Despite the looming threat that the U.S. Supreme Court will overturn Roe v. Wade this summer, Andrea Miller, president of the National Institute for Reproductive Health, does not want to dwell on gloom and doom.
Instead, she’s opting to focus on the significant expansion of reproductive health care that has been unfolding in states eager to protect choice and ensure that anyone who wishes to end a pregnancy can do so safely and easily.
“Turning this around and making lasting change will require good infrastructure on the ground. That’s happening.”
“One of the untold stories, because we’ve been so fearful and focused on the Supreme Court, is that 2021 was a watershed year for reproductive health and justice,” Miller tells The Progressive. “Ten states passed fourteen laws that solidify abortion rights or expand the availability of care.”
For example, Illinois repealed its parental notification requirement for minors, Virginia rolled back its ban on private insurance coverage through the state’s health insurance exchange, New Mexico repealed a 1969 law that criminalized abortion, Hawaii passed a bill to allow advanced practice registered nurses to perform first trimester terminations, and Connecticut passed legislation to prohibit anti-choice Crisis Pregnancy Centers from deceptive practices in advertising and counseling.
At the city level, Austin, Texas; Portland, Oregon; and New York City have allocated municipal money to help regional abortion funds cover travel, lodging, food, and other costs for patients.
Miller calls these shifts a “creative ratcheting up” of access and says that a half-dozen additional states and cities are currently considering ways to advance reproductive health. “Every community needs to look at what their needs are and build access to clinical care and medication abortion,” she argues. “The critical thing now is that there are lots of people, including elected officials, who are looking for a real opportunity to make a difference.”
New Jersey is a possible—albeit limited—model thanks to the newly-signed Freedom of Reproductive Choice Act.
THRIVE, a New Jersey coalition of more than forty groups, is working to build on the act, which was signed into law by Governor Phil Murphy in January.
The act codifies the right to abortion throughout New Jersey, ensuring that pregnant people can end unwanted pregnancies regardless of Supreme Court rulings to limit or eliminate Roe-enabled protections. It was the fifteenth state to pass this type of safeguard.
Other changes were also put in place. A second bill to expand insurance coverage for birth control was signed by Murphy. What’s more, the bill authorized the state’s Department of Banking and Insurance (DOBI) to study the efficacy of mandating that every insurance carrier provide abortion coverage.
And, in October 2021, the New Jersey State Board of Medical Examiners unanimously voted to adopt new rules to eliminate the medically unnecessary regulation of clinics—commonly referrred to as Targeted Restriction of Abortion Provider, or TRAP, laws—that force facilities to operate as ambulatory surgical centers. Lastly, the state repealed a requirement that banned doctors from providing in-office abortions after fourteen weeks of pregnancy, and cleared a path to enable advanced care professionals—nurse practitioners, physician’s assistants, and midwives—to perform first trimester surgeries.
Roxanne Sutocky, director of community engagement at the Women’s Centers, a five-clinic chain with offices in Connecticut, Georgia, New Jersey, and Pennsylvania, and a member of THRIVE-NJ, tells The Progressive that, though the Freedom of Reproductive Choice Act is a step forward, much remains to be done to ensure full reproductive justice to state residents.
“Although New Jersey does not have as many restrictions or barriers to access as other states . . . financial and logistical barriers continue to exist,” Sutocky explains. “A bill first introduced in December 2020, called the Reproductive Freedom Act, would have guaranteed funding for people without health insurance, including the undocumented, to help them meet their needs for abortion or contraception, and would have set firm deadlines and allocated resources for the DOBI survey. The Freedom of Reproductive Choice Act does not do any of this.”
THRIVE-NJ members are continuing to push for these protections while simultaneously keeping a watchful eye on abortion and contraceptive availability in other parts of the country, topics that are sure to come up in November’s midterm elections. They’re also keeping an eye on SCOTUS since an abortion ruling will likely be announced this summer.
“Should the Supreme Court overturn or seriously gut Roe, approximately half the states will oppose abortion bans,” says Miller of the National Institute for Reproductive Health. “About one-third will offer explicit protections to pregnant people wishing to abort. The rest of the ban-opposing states will likely offer some protections but also impose some restrictions on when, where, and by whom an abortion can be provided. But the reality is that at least twenty-one states will likely ban abortion.”
This, Miller adds, will cause tremendous hardship to those who have the fewest resources and are in the most desperate situations.
Yet despite this grim assessment, Miller remains cautiously optimistic. “Turning this around and making lasting change will require good infrastructure on the ground. That’s happening,” she says. Over the past few years, beginning right after Donald Trump took office, people began getting mobilized. There is now greater awareness of the threat to abortion access and a growing acknowledgement of the importance of being involved at the state and local levels.”
“Even in places where abortion is already badly restricted, there’s been a tremendous effort to figure out how to help people get the care they need,” Miller says. “There’s a lot of momentum and no limit to what people can do once they step up.”