Pamela Hill speaks about the need to restore access to abortion care at a news conference for the Arizona Abortion Access Act in Phoenix, on July 3, 2024. Hill received an abortion as a teen, when the procedure was illegal, and because of her provider’s lack of experience and training, she suffered from painful fertility issues for many years afterwards. Photo by Gloria Rebecca Gomez | Arizona Mirror
Heading into the third year since Roe v. Wade was overturned, states will continue to introduce and consider legislation to expand or restrict access to reproductive health care and abortion as legislative sessions begin. In anticipation of President-elect Donald Trump’s return to the White House in January, states with broad reproductive rights protections have introduced bills to shield patients and doctors if the incoming Republican administration overturns protections implemented under President Joe Biden. States with strict bans, meanwhile, have started floating fetal personhood bans, abortion pill punishments and other restrictions.
Most legislatures will convene during the second week in January or later and adjourn midway through the year. Arizona’s legislative session is set to begin Jan. 13.
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California tries to protect abortion pills and medical privacy
On the campaign trail, Trump insisted he would not sign a federal abortion ban and even criticized some strict state laws. But the fate of a host of federal abortion-related policy and lawsuits now rests with Trump and his appointees.
National anti-abortion groups are lobbying the incoming Trump administration to implement a long list of regulatory measures, including revoking a Biden-era rule that requires emergency health workers to stabilize pregnant patients even if treatment involves an abortion procedure.
Anti-abortion leaders told States Newsroom they are especially focused on lobbying the U.S. Department of Health and Human Services to restrict medication abortion and prohibit its use via telemedicine. Trump’s nominee for HHS secretary, Robert F. Kennedy Jr., has previously defended abortion rights, but anti-abortion activists are trying to appeal to Kennedy’s outspoken skepticism of pharmaceuticals, arguing that negative health and environmental side effects of abortion drugs were insufficiently tested, which the U.S. Food and Drug Administration has disputed. Kennedy recently signaled he is open to restricting the medications.
Ahead of the new year, California Democrats introduced several bills to safeguard medication abortion and enforce the state’s Reproductive Privacy Act, which ensures the right to make reproductive care decisions without government interference.
Assembly Bill 40 would include emergency abortion and reproductive health services in the definition of “emergency services and care”; Assembly Bill 45 would prohibit providers from releasing patients’ abortion-related medical information to other states; and Assembly Bill 54 would shield abortion-pill manufacturers and distributors and health professionals from legal and professional liability.
Bills to restrict abortion drugs
In Texas, where abortion was banned in 2021, Republican lawmakers and law enforcement officials have signaled they are cracking down on abortion drugs, which are often mailed from states with so-called shield laws to states with abortion bans. Texas set up an interstate legal battle in December, when Republican Attorney General Ken Paxton sued a New York doctor accused of prescribing abortion pills to a Texas woman via telemedicine.
In November, Republican Texas Rep.-elect Pat Curry introduced House Bill 1339, which would classify mifepristone and misoprostol as controlled substances, despite the FDA determining the drugs are safe.
The bill is similar to a Louisiana law enacted last year, over which health care providers have sued, saying the measure requires stricter storage and documentation that could delay care for patients in emergency situations. It was sponsored by Republican Louisiana Sen. Thomas Pressly, whose pregnant sister was given abortion-inducing medication against her knowledge by her ex-husband.
Anti-abortion groups have been building the narrative that more state legislation targeting abortion drugs is needed to address coerced or unwanted abortions. The Charlotte Lozier Institute, an anti-abortion research think tank behind retracted abortion-pill research, claims unwanted or coerced abortion is a “hidden epidemic,” based in part on their 2023 study of surveyed women. Their finding that “nearly 70% of abortions are coerced, unwanted or inconsistent with women’s preferences” lumps in women who said their abortion was “unwanted or coerced” (24%) with women who said their abortions were “accepted but inconsistent with their values and preferences” (43%).
The Heritage Foundation, the conservative group behind a set of policies known as Project 2025, has gathered several examples of abortion pills given to pregnant women without their consent. To combat the problem, they recommend states ban telemedicine and mail-order abortion pills and strengthen or enact laws targeting abortion coercion. Kansas passed a law in 2024 making it a felony to force a woman to end a pregnancy, overriding the governor’s veto.
Lawmakers push bills to establish fetal personhood
In 2025, states with abortion bans are expected to push for explicit fetal rights in the law.
In Oklahoma, abortion is banned under a 1910 criminal law that calls for two to five years in prison. House Bill 1008, introduced by Republican Rep. Jim Olsen, would grant protections for fetuses and make abortion a felony crime for health care providers, punishable by up to $100,000 in fines and/or 10 years imprisonment. The proposed bill only allows abortions if the provider “judges the birth of the baby to be a threat to the life of the pregnant woman.”
Tennessee already has a strict abortion ban with some health exceptions. But House Bill 26, introduced by Republican state Rep. Gino Bulso, would take the law much further. It declares “human life begins at fertilization,” says “an unborn child is entitled to the full and equal protection of the laws that prohibit violence against any other person,” and makes it a federal crime under the Comstock Act — punishable by up to $5 million — to mail or deliver abortion pills. Bulso also introduced House Joint Resolution 7, to amend the state constitution to affirm equal protection rights for “every human being from fertilization to natural death.”
Legislation to expand, protect and restrict abortion access following ballot initiatives
As ballot initiative organizers have told States Newsroom, beliefs about abortion rights in America don’t neatly align with partisan leanings.
There was no better demonstration of that phenomenon than during the 2024 presidential election, when voters in states that favored Trump also voted to protect abortion access, some by overwhelming margins.
Policy questions related to abortion were on the ballot in 10 states in November — including Arizona — which was one of seven states that voted to pass their measures. The three states where measures failed were Florida, Nebraska and South Dakota. Though 57% of Florida voters favored the side to restore access, the state constitution requires 60% for an amendment to pass.
In Nebraska, a competing amendment to keep abortions limited to the first trimester, roughly 12 weeks’ gestation, triumphed over an amendment that would have protected abortion access until fetal viability in the state constitution. But Nebraska’s abortion-rights measure did not fail as miserably as South Dakota’s effort to enshrine abortion access in the first trimester, rejected by nearly 59% of the state’s voters.
But in Arizona, voters overwhelmingly approved a measure to restore abortion access, and a slim majority in Missouri did the same, although clinics are still waiting for the courts to determine whether they can start offering abortion care again. In Montana, where abortion access has been largely uninterrupted since the Dobbs v. Jackson Women’s Health Organization decision, the electorate approved a measure spelling out the right to an abortion as part of reproductive health care, prohibiting government interference before viability. Similarly in Nevada, 63% voted to add the right to their constitution, although it won’t become official unless voters approve it again in 2026.
In all of those states, Trump took the electoral college vote. After voters showed their support for the restoration of abortion rights in Arizona, Gov. Katie Hobbs, along with other Democrats and pro-choice advocates, called for the state to repeal remaining abortion restrictions and related laws that are still on the books, including a 2010 law that requires the state to publish an annual abortion report.
States that already had broad abortion access, including Colorado, Maryland and New York, passed measures expanding it further. Colorado will require insurers to pay for treatment, Maryland added the right to its state constitution, and New York prohibited discrimination because of pregnancy.
At least one state will attempt to qualify an abortion ballot question for the 2026 midterms. Idahoans United for Women and Families launched in April and filed its ballot titles for approval in August. Melanie Folwell, the group’s spokesperson, told States Newsroom that signature gathering will likely begin in late January, and the group has already raised $321,000. Folwell said more than 500 people have signed up to volunteer and help collect signatures.
Legislation to return some access in states with abortion bans
North Dakota is in limbo after a district judge struck down the state’s abortion ban in a September ruling, calling the law unconstitutional. The state quickly appealed to the North Dakota Supreme Court, which recently heard arguments to determine whether abortions can legally take place while they consider the appeal. The ban made all abortions illegal, with exceptions for “serious health risks” or cases of rape or incest, but only if the person had been pregnant for less than six weeks.
Amid the legal wrangling, medical school professor and Republican state Rep. Eric Murphy proposed a bill that he says would offer a middle ground based in science for abortion access in the state, North Dakota Monitor reported.
The legislation would allow abortions for any reason through 15 weeks of pregnancy, since most people don’t know they’re pregnant for several weeks and should have time to decide whether they want to continue the pregnancy, Murphy said. Between weeks 16 and 26, abortions would be permitted if a committee of three doctors determined it was medically necessary. The bill would allow doctors to perform abortions for emergency health reasons at any time without the committee’s approval.
This type of model is in place in other states such as Alabama, but the exception is rarely utilized by medical professionals for fear of their decision being questioned or prosecuted, threatening their medical license or freedom. Although the Monitor noted a recent poll showed 55% of North Dakotans oppose the state’s abortion ban, fellow Republican lawmakers say Murphy’s bill is likely going nowhere in the upcoming legislative session.
Efforts to improve maternal health, pregnancy rights
While some states remain focused on abortion restrictions, others are turning attention to maternal health care, particularly for people of color and those living in rural areas, and extra protections for individuals in states with abortion access.
Lawmakers in Michigan’s Senate advanced a package of eight bills called “Momnibus,” a play on “omnibus,” aimed at improving maternal health outcomes and decreasing racial disparities in health outcomes during pregnancy, Michigan Advance reported. Among them, Senate Bill 819 would require a government agency to take reports of obstetric violence or racism. The legislative body is also pushing through a bill to protect reproductive health care data.
Virginia lawmakers are also preparing to consider maternal health care bills that would include remote monitoring services for some high-risk patients in rural areas, as well as an expansion of Medicaid, according to Virginia Mercury. In Kentucky, a state with a near-total abortion ban, there is also a push to establish special insurance coverage periods two years postpartum, recruiting more people of color to medical teams, hiring more doula workers for care teams and more, Kentucky Lantern reported. In California, there’s a proposal to reimburse alternative birth centers under state Medicaid.
Texas legislators may also debate passage of a package of proposals aimed at addressing maternal health care in rural areas. Almost half of all Texas counties offer no maternity care services, according to Texas Tribune, and living in a “maternity care desert” contributes to delayed prenatal care, increased pregnancy complications and worse delivery outcomes.
New Jersey Monitor reported a bill that would allow workers to take between seven and 21 days of leave for the death of a child, miscarriage, stillbirth or other related reproductive losses faces one more hurdle in the state senate before it may become law.
***Contributing reporting by the Arizona Mirror’s Caitlin Sievers.
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