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.
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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.