in January 2026. 

• A California Doctor is Facing Criminal Charges For Mailing Abortion Medication Into Louisiana: 

• Louisiana has issued an arrest warrant for California doctor Remy Coeytaux as a part of its ongoing crusade to end the flow of abortion pills into the state. California’s shield laws seek to protect clinicians who mail the drugs over state lines, including into ban states like Louisiana. Dr. Coeytaux has allegedly been providing medication abortion under protection of these laws. Texas has also filed a wrongful death suit against Dr. Coeytaux in federal court in connection with a Texas resident’s medication abortion, and both Louisiana and Texas have initiated legal proceedings against a New York shield provider. New York has thus far stood behind its shield laws and refused to cooperate with the cases. Each of these proceedings creates an opportunity for the courts to test and weigh in on the legal strength and enforceability of post-Roe interstate shield laws. The question of how and to what extent one state can enforce its abortion laws across its border is likely to end up before the Supreme Court in the coming years.  

Trend and Policy Watch:

• The FDA Has Approved a New Generic Version of Mifepristone: 

• The FDA has quietly approved a new generic version of mifepristone as advocates on both sides of the issue fiercely fight over access to medication abortion. FDA approved the first generic version, manufactured by GenBioPro, in 2019, and GenBioPro is currently a party in the federal lawsuit challenging the agency’s approval of mifepristone and its terms of use. The approval of the new generic version is largely a matter of procedure and does not appear to reflect the administration’s position on access to abortion. Regardless, anti-abortion groups have reacted with outrage, particularly as FDA and HHS recently committed to conducting a review of the safety of mifepristone. 

•  Preliminary Data Shows a Decline in Abortion Numbers: 

• New data from Guttmacher appears to show a decline in abortion numbers in states without total bans. The research is preliminary, but it does mark the first time post-Roe that abortions appear to be decreasing, rather than slightly increasing. A full breakdown of the research can be found at the accompanying Policy Analysis. 

• At Some Catholic Universities, Students Rely on Student Networks to Obtain Prohibited Birth Control: 

• At DePaul University in Chicago – the largest Catholic university in the United States – distribution of any kind of contraception on campus is prohibited.  Students in need of resources are turning to student-run ‘womb-service’ operations that provide emergency contraception and condoms just off campus. DePaul is not the only school in the country where student activists are working to fill gaps left by restrictive institutional policies. As the federal administration and certain states work to defund access to cost-effective care and tighten restrictions on contraception, these networks will take on increasing urgency. 

• ​​Research Shows the Relationship Between Abortion Bans, Poverty and Crime: 

• Research published in the National Bureau of Economic Research and reported on by the 19th appears to show a link between abortion bans and increases in property crime. The study looked at Texas and controlled for how far individuals now needed to travel in order to access care; it found that property crimes increased the most in areas where the travel distance was greatest. This relationship between crime and abortion bans can likely be explained by the increased financial strain that an unplanned pregnancy places on a family. 

REPRODUCTIVE HEALTH DIGEST (9/25/2025)

Developments in Abortion, Autonomy, and Access:

This week’s Digest covers the legal battles over abortion rights in states where voters have passed ballot initiatives, South Carolina’s attempt to pass a total abortion ban that would allow pregnant patients to be charged with homicide, legislation and litigation impacting access to medication abortion, and the federal government’s attempt to defund Planned Parenthood. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

Legislation & Litigation:

• Overview:

• Missouri, Ohio and Arizona continue to fight in the courts over the proper scope of their states’ abortion restrictions, despite citizens having passed constitutional amendments protecting the right to access; 

• South Carolina lawmakers have set a hearing on a draconian total abortion ban that, among other things, would allow prosecution of abortion patients for the crime of homicide; 

• Texas Governor Greg Abbott has signed HB 7 into law, severely restricting access to medication abortion and allowing citizens to bring ‘bounty-hunter’ style lawsuits against individuals possessing or transferring the drugs; and 

• The First Circuit Court of Appeals issued a ruling allow the federal administration’s attempt to “defund” Planned Parenthood to move forward during the pendency of litigation; 

• The Center for Reproductive Rights has filed a new lawsuit seeking detailed information about the Trump Administration’s decision to review mifepristone’s safety. 

• States With Citizen-Passed Abortion-Rights Constitutional Amendments Continue to Fight to Limit Access: 

• Missouri Judge Orders Ballot Initiative Summary Language to be Rewritten: 

• A Missouri Judge has ordered the state to rewrite ballot measure summary language for a proposed constitutional amendment that would reinstate a near-total abortion ban. Last November, Missouri became the first state to overturn a total abortion ban via citizen-led ballot measure. The state is now attempting to use that same process to rescind those newly-passed protections in the 2026 election. Missouri Secretary of State Denny Hoskins certified a ballot summary stating that the proposed amendment would do a number of things, including “ensure women’s safety during abortions,” and “guarantee access to care for medical emergencies, ectopic pregnancies, and miscarriages.” The summary failed to mention the proposed amendment’s most important function: banning abortion in Missouri once again. The ACLU sued, arguing that this language did not comply with state requirements to fairly portray the proposed amendment and that it violated the rule that any amendment contains only one subject. The court agreed, giving the Secretary of State seven days to provide revised language that accurately reflects the full scope of the measure. 

• Ohio Continues to Litigate Over the Scope of Abortion Restrictions in the State: 

• In 2023, Ohio voters passed a constitutional amendment guaranteeing the right to pre-viability abortion care, rendering the previously-enforced 6-week ban unconstitutional. Despite this, the state continues to assert that several of the ban’s provisions, including certain record-keeping requirements, should remain in effect. Ohio Attorney General Dave Yost’s legal team argued in court last week that the provisions are ‘severable’ from the ban itself – meaning that the legislature intended them to remain in effect even if portions of the law were struck down. Conversely, the other side argued that the remaining restrictions and regulations have no meaning on their own and cannot stand without the 6-week ban in place. In addition to fighting in the courts, the state is also attempting to pass renewed legislation imposing limitations on access to care, including a medically unnecessary 24-hour waiting period. 

• Arizona Anti-Abortion Lawmakers Defend Arizona Restrictions:

• In the 2024 election, Arizona voters utilized a citizen-led ballot initiative to enshrine pre-viability abortion rights into the state constitution. However, significant restrictions on care remain on the books – including a 24-hour waiting period, a ban on telemedicine abortions, and a ban on abortions sought because of a fetal genetic abnormality. Each of these laws has a disproportionate  impact on rural patients and those who already lack the financial and practical resources to access care. Last week, attorneys for Republican lawmakers in the state argued in court that the case challenging these restrictions should be dismissed on standing grounds, alleging that the plaintiff doctors have not shown a threat of prosecution. On Tuesday, Maricopa County Superior Court Judge Greg Como rejected that argument, finding that the doctors have a right to have the case heard and that, in light of the constitutional protections for abortion, “any restrictions on [abortion]  are presumptively invalid.” 

• South Carolina Lawmakers Push for Draconian Total Abortion Ban: 

• South Carolina lawmakers have set a hearing for SB 323, the ‘Unborn Child Protection Act’, a total abortion ban that would be the most severe in the nation if passed. The bill is being considered outside of South Carolina’s regular legislative session. At present, South Carolina bans abortion after detection of fetal cardiac activity, with exceptions for rape, incest, fetal anomalies, and medical emergencies. The Unborn Child Protection Act would render all non-emergency abortions illegal and prosecutable as homicide. In addition to banning abortion, the ACLU of South Carolina explains that the bill would: 

• “Allow imprisonment up to 30 years for a person having an abortion or aiding in abortion 

•  Prohibit transporting a minor out of state to obtain an abortion

• change the definition of a legal “contraceptive” to exclude anything that prevents ovulation or implantation of a fertilized ovum

• open the door to restrictions on in vitro fertilization (IVF) by defining a “human embryo” as a fertilized egg or zygote

• make it unlawful to possess any drug or substance that can be used for abortion 

• make providing information about abortion unlawful, including via a website or phone call; [and] 

• require public school students to watch a propaganda video called "Meet Baby Olivia," produced by the anti-abortion group Live Action”

• If passed, the bill would have devastating consequences on access to health care in South Carolina and open the door for sweeping restrictions on birth control and assisted reproduction. We will be following the bill’s progress closely and reporting on any new developments. However, regardless of its success or failure, it serves as an urgent reminder of how far the extreme anti-abortion movement would like to go if given the political power to enact their full vision. 

• Texas Governor Greg Abbott Signs Bill Severely Restricting Medication Abortion Access: 

• As we reported in our last Digest, Texas lawmakers recently passed HB 7, a law severely restricting access to medication abortion and allowing private citizens to sue for perceived violations. It is aimed at reducing the efficacy of shield laws by cutting off Texans’ ability to safely access abortion pills from across state lines. Last week, Governor Greg Abbott signed that bill into law. It will take effect in early December. 

• Federal Court Allows Trump Administration to Move Forward with ‘Defunding’ Planned Parenthood 

• The First Circuit Court of Appeals has lifted a lower court’s ruling temporarily blocking the Trump Administration from ‘defunding’ Planned Parenthood. Earlier this year, the Administration passed a spending bill that included provisions effectively precluding Planned Parenthood from receiving Medicaid Reimbursements for one year, handing the anti-abortion movement a major win in its decades-long crusade to shut down the reproductive healthcare provider. Planned Parenthood estimates that around 200 clinics may close, impacting over a million patients nationwide. Under the Hyde Amendment, federal funds are already prohibited from covering abortion, with extremely narrow exceptions. Defunding Planned Parenthood will instead cut off funding for low-income patients in need of pregnancy testing, cancer screenings, STI testing and treatment, prenatal care, contraception and other critical health services. 

• A New Lawsuit Challenges the Trump Administration’s ‘Review’ of Mifepristone’s Safety: 

• A new lawsuit filed by the Center for Reproductive Rights (CRR) seeks information about the government’s decision to review mifepristone’s safety record. The complaint alleges violations of the Freedom of Information Act (FOIA), following FDA and HHS’s failures to adequately respond to the CRR’s inquiries. In June, FDA Commissioner Marty Makary announced that the Agency would conduct a review of mifepristone, despite the drug’s decades of safe and effective use. CRR filed FOIA requests seeking information about that review process and the data driving the Agencies’ decision. In its press release regarding the lawsuit, CRR cites evidence for its concerns that the decision was motivated by anti-abortion politics rather than legitimate scientific or medical concerns. Earlier this week, Makary and HHS Secretary RFK Jr. sent a letter to 22 Republican attorneys general affirming that FDA is conducting an investigation into the drug’s record. 

Trend and Policy Watch:

• Texas Attorney General Ken Paxton Has Dropped a Lawsuit Against a Texas Doctor:

• Texas has dropped a lawsuit against a pediatric endocrinologist accused of providing gender-affirming care to minors in violation of Texas law. Despite previously referring to doctor Hector Granados as a “scofflaw who is harming the health and safety of Texas children,” the AG’s office has concluded that no legal violations occurred and filed a nonsuit in the case. The state is continuing to pursue two other Texas providers based on similar accusations. 

• Federal Judges Investigate Transgender Civil Rights Lawyer: 

• Prosecutors in Alabama have indicted a transgender civil rights attorney for allegedly making false statements under oath. Although that might not sound like cause for alarm, the attorney and others like him have faced a years-long campaign of harassment and questionable prosecutorial behavior. Mother Jones has done in-depth reporting on this case and why it  reflects an alarming escalation in scrutiny and investigation into advocates fighting for LGBTQ+ rights in the South. 

• Oregon Looks to Protect Access to Abortion as the Federal Landscape Shifts: 

• As the federal government seeks to use the federal budget to strip Medicaid funding from Planned Parenthood, abortion-protective states like Oregon are looking at ways to ensure their citizens continue to have access to care. Oregon House Democrats announced last week that they will be forming working groups ahead of their 2026 legislative session in order to assess options for preserving continued abortion access and protections for clinicians who provide care. Members of the proposed working groups denounced the Administration’s actions with respect to Planned Parenthood and reaffirmed Oregon’s commitment to honoring abortion and gender-affirming care as fundamental rights and critical components of health care. 

REPRODUCTIVE HEALTH DIGEST (9/11/2025)

Developments in Abortion, Autonomy, and Access:

Today’s Digest is a bit shorter than usual, as the author is at a conference much of this week. However, as always, we strive to bring you the most important news on reproductive rights and bodily autonomy from around the country. This week’s edition goes through the latest attacks on the rights of transgender people, litigation developments at the state and federal levels, increasing concern around abortion surveillance, and proposed legislation out of Texas. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

Legislation & Litigation:

• Overview:

• Texas and Florida are seeking to intervene as plaintiffs in a federal lawsuit challenging the FDA’s approval of mifepristone; 

• Texas lawmakers have passed legislation prohibiting the sending of medication abortion into the state, making it more difficult for Texans to access care; 

• A dispute that pits New York’s shield laws against Texas’s abortion ban is continuing to accelerate, with New York Attorney General Letitia James joining the lawsuit; 

• Illinois has passed two bills improving access to reproductive care in the state; and 

• A federal judge has blocked a DOJ subpoena seeking the records of trans minors from Boston Children’s Hospital. 

• Texas and Florida Seek to Intervene in Mifepristone Lawsuit:

• Florida and Texas are seeking to intervene in the lawsuit formerly known as Alliance for Hippocratic Medicine vs. FDA. The plaintiffs in the case aim to roll back FDA’s regulations approving the use of mifepristone for medication abortions in the first 10 weeks of pregnancy. The lawsuit was originally brought by a group of anti-abortion doctors and organizations; however, their case was dismissed for lack of standing. Following that dismissal, Idaho, Missouri and Kansas joined as plaintiffs in an attempt to keep the dispute alive. The lawsuit is currently in front of far-right judge Matthew Kacsmaryk, who has a history of rubber-stamping anti-abortion lawsuits. 

• Earlier this year, the Trump Administration argued that the case should once again be dismissed on the grounds that Missouri, Idaho and Kansas do not have standing in a Texas federal court. If allowed to join, Texas’s presence in the case could help quell those arguments and spur a change in position. Texas and Florida argue that their intervention is appropriate because Missouri, Kansas and Idaho are not able to adequately represent the interests at stake. The case is likely to eventually end up back before the Supreme Court, where it will play a substantial role in shaping access to medication abortion in the U.S. 

• Texas Lawmakers Pass Legislation Restricting Medication Abortion:

• Texas lawmakers have passed HB 7, a new law restricting access to medication abortion. It now awaits Governor Greg Abbott’s signature. Although Texas is already enforcing a total abortion ban, the legislation makes access to care even more legally fraught by allowing  private citizens to bring lawsuits against anyone who mails or distributes abortion pills in the state. This citizen ‘bounty-hunter’ style of law is one that Texas originated with its pre-Dobbs “heartbeat” ban.  The new law applies even if an abortion does not actually take place. It also specifically declares that another state’s shield laws are not a defense, adding another layer to the ongoing interstate disputes over shield laws and abortion bans. Anti-abortion lawmakers insist that HB 7 is necessary to protect Texans from the supposed dangers of medication abortion, casting the women who utilize them as victims. 

• Shield Law Dispute Between Texas and New York Accelerates:

• A dispute that pits Texas’s abortion ban against New York’s abortion shield law continues to develop. Earlier this year, Texas brought a lawsuit against New York shield provider Dr. Maggie Carpenter for mailing abortion pills into Texas. Although a Texas court issued a judgment against her, New York has declined to enforce that judgment or extradite Dr. Carpenter to Texas, citing the state’s shield protections. New York Attorney General Letitia James announced this week that she will intervene in the dispute to defend New York’s law, stating that Texas “cannot commandeer New York’s courts to enforce its punitive abortion laws, and that New York has the legal right and responsibility to safeguard its residents, its providers and its courts from out-of-state overreach.” The case is one of the first substantive legal battles over the enforceability and strength of post-Dobbs shield laws. Experts speculate that the issues involved will likely end up before the U.S. Supreme Court.

• Illinois Expands Protections for Reproductive Rights and Access:

• Illinois Governor JB Pritzker has signed two new bills expanding reproductive rights in the state. The first, HB3637 extends the state’s current shield law to cover all healthcare providers, including midwives and drug distributors. It also amends the Illinois Food, Drug and Cosmetic Act to allow providers to continue to prescribe drugs as long as they remain approved by the World Health Organization, even if the FDA revokes its approval. The second measure, HB 3709, requires public universities to offer contraception and medication abortion on campus in order to address gaps in care. 

• A Federal Judge Has Blocked a Subpoena Seeking the Records of Trans Minors from a Boston Hospital:

• In July, Attorney General Pam Bondi announced that the Department of Justice had issued over 20 subpoenas to health care facilities providing gender-affirming care to minors. She claimed that they were for the purpose of investigating fraud and similar unlawful activities; however, the subpoenas requested expansive information concerning the care provided to individual patients. One of the recipient hospitals, Boston Children’s, asked a federal court to block the subpoena. This week, Judge Myong Joun granted that request. In his order Judge Joun pointed to the Administration’s open animus towards the transgender community and stated that “it is abundantly clear that the true purpose of issuing the subpoena is to interfere with [Massachusetts’] right to protect [gender-affirming care] within its borders, to harass and intimidate [Boston Children’s Hospital] to stop providing such care, and to dissuade patients from seeking such care.” This court order comes as over 20 hospitals and clinics nationwide have ceased providing care to minors under mounting pressure from the federal government. 

Trend and Policy Watch:

• New Mexico Becomes the First Care to Make Child Free:

• New Mexico Governor Michelle Lujan Grisham announced this week that, beginning in November, childcare will be cost-free for New Mexico residents. The new policy applies regardless of a family’s income and is expected to save families up to $12,000 a year. New Mexico is the first state to take this step and will serve as a model for other states to follow, bringing the United States more in line with childcare assistance in comparator nations. 

• Austin Decides to Close its Abortion Travel Fund:

• The City of Austin has made the decision to end its abortion travel fund under pressure from the state and newly passed prohibitive legislation. The city had originally allocated $100,000 for organizations that help Texans travel out of state for care. However, in late August, Greg Abbott signed SB 33 into law, which prohibited governmental entities from funding logistical support for abortion. Texas Attorney General Ken Paxton had previously sued the city for what he called an illegal appropriation of funds. 

• Missouri Continues to Attempt to Stymie the Will of its Voters:

• Missouri continues to fight to get an anti-abortion and anti-gender-affirming care ballot measure on the ballot for 2026. If passed, the measure would undo the recently-passed constitutional amendment legalizing abortion until viability in the state. Simultaneous with this effort, lawmakers are legislating to raise the threshold for citizens to enact constitutional amendments altogether, following successful voter passage of abortion rights, legalization of marijuana and increased minimum wage. If the new law passes, citizen-led initiatives would need a statewide simple majority and a majority in all eight congressional districts, allowing a small cohort of voters to effectively defeat any proposed measure. 

• Lawmakers Embrace ‘Restorative Reproductive Medicine’: 

  • As debates around access to fertility treatments continue at both the federal and state levels, some conservative lawmakers are backing policies supporting so-called “restorative reproductive medicine” (RRM).  Restorative Reproductive Medicine purports to offer holistic alternative approaches to infertility involving “ultrasounds, blood tests, hormone measurements, exploratory surgeries, ‘natural procreative technology” and fertility awareness methods like cycle tracking. Some states, including Arkansas, are passing laws requiring insurance coverage for RRM. Although access to a broad spectrum of supportive reproductive practices is facially positive, experts warn that RRM is not a proven alternative to assisted reproductive technologies like IVF. And, the supporters of the practice often come from groups ideologically opposed to assisted reproduction and contraception.

REPRODUCTIVE HEALTH DIGEST (8/21/25)

Developments in Abortion, Autonomy, and Access:

Today’s Digest is a bit shorter than usual, as the author is at a conference much of this week. However, as always, we strive to bring you the most important news on reproductive rights and bodily autonomy from around the country. This week’s edition goes through the latest attacks on the rights of transgender people, litigation developments at the state and federal levels, increasing concern around abortion surveillance, and proposed legislation out of Texas. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Legislation & Litigation:

• Overview:

• Following the Supreme Court’s Skrmetti decision, federal courts for the 10th and 8th Circuit Courts of Appeals have issued rulings allowing states to enforce their bans on gender-affirming care for minors; 

• Tennessee has issued subpoenas to four medical groups, requesting records related to abortions provided in the state. Although the subpoenas arise out of a case challenging the scope of the state’s abortion ban, it raises alarms about abortion surveillance; 

• The Missouri Supreme Court has declined to review a lower court ruling enjoining certain abortion restrictions prior to the case moving through the appellate process;

• An Indiana Appeals Court has ruled that the state can continue to enforce its total abortion ban without modification or expansion of its current exceptions and requirements; and 

• The Texas legislature appears poised to pass a law that would further expand liability around medication abortion and restrict access to care from out-of-state  shield providers. 

• Federal Courts Rule that Oklahoma and Arkansas Can Enforce Their Bans on Gender-Affirming Care:

• Both the 10th Circuit and the 8th Circuit Courts of Appeals have ruled to uphold state-level bans on gender-affirming care for minors in light of the Supreme Court’s Skrmetti decision. The states involved, Oklahoma and Arkansas, both passed laws banning gender-affirming care for minors, and in both cases, healthcare providers and the families of trangender minors sued on constitutional grounds. However, since the filing of those lawsuits, the U.S. Supreme Court issued its landmark decision in U.S. v. Skrmetti. In its order, the Court found that Tennessee’s ban on gender-affirming care for minors did not discriminate on the basis of sex or transgender status, but instead merely distinguished based on age and medical use. To date, over half of U.S. states have implemented bans on gender-affirming care, and we are likely to see more federal courts apply Skrmetti’s analysis to uphold those laws. Indeed, the Skrmetti decision has already had a significant precedential impact on many ongoing cases involving the rights of transgender people, creating a blueprint for states to lawfully discriminate.  

• Tennessee has Issued Subpoenas Requesting Records of Abortions Performed: 

• Tennessee has issued subpoenas to four medical groups seeking records and information about abortions performed in the state. The subpoenas are a part of a lawsuit brought by a group of women who were denied medically necessary care under the state’s total abortion ban. In requesting records related to the guidance that Tennessee providers use to determine if a patient is eligible for an abortion, Tennessee is likely seeking to establish a case that the law itself is not a problem as written, but instead, providers are simply failing to apply it properly. Although certain confidentiality and privacy protections are in place for the subpoenas, the investigation raises alarms around heightened government scrutiny into the individual actions of healthcare providers and the surveillance of patients’ care. 

• The Missouri Supreme Court Has Refused to Prematurely Review a Lower Court Ruling That Blocked Abortion Restrictions: 

• Since the passage of a ballot measure overturning Missouri’s total abortion ban last November, Missourians have been locked in a battle with the state to vindicate their now constitutionally-enshrined reproductive rights. Although the constitutional amendment technically protects abortion rights up until ‘viability,’ the state has repeatedly argued in favor of strict restrictions that make actually accessing care extremely difficult. Circuit Judge Jerri Zhang has repeatedly enjoined those restrictions. In response to Judge Zhang’s most recent ruling, Tennessee Attorney General Andrew Bailey requested that the Supreme Court take up the case directly, without it going through the normal appeals process. Last week, the court declined that request, finding that jurisdiction is proper in the appellate court. For now, abortion will remain available in the state. 

• An Indiana Appeals Court has Ruled to Uphold the State’s Abortion Ban:

• An Indiana Appeals Court has ruled to uphold the state’s abortion ban without alteration. Plaintiffs argued that the law, which bans abortion at all gestational ages with extremely limited exceptions, was too narrow and placed patients at risk. However, the Court found that it did not violate the “life, liberty, and the pursuit of happiness” clause of the Indiana Constitution and affirmed that only certain extreme medical scenarios create a constitutional right to abortion. It also rejected a challenge to the law’s requirement that abortions be performed in a hospital or outpatient surgical center, reasoning that a constitutionally-protected abortion would almost always involve a circumstance where a patient would need to be in the hospital. 

• Texas Poised to Pass a Law Expanding Liability around Medication Abortion:

• Texas appears poised to pass yet another law limiting and criminalizing abortion access. Although the state is already enforcing a total abortion ban, Senate Republicans have introduced a new bill, the “Women and Child Protection Act,” which would both expand civil liability for anyone involved in the manufacture, prescription, mailing, delivery, or distribution of abortion pills and permit wrongful death lawsuits related to the pregnant person or fetus within a 6-year statute of limitations. The law also takes aim at other states’ ‘shield laws,’ by declaring that they are not a defense to the statute’s prohibitions. Senator Brian Hughes, the sponsor of the bill, sought to cast it as an effort to protect women, stating his view that “moms are the victims here.” Texas’s latest attempted crackdown comes as more and more Americans are relying on medication abortion to access care. 

Trend and Policy Watch

• Trump Administration Moves to Block Health Insurance Coverage for Transgender Federal Employees:

• The Trump Administration has reportedly taken actions to quietly remove coverage for gender-affirming care for adults from the programs that administer benefits to federal employees. Echoing the strategy of many state-level bans, the policy change specifically only applies to transgender people seeking care to treat gender dysphoria. It does not apply to other treatments that might require hormone therapy like cancer or certain reproductive conditions. The letter indicating the change also includes exceptions for ‘counseling services’ for gender dysphoria and requires carriers to create an exceptions process, to be applied case-by-case, for individuals who are mid-treatment. This latest move to strip adults of evidence-based care undercuts any assertions by the Administration that it is primarily concerned with impacts of gender-affirming care on minors. 

• Despite Campaign Promises, the Trump Administration Will Not Cover IVF Treatment:

• The Federal Administration reportedly has no plans to cover IVF treatments, despite promises made on the campaign trail. In the run-up to last year’s presidential election, the Trump Campaign announced that “under the Trump administration, your government will pay for – or your insurance company will be mandated to pay for – all costs associated with IVF treatment.” Then-candidate Trump even referred to himself as “the father of IVF” during a Fox News town hall event. Despite these lofty promises, mandating coverage of IVF would require an act of Congress, and the Administration reportedly does not intend to ask Congress to draft or pass such legislation. However, as Rolling Stone points out, the White House does “plan to redirect funds from a long-standing federal program that helps low-income women access birth control and testing for [STIs]” and instead give those funds to an “‘infertility training center’ that promotes ‘holistic’ approaches to combatting infertility.” 

REPRODUCTIVE HEALTH DIGEST (8/7/25)

Developments in Abortion, Autonomy, and Access:

This week’s Digest covers litigation challenging the federal government’s attempts to withhold funding for healthcare, interstate conflicts over shield laws, new state-level regulations restricting care, and the Trump Administration’s move to strip veterans and their beneficiaries of abortion coverage in emergencies and cases of rape or incest. As always, please read on to the end for the news that you need to know.

Want access to a detailed analysis of the abortion law in every U.S. state and territory?Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News:

This Week’s Must-Read:

This week’s must-read comes from Time and tells the story of a woman who was denied prenatal care because she is unmarried. The provider reportedly told her that it goes against their Christian values to treat an unwed mother. She was not seeking an abortion - just standard prenatal care. However, Tennessee recently expanded its so-called “conscience” laws to allow providers to decline to provide or participate in any healthcare that “violates the conscience of the healthcare provider.” Historically conscience laws, which permit a provider to decline services that conflict with their sincerely held beliefs, have been cabined to narrow circumstances or specific types of care, like abortion. However, expansions like Tennessee’s could open the door to broad and arbitrary denials of care. 

Legislation & Litigation

• Overview:

• A coalition of Democratic state attorneys general have brought a lawsuit against the Trump Administration over its attempt to ‘defund Planned Parenthood’ through the recently passed budget reconciliation bill; 

• Louisiana has passed two new laws restricting abortion. The first makes it easier for patients to bring lawsuits against out-of-state medication abortion providers, and the second expands the definition of ‘coerced abortion;’  

• Oklahoma Governor Kevin Stitt passed an executive order restricting state Medicaid funds from going to entities affiliated with abortion; 

• State attorneys general filed a complaint against the Trump Administration over its intimidation of gender-affirming care providers, arguing that the government’s actions violate the Administrative Procedure Act and constitutional protections; 

• The Trump Administration has announced its plans to cut abortion coverage for veterans and their dependents in medical emergencies or cases involving rape or incest; 

• A group of anti-abortion lawmakers have sent a letter to Congress urging it to pass a law preempting state shield laws; 

• Missouri Attorney General Andrew Bailey has filed a lawsuit against Planned Parenthood, arguing that their claims about the safety of mifepristone violate consumer protection laws; and 

• Nevada has reinstated parental notification requirements for minors seeking abortion care. 

• Democrat State Attorneys General Sue the Administration Over “Defunding” of Planned Parenthood:

• A coalition of Democratic attorneys general and governors are suing the Trump Administration over its attempt to defund Planned Parenthood through the recently-passed budget reconciliation bill. The lawsuit argues that the spending bill intentionally targets Planned Parenthood – even if it doesn't identify the entity by name – through its revocation of federal funding for entities that are associated with the provision of abortion and receive over $800,000 in Medicaid funding annually. The Complaint alleges a host of constitutional deficiencies, including a lack of due process, unconstitutional vagueness, and a First Amendment claim based on the targeting of Planned Parenthood for its advocacy activities. In a press conference about the lawsuit California Attorney General Rob Bonta said the following: “we need to just call it what it is: punishment for Planned Parenthood’s constitutionally protected advocacy for abortion.”

• Planned Parenthood itself has filed a similar lawsuit challenging the same spending bill provision. In that case, Judge Indira Talwani has preliminarily blocked the provision from taking effect. Although the Trump Administration appears reticent to take anti-abortion action as overt as passing a federal abortion ban, actions like aggressively cutting Medicaid funding for providers are an effective backdoor way to legally enshrine restrictions on care. 

• Louisiana Passes Two New Laws Restricting Abortion:

• Louisiana has passed two new laws targeting abortion care. The state is already enforcing a total abortion ban with exceptions only for the life or health of the patient. It has also aggressively pursued other legislative avenues for limiting access to abortion, including the reclassification of abortion pills as controlled substances. Last week, two new restrictive laws took effect. The first, HB 575, targets medication abortion providers by allowing Louisiana residents to sue out-of-state doctors and activists for providing them with abortion pills. It also expands the statute of limitations to file suit from three years to five years. The second bill, HB 425, expands the definition of ‘coerced abortion’ to include control or intimidation, as well as physical force.

• Oklahoma Governor Passes Executive Order Expanding Restrictions on Medical Funding:

• Oklahoma Governor Kevin Stitt has passed an Executive Order barring state Medicaid funds from going to any “individual or entity directly affiliated with a physician, medical practice or other organization providing abortion services or facilitating the procurement of abortion services.” The EO further directs the Oklahoma Health Care Authority (OHCA) to exclude certain providers, including those who are “under common ownership” of an entity that provides abortions that are unlawful in Oklahoma. Because abortion is entirely banned in Oklahoma, this EO is very clearly targeting entities like Planned Parenthood that run state clinics under a national umbrella organization. Those state clinics do not, of course, provide abortions; instead, they provide services including cancer screenings, pregnancy testing, contraception, prenatal care, and STI screening and treatment. The new order comes on the heels of the Supreme Court’s ruling in Medina v. Planned Parenthood South Atlantic, which found that individuals do not have a right to sue over a state’s decision to exclude Planned Parenthood from Medicaid coverage. 

• State Attorneys General Sue Administration Over Gender-Affirming Care Restrictions:

• A coalition of 17 Democrat-Led states are suing the Trump Administration over its intimidation of clinicians and hospitals that provide gender-affirming care to minors. This lawsuit comes after a month of back-to-back announcements that hospitals and clinics in states where care is legal are shuttering their gender-affirming care programs.  A sample of those cases are detailed below: 

• On July 22nd, Children’s Hospital Los Angeles (CHLA) closed its Center for Transyouth Health and Development.  CHLA initially paused care for new patients under 19 in February, then resumed services following backlash. But after hospital leadership reportedly looked to federal agencies for guidance, including the FBI, HHS, DOJ, and CMS,  CHLA made the final decision to close the clinic. Though CHLA claims patients will be transitioned to other providers, advocates warn that many young people will be left without specialized, life-saving care. 

• On July 18th, Children’s National Hospital in Washington, D.C announced  that it will cease offering gender-affirming care for minors at the end of this month. The hospital cited “escalating legal and regulatory risks” tied to DOJ subpoenas and federal pressure. While medical transition services will no longer be offered, Children’s National says it will continue mental health and other supportive services. 

• On July 18th, University of Chicago Medical Center announced that it was ending its gender-affirming care services for minors, citing a need to protect its ability to continue to serve Medicare and Medicaid patients.

• Also in Illinois, University of Illinois indicated in late-July that it would cease providing gender-affirming surgical care for patients under the age of 19. 

• In Connecticut, Yale Medicine and Yale New Haven Hospital have confirmed that they will no longer be offering care for minors under 19; as with the other hospitals, they cited the looming threat created by the Trump Administration’s executive orders. They indicated that they will continue to offer support and mental health services. 

• In California,  Kaiser Permanente will cease offering gender-affirming surgery for individuals under 19 at the end of August as a result of federal pressure. It will continue to offer non-surgical care. 

• In the opening paragraph of the Plaintiffs’ Complaint, they assert that “since taking office on January 20, 2025, President Donald J. Trump and his administration have relentlessly, cruelly, and unlawfully targeted transgender individuals” by seeking to “deny their very existence, banish transgender residents from the public square, and refuse them medically necessary healthcare through unlawful Executive Orders [ ] and a raft of federal agency actions.” The states assert a number of Administrative Procedure Act and constitutional claims, arguing that the Administration is unlawfully intimidating states in an attempt to effectuate a nationwide ban on gender-affirming care for minors. The states are asking the court to declare the challenged actions unlawful and issue an order blocking their continued implementation. 

• Trump Administration Takes Moves to Cut Abortion Access for Veterans:

• The Department of Veterans Affairs under the Trump Administration has announced plans to change its policy of offering abortion coverage for victims of rape or incest or individuals facing life-threatening emergencies. The coverage policy was enacted under the Biden Administration in the wake of Dobbs; it created a lifeline for servicemembers and their families located in ban states. However, the Trump Administration claims the coverage expansion was a matter of federal overreach, saying it “contradicted decades of federal policy against forced taxpayer funding for abortion.” However, the federal policy that prohibits federal funding for abortion includes exceptions for emergencies or in cases of rape or incest, contradicting the Administration’s purported policy rationale for the change. Revoking already extremely limited coverage for servicemembers serves no discernible policy purpose other than further restricting access to abortion. The move is especially cruel when considering that servicemembers and veterans face disproportionately high rates of sexual assault and PTSD related to their service. 

• Anti-Abortion Lawmakers Send Letter Urging Congress to Restrict Shield Laws:

• Republican attorneys general from 15 states have sent a letter to Congress calling on it to take steps to preempt abortion shield laws. Following the Dobbs decision and the proliferation of abortion bans across the country, nearly half of U.S. states passed some form of ‘shield law’ – laws which are intended to protect providers and patients from legal consequences related to reproductive health care. These laws have allowed many patients to continue to safely access healthcare, either by traveling to a shield state or by utilizing telehealth. The letter sent to Congress decried these laws, calling them a “blatant attempt[] to interfere with States’ ability to enforce criminal laws within their borders.” This move is the latest escalation in the interstate battle over how and to what extent states are able to enforce their abortion restrictions in an increasingly complex web of conflicting state laws. 

• While anti-abortion states call on the federal government to take action against shield laws, Texas and New York continue to dispute New York’s shield law at the state level. As we have reported on previously, Texas and Louisiana are both attempting to enforce their abortion laws against New York doctor Maggie Carpenter, who prescribed abortion pills into the states – an action protected by New York’s shield law. Thus far, New York has rebuffed Texas’s attempt to enforce a judgment against the doctor. Last week, Texas Attorney General Ken Paxton escalated his efforts by suing Ulster County Clerk Taylor Bruck in his official capacity. Bruck responded by saying that the act was “unprecedented” but not unexpected, and that he is acting to “uphold[] New York State’s Shield Law.” 

• Missouri Attorney General Files Lawsuit Against Planned Parenthood:

• Missouri Attorney General Andrew Bailey has filed a lawsuit against Planned Parenthood, arguing that the organization violated consumer protection laws by making “deceptive” claims about the safety of medication abortion drug mifepristone. Despite the medication’s exemplary safety and efficacy record, the lawsuit argues that Planned Parenthood has failed to adequately disclose risks associated with its use. AG Bailey is seeking a court order blocking Planned Parenthood from advertising mifepristone, as well as substantial monetary damages and reimbursement of Medicaid funded emergency care related to medication abortion complications. If the lawsuit is successful, it will create a blueprint for leadership in other anti-abortion states. This is particularly concerning as the federal government takes aim at Planned Parenthood and states continue to crack down on access to mifepristone. 

• Nevada Reinstates Parental Notification Requirement for Minors:

• For the first time since it was passed in 1985, a Nevada law requiring minors to notify a parent or guardian before getting an abortion is now in effect. The law had been blocked by a federal injunction for decades, but that block was recently lifted after prosecutors argued it no longer applied following the overturning of Roe v. Wade. In response, Planned Parenthood Mar Monte filed a lawsuit to stop the law, saying it’s vague, lacks clear guidance for minors to seek an exception, and could put young people—especially those in foster care or facing abuse—at risk by delaying or denying care. 

Trend and Policy Watch: 

• The Trump Administration Appears Poised to Have $10 Million in Contraceptives Incinerated:

• The Trump Administration appears poised to burn nearly $10 million worth of contraceptives that were originally designated for use by women and girls overseas. The contraceptives are currently being held in Belgium and reportedly expected to be sent to France for destruction. They were owned by the now-defunct USAID, and State Department spokesperson Tommy Pigott has reportedly said that issuing the contraceptives may be in violation of a policy – known as the Mexico City Policy – that bars U.S. funds from going to organizations that provide abortions. He also stated that the products being held include “abortifacients”, or abortion-inducing drugs. However, a review of the supplies contradicts that assertion. The stock includes copper IUDs, rod implants, birth control injections, and birth control pills, none of which cause abortion, despite certain anti-abortion activists' insistence to the contrary. France and Belgium have faced pressure from the international community to take steps to stop the destruction of the medications, which do not expire until, at the earliest, 2027. And, multiple groups have offered to either purchase the medications for distribution or handle their transfer and distribution. The State Department has reportedly not reached any such agreement. The destruction of the medications will not only be a catastrophic loss of critical resources intended for underserved populations, but it will also cost U.S. taxpayers. 

• New Data Shows that Over a Third of Idaho’s Ob-Gyns Left the State Following the Enactment of its Abortion Ban:

• A new study shows that Idaho lost over a third of its ob-gyns following the implementation of its abortion ban. Although 20 obstetric physicians came to the state in that time, “another 114 of 268 physicians stopped practicing obstetrics, left the state, closed their practices within the state or retired.” According to the study, 37 counties, comprising 569,000 Idahoans are being served by only 23 ob-gyns. As maternity care deserts expand, patient outcomes worsen, and Idaho is a direct example of how abortion bans diminish the efficacy of an already strained healthcare system. 

REPRODUCTIVE HEALTH DIGEST (6/26/25)

Developments in Abortion, Autonomy, and Access: 

This week’s Digest walks through major decisions from the U.S. Supreme Court, including a decision undercutting Medicaid patients’ right to choose their provider, two religion-based cases involving reproductive freedom, and the much-anticipated Skrmetti decision. We also discuss litigation developments before the lower federal courts and in the states. Finally, we take a brief look at the current policy landscape for reproductive health, nearly three years after the Dobbs decision. As always, please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News: 

This week’s must-read: 

This week’s must-read comes from the New York Times and details a day in the life of an abortion provider who prescribes medication in ban states under Delaware and New York’s shield laws. The piece offers an intimate and compassionate perspective on what it entails to take on significant personal and professional risks in order to continue providing care. It also illustrates how shield law providers act as a lifeline for pregnant people from all walks of life, including those who identify as pro-life but find themselves in need of care. In a Digest issue full of bad news and challenging Supreme Court decisions, I found it valuable to read the perspective of one of the many steadfast advocates who continue to show up and do the work every day. 

Legislation & Litigation: 

• Overview: 

  • The Supreme Court has issued its decision in U.S. v. Skrmetti, finding that Tennessee’s ban on gender-affirming care for minors does not violate the equal protection clause of the Fourteenth Amendment; 

  • The Supreme Court issued a ruling in Medina v. Planned Parenthood South Atlantic finding that patients do not have a right to sue to enforce Medicaid’s any qualified provider provision; 

  • A federal judge has struck down the 2024 HIPAA reproductive health care privacy rule; 

  • The Supreme Court waded back into abortion waters in two religion-based cases; it sided with the religious entities in both instances; 

  • A federal judge has issued an order siding with trans rights in a case involving the Trump Administration’s attempts to ban trans people from obtaining passports consistent with their gender identity; 

  • Louisiana Legislators have once again declined to add an exception for rape or incest to the state’s total abortion ban; and 

  • Arizona’s Attorney General has indicated that the state will not defend remaining abortion restrictions in light of the new constitutional amendment protecting pre-viability care. 

• The U.S. Supreme Court Determines that Tennessee’s Ban on Gender-Affirming Care for Minors Does not Violate the Equal Protection Clause: 

  • On June 18th, the Supreme Court handed down its much-anticipated decision in United States v. Skrmetti. The Court was asked to rule on the question of whether Tennessee’s ban on gender-affirming care for minors violates the equal protection clause of the Fourteenth Amendment by discriminating on the basis of sex and transgender status. In a 6-3 decision authored by Chief Justice John Roberts, the Court allowed the law to stand, holding that it did not merit heightened scrutiny because it merely discriminated on the non-protected bases of age and ‘medical use.’ The law in question, SB1, prohibits the provision of gender-affirming care to minors in order to treat gender dysphoria, while explicitly allowing identical treatments for cisgender minors to treat any number of conditions. For example, a person assigned female at birth who seeks hormone therapy to stop unwanted growth of facial hair would be legally permitted to access that care, while a minor assigned male at birth would not be able to do so in order to treat gender dysphoria. In other words, the patient’s sex assigned at birth is precisely what determines whether or not they are able to access care. The Court went out of its way to avoid this obvious reality, reasoning instead that the law merely discriminates on the sex-neutral basis of medical use by allowing hormone therapy and puberty blockers to treat certain conditions, while prohibiting it for others. The flaw in this logic is, of course, that the factor determining the underlying medical use is based entirely on the patient’s sex and gender identity. 

  • Although the Court’s ruling was cabined to Tennessee’s law, it is likely to have significant implications for the 27 states that have enacted similar gender-affirming care bans. The majority’s reasoning could also be extended to restrict adult access to care by arguing that such a ban is based only on medical diagnosis and not on sex or any other protected classification warranting heightened scrutiny. And, by weakening the standards for what is considered sex-based discrimination, the Court’s decision could have ramifications for challenges to any law involving distinctions on the basis of sex, including in the abortion and reproductive rights contexts. As Justice Sotomayor articulated in her dissent, the court's finding “invites legislatures to engage in discrimination by hiding blatant sex classifications in plain sight.” 

  • Although a devastating blow, the Court stopped short of issuing a sweeping declaration that discrimination on the basis of transgender status is per se constitutional and left undisturbed other important precedents protecting trans rights. Legal strategies remain available to continue challenging discriminatory laws, and the advocates in the case have indicated that they fully intend to pursue them. 

• The Supreme Court Rules that Medicaid Patients Cannot Sue to Enforce Their Right to See Any Qualified Provider:

• Today, the Supreme Court issued a 6-3 ruling in Medina v. Planned Parenthood South Atlantic (PPSAT), finding that Medicaid patients cannot sue to enforce their right to see any qualified healthcare provider. The case originated from South Carolina Governor Henry McMaster’s 2018 directive that state Medicaid funds should not go to Planned Parenthood, based on PPSAT’s provision of abortion care. The case before SCOTUS focused on the technical legal question of whether the Medicaid provision at issue, which allows patients to receive care from any clinician qualified to provide it, is enforceable by individual patients. The Court ruled in the negative, opening the doors for anti-abortion states to strip funding from Planned Parenthood and other reproductive health entities without accountability to the patients who rely on those clinics’ services. As Justice Jackson wrote powerfully in her dissent, “Today’s decision is likely to result in tangible harm to real people[;] [a]t a minimum, it will deprive Medicaid recipients in South Carolina of their only meaningful way of enforcing a right that Congress has expressly granted to them. And, more concretely, it will strip those South Carolinians – and countless other Medicaid recipients around the country – of a deeply personal freedom: the ‘ability to decide who treats us at our most vulnerable.’ 

• Federal Judge Strikes Down HIPAA Reproductive Healthcare Privacy Rule 

• Northern District of Texas Judge Matthew Kacsmaryk issued a ruling last week striking down a Biden-era HIPAA privacy rule protecting reproductive healthcare information. The Rule was enacted post-Dobbs in response to rising threats of investigation and criminalization of reproductive health care and gender-affirming care. It protected only against the disclosure of patient information related to the provision or receipt of lawful healthcare, while creating exceptions for functions like public health or law enforcement investigations into unlawful practices. However, Judge Kacsmaryk – notorious for his anti-abortion rulings – issued a nationwide order striking down the Rule on the grounds that the Department of Health and Human Services exceeded its authority in creating special protections for reproductive healthcare. It is not yet clear whether HHS will attempt to appeal the ruling.

• The Supreme Court Weighs in on Abortion and Religious Liberty Once Again:

• The U.S. Supreme Court took two actions relating to abortion rights last week, siding with religious groups in both cases. First, the Court agreed to hear First Choice Women’s Resource Centers v. Platkin, a New Jersey case involving a state investigation into a crisis pregnancy center. The case was brought by the Alliance Defending Freedom, a prominent right-wing group involved in anti-abortion litigation around the country. In the suit, the New Jersey Attorney General subpoenaed the centers as a part of an investigation into whether they had violated consumer protection laws by misleading donors and patients about their services. The Court agreed to take the case on the question of whether the plaintiff centers must proceed in state court prior to bringing their First Amendment action before a federal court. 

• The Court’s second action involved sending a case back to the New York Court of Appeals for reconsideration of whether the state’s employer-provided insurance plan coverage requirements unconstitutionally violated the plaintiffs’ religious beliefs. The requirements in question mandate coverage for medically necessary abortions and include religious exemptions; however, the plaintiffs argued that those exemptions were too narrow. Although the New York Court of Appeals ruled against the plaintiffs, the Supreme Court is requiring it to reconsider that ruling in light of a recent decision about tax exemptions for religious employers. In both of these cases, the Supreme Court issued rulings favorable to the religious entities, strengthening the legal theory that assertions of religious objection to abortion can trump state laws protecting access to care. 

• Federal Judge Sides with Trans Plaintiffs in Case Involving Gender Identity and Passports: 

• Despite the Skrmetti ruling, many federal courts are continuing to rule against the Administration’s attempts to aggressively limit the rights of transgender and gender-diverse people. Last Tuesday, the federal district court over Massachusetts issued a ruling blocking the Trump Administration’s changes in passport policy. Previously, the State Department allowed passport holders to select the gender marker that aligns with their gender identity, and permitted an “X” indicator for intersex,  nonbinary, and gender non-conforming individuals. However, in January, the federal administration issued an executive order requiring individuals to only have documentation that reflects their sex assigned at birth, even in cases where the person’s legal documentation has been changed to accurately reflect their gender identity. In April, the Massachusetts District Court issued a preliminary injunction as to the six individual plaintiffs in the case. This week, that injunction was expanded to all persons impacted by the administration’s policy change. This means that individuals can, at least for the time being, apply for and renew travel documentation that is consistent with their gender identity.

• This ruling comes as other federal courts have similarly ruled against the Trump Administration's discriminatory policies against the LGBTQ+ community. Earlier this month, a federal judge for the D.C. District Court issued an order finding that the Bureau of Prisons must continue to provide gender-affirming care to incarcerated individuals. And, two weeks ago, a California federal court ruled against the Administration’s revocation of federal funding for groups providing critical support to the LGBTQ+ community. The Court explicitly called out the Administration’s open animus towards the rights of gender-diverse people in making its ruling. 

• Louisiana Legislators Decline to Add an Exception for Rape or Incest to the State’s Abortion Ban: 

• For the third year in a row, Louisiana lawmakers have declined to add any exceptions for rape or incest to the state’s total abortion ban. The proposed legislation would have created a limited exception to allow minors under the age of 17 to access care if they became pregnant following an assault. The debate over the measure was significantly focused on the religious beliefs of the legislators involved, with one Democratic representative citing her Christian beliefs as a reason why she could not approve adding the exception. Louisiana’s law will continue to include a total ban with exceptions only for the life or health of the pregnant person or in certain cases of grave fetal abnormalities. 

• Arizona Attorney General Will Not Defend Laws Restricting Abortion Care: 

• As we reported in our last Digest, advocates in Arizona have brought challenges to abortion restrictions that remain on the books following the state’s passage of an abortion rights ballot measure. The restrictions at issue include 1) a prohibition on abortion because of nonfatal genetic conditions; 2) a requirement that a patient receive an ultrasound 24 hours prior to an abortion; and 3) a ban on telehealth abortion care, including for medication abortion. In a piece of good news, Arizona Attorney General Kris Mayes has indicated that the state will not defend the laws, citing her determination that they run afoul of the newly added constitutional protections. 

Trend and Policy Watch: 

• New Data Finds Abortion Bans are Extremely Costly: 

  • Three years after the Dobbs decision overturned Roe, we are starting to get a clear picture of the consequences of widespread abortion bans and restrictions, including the financial consequences. New analysis from the Institute for Women’s Policy Research has found that the “16 states with the most restrictive abortion policies cost the US economy more than $64 billion annually.” And, when “factoring in state-level policies that impose significant barriers, such as mandatory waiting periods and medically unnecessary restrictions on providers…the annual economic toll rises to over $133 billion.” 

• Republican Lawmakers Have Asked the EPA to Investigate Mifepristone’s Effect on Water Safety: 

• A group of Congressional Republicans has asked the EPA to investigate whether mifepristone, a drug commonly used for medication abortions, is contaminating the water supply. The lawmakers issued a letter in which they point to unfounded concerns about potential effects that the “byproducts” of mifepristone could have on fertility and the safety of drinking water. As Abortion Every Day’s Jessica Valenti explains, this is not a new anti-abortion strategy. Students for Life has been championing the idea that medication abortion harms the water supply for years, and its Vice President for Policy testified to Texas legislators last month that we “are all drinking other people’s abortions.” 

• The UK Parliament Has Voted to Decriminalize Abortion: 

• In a significant victory for international abortion rights, the U.K. Parliament has voted to decriminalize all abortions, meaning that women cannot face arrest or prosecution for their pregnancy outcomes, regardless of the gestational age of their pregnancy. The vote was 379 to 137. One author of an amendment to the new law, MP Tonia Antoniazzi, explained that the decriminalization efforts are “about recognizing that these women need care and support, and not criminalization.” 

• Abortion Is Still On the Rise, 3 Years After Dobbs: 

• WeCount’s newly released data shows that, despite the enactment of state-level abortion bans post-Dobbs, abortions have continued to rise in the past two years. According to the research, although the majority of abortions continue to take place in person, telehealth abortions have been steadily increasing, likely a significant contributing factor to the rising numbers. Additionally, protective states’ shield laws have allowed those residing in abortion ban states to continue to access care both in person and via telehealth. 

REPRODUCTIVE HEALTH DIGEST (6/5/25)

Developments in Abortion, Autonomy, and Access: 

This week’s Digest goes through the federal government’s decision to rescind guidance directing hospitals to provide emergency abortions, new lawsuits filed by reproductive rights advocates in Arizona and Kansas, and litigation developments in Kentucky and Missouri. We also discuss new research about the safety and efficacy of gender-affirming care, the closure of Planned Parenthood clinics, and trends in pregnancy criminalization. Please read on to the end for the news that you need to know. 

Want access to a detailed analysis of the abortion law in every U.S. state and territory? Please view our free Policy Resource Hub for Reproductive Health, an exclusive legal database where we update the state of the law every single day - so you’re always up to speed.

Reproductive Rights and Health Equity News: 

This week’s must-read: 

On Tuesday, the Trump Administration announced its decision to rescind Biden-era guidance directing hospitals to provide emergency abortion care regardless of state-level abortion laws. Under the federal Emergency Medical Treatment and Active Labor Act (EMTALA), all hospitals that receive Medicare funding are required to provide stabilizing treatment to any patient that presents with an emergency. In response to the Dobbs decision and the wave of state abortion bans that followed, the Biden Administration issued guidance clarifying hospitals’ continued obligation to stabilize patients–even if the treatment required is an abortion that may conflict with a state’s abortion ban. The Biden-era guidance did not create any new abortion rights, it merely allowed providers to treat patients facing acute medical crises without fear of being prosecuted under their states’ laws. By rescinding that guidance, the Trump Administration places the lives of pregnant patients at immediate risk and further confuses the question of when providers can and cannot safely intervene. 

Legislation & Litigation: 

• Overview: 

• Following the passage of an abortion rights constitutional amendment last November, Arizona providers have filed a new lawsuit challenging remaining restrictions on care; 

• The Missouri Supreme Court has issued a decision overturning lower court rulings that allowed abortion to resume in the state; for the time being, care has once again been paused; 

• In Texas, a dangerous bill that would have further restricted access to medication abortion has seemingly failed to cross the legislative finish line this session; 

• The ACLU has voluntarily dismissed its lawsuit challenging Kentucky’s abortion ban; and 

• A lawsuit has been filed in Kansas challenging the state’s laws interfering with end of life choices for pregnant patients. 

• Arizona Providers File Lawsuit Challenging Remaining Arizona Abortion Restrictions: 

• Two Arizona physicians and the Arizona Medical Association have brought a new lawsuit challenging remaining restrictions on abortion care in the state. Last November, Arizona voters passed Proposition 139, an abortion rights amendment legalizing care until ‘fetal viability.’ In light of those new constitutional protections, a state court struck down the prior 15-week abortion ban; however, multiple medically unnecessary restrictions remain on the books. These restrictions include 1) a prohibition on abortion because of nonfatal genetic conditions; 2) a requirement that a patient receive an ultrasound 24-hours prior to an abortion; and 3) a ban on telehealth abortion care, including for medication abortion. Removing these restrictions would significantly improve access to care in the state, particularly for individuals who cannot travel to an in-person clinic or take multiple days off of work to comply with the current waiting period. Democratic Arizona Attorney General Kris Hayes will now have to determine whether the state intends to defend the laws. 

• Missouri Supreme Court Overturns Lower Court Rulings that Allowed Abortion to Resume in the State: 

• The Missouri Supreme Court issued a ruling last week functionally reinstating the state’s abortion ban. Last November, voters made Missouri the first state to overturn a total abortion ban through citizen-led ballot initiative. However, that victory has faced relentless opposition from anti-abortion lawmakers in the months since, including an attempt to outright overturn the amendment. The most recent blow comes from the state supreme court, which ordered a lower court to lift an injunction blocking medically unnecessary abortion restrictions, including an abortion clinic licensing requirement. The supreme court argued that the lower court had applied the wrong legal standard. The previous lifting of the licensure requirement had allowed abortions in the state to resume for the first time since Dobbs. However, in light of the latest ruling, clinics once again were forced to cancel appointments and cease providing care. Advocates are hopeful that this is only a temporary setback, and that the lower court will issue a renewed injunction allowing care to resume. 

• Dangerous Texas Bill Restricting Medication Abortion Fails to Move Forward: 

• As the Texas legislative session comes to a close, it seems efforts to pass a dangerous anti-abortion bill will end with it–at least for this year. SB 2880 would have further restricted access to mifepristone by allowing citizens to sue individuals who manufacture or distribute the medication in Texas. The bill clearly aimed to eliminate Texans’ ability to access care from out-of-state providers and organizations. However, despite its previous forward progress, SB 2880 failed to be scheduled for a floor vote prior to the deadline, likely ending any chance of its imminent passage. The bill is highly likely to be reintroduced in the next legislative session. 

• The ACLU has Dismissed its Lawsuit Challenging Kentucky’s Abortion Ban: 

• The ACLU has voluntarily dismissed its lawsuit challenging Kentucky’s abortion ban. The suit was brought on behalf of a pregnant woman who later traveled out of state to receive care. No legal explanation was offered for the voluntary dismissal; however, the ACLU issued the following statement: “people have the right to control their own bodies without government interference, and we will never stop fighting to restore abortion access in Kentucky. We are strategizing our next steps in this fight. In the meantime, our work to address the commonwealth’s maternal mortality rates and lack of widespread paid leave coverage will continue as long as Kentucky remains a forced-birth state.”

• Lawsuit Filed in Kansas Challenging Law Interfering with End-of-Life Choices for Pregnant Patients:

• A group of physicians and women in Kansas have filed a lawsuit challenging the state’s regulations on end-of-life treatment in cases involving pregnant patients. Kansas law allows the state to interfere with or override a pregnant patient’s advance directive, regardless of the fetus’s gestational age. In other words, if a person has indicated that, in the event of an incapacitating accident or illness, they do not wish to be kept on life support, the state can disregard that directive in the interest of preserving fetal life. The Kansas plaintiffs argue that this is unconstitutional and violates equal protection, privacy, autonomy, and freedom of speech rights. Ethical and legal questions around end-of-life care for pregnant patients have been brought to the forefront of public discourse in recent weeks following reporting about a braindead pregnant woman in Georgia who is being kept alive in an attempt to gestate her fetus to viability. 

Trend and Policy Watch: 

• A Utah Study Ordered by Republicans Finds that Gender-Affirming Care for Minors is Safe and Effective:  

• Over two years ago, Utah Governor Spencer Cox put a “moratorium” on the provision of gender-affirming care for minors. At the same time, he ordered the Utah health department to undergo a systematic review of medical evidence around the safety and efficacy of such treatment. That review is now complete and publicly available, and its findings are clear – gender-affirming care is a safe and effective treatment for gender dysphoria. As reported by Mother Jones, the authors of the review summarized their findings in the following way: “[t]he consensus of the evidence supports that the treatments are effective in terms of mental health, psychosocial outcomes, and the induction of body changes consistent with the affirmed gender in pediatric [gender dysphoria] patients. The evidence also supports that the treatments are safe in terms of changes to bone density, cardiovascular risk factors, metabolic changes, and cancer…It is our expert opinion that policies to prevent access to and use of [gender-affirming hormone therapy] for treatment of [gender dysphoria] in pediatric patients cannot be justified based on the quantity or quality of medical science findings or concerns about potential regret in the future, and that high-quality guidelines are available to guide qualified providers in treating pediatric patients who meet diagnostic criteria.” 
  
  The Utah review’s findings contrast with guidance issued in a letter from the Department of Health and Human Services urging healthcare providers to follow a highly-criticized government-issued report, rather than existing clinical practice guidelines. The HHS report was produced in response to the Trump Administration’s executive order disavowing government support for gender-affirming care and referring to it as “chemical and surgical mutilation.” 
  

• Investigations into Miscarriages Continue: 

• Law enforcement in Toledo, Ohio are reportedly investigating fetal remains found at an apartment complex. The coroner examined the fetal tissue and found that it was nonviable and at an early stage of development–in other words, the remains of a miscarriage. Although this story on its own may not seem important, it is a part of an ongoing trend of law enforcement investigating women for miscarriages, and in some cases even arresting and charging women with crimes like abuse of a corpse. Just this week, a West Virginia prosecutor indicated that criminal charges could be levied against women who miscarry, depending on how they dispose of fetal remains. It is unclear at this time whether the investigation into the Toledo incident is ongoing; however, the fact that law enforcement was involved at all is cause for concern. 

• Texas Police Have Reportedly Used a Nationwide License Plate Tracking System to Track a Woman Who Self-Managed An Abortion:

• In Texas, the Johnson County Sheriff’s Office reportedly used a nationwide surveillance system comprising more than 83,000 license plate readers to try and track down a woman who self-managed an abortion. The search was initiated after the woman’s family contacted law enforcement with concerns that she would “bleed to death,” and it extended into states where abortion is legal. Although the sheriff involved stated that they were not attempting to stop the woman from leaving the state, reproductive rights advocates warn that such surveillance could be used to track, monitor and criminalize people traveling for abortion care. 

• Planned Parenthood is Shuttering Over 20 Clinics Across Seven States As it Faces Renewed Threats: 

• Planned Parenthood is reportedly shuttering over 20 clinic locations across seven states as it faces renewed threats, including loss of Title X funding and a reconciliation bill that calls for its ‘defunding.’ In Iowa alone, four of the six remaining clinics are set to close, including the one clinic that provides abortion services. The organization has been forced to lay off employees and limit services offered, impacting access to cost-effective healthcare for countless Americans. The CEO of Planned Parenthood North Central States, Ruth Richardson, gave the following statement: [w]e have been fighting to hold together an unsustainable infrastructure as the landscape shifts around us and an onslaught of attacks continues.”