Abortion rights are effectively moot for millions of Americans

The future of Roe vs. Wade is now in doubt because the Supreme Court with a conservative majority 6-3 reported a desire to roll back abortion rights. On Wednesday, the nine judges heard oral arguments in Dobbs v. Jackson Women’s Health Organization (JWHO), regarding a Mississippi law that would ban abortions after 15 weeks of pregnancy. It would be a direct challenge for Roe deer and nearly 50 years of precedent that before fetal viability, the Constitution guarantees the right to abortion. Should the court decide in Dobbs v. JWHO that certain prohibitions on foreseeability are constitutional and / or annulled Roe deer, abortion rights could be left to states. More … than 36 million women—Almost half of women of reproductive age in the United States — as well as others who may become pregnant could lose access to abortion care.

But the Supreme Court doesn’t have to overturn Roe deer so that people are unable to exercise their right to abortion. As it is, although Roe deer is still in effect, the right to abortion is more theoretical than real for far too many people in the United States

Abortion is a common and safe healthcare procedure. One in four women in the United States will have one by the age of 45 according to current projections. But abortion opponents have been undermining the right to abortion ever since Roe deer, by adopting over 1,300 abortion restrictions at state and federal levels. One of the most serious is the recent Texas SB 8 ban on abortion. It prohibits abortion from the sixth week of pregnancy, making the right to abortion under Roe deer effectively meaningless. One in 10 women in the United States of childbearing age live in Texas and have had their abortion rights suspended by this law.

But it’s not only gestational age prohibitions like the one in Texas which puts abortion care out of reach. A whole range of restrictive state laws combine to restrict access to abortion and make abortion rights under Roe deer effectively irrelevant, of targeted restrictions on abortion providers (or TRAP laws) and other medically unnecessary requirements such as mandatory counseling and waiting periods, to laws allowing health care providers to deny a person abortion care on behalf of religion. Individually, all of these laws are harmful, but as a new research paper “Beyond Roe deer“found, together, they form a hostile environment that makes exercising the right to abortion virtually impossible in many places in the United States

Participants hold placards at the Women’s March “Hold The Line For Abortion Justice” at the United States Supreme Court on December 1, 2021 in Washington, DC
Shannon Finney / Getty Images for Women’s March Inc.

Abortion restrictions place logistical and financial burdens on patients already facing systemic barriers to healthcare, compounding existing inequalities. For example, due to structural racism and income inequality, Blacks, Indigenous Peoples and People of Color (BIPOC) have a higher likelihood of being eligible for Medicaid and other public health coverage by compared to their white counterparts. This means that they are disproportionately affected by the Hyde Amendment and insurance cover prohibitions excluding abortion care from coverage. These restrictions leave those seeking abortion services with no choice but to pay out of pocket, a health expense that many can’t afford.

Being denied an abortion or not having access to abortion care has long-term consequences for health and economic outcomes. The Diversion study, a 10-year longitudinal study of women seeking abortion care at 30 facilities in the United States, found that women who were denied an abortion were more likely to experience economic hardship and insecurity for years than women who have had an abortion. It also exacerbates existing health disparities, including those that exist in maternal health.

Abortion restrictions are causing clinics to close, forcing people to travel longer distances to reach an abortion provider, which is associated with delays in care, lost wages and costs higher (for childcare, transport, accommodation). This is weighing not only on patients, but also on providers in neighboring states unable to meet growing demand. In Texas, some patients are forced to drive almost 250 miles a way, across the state border, to access abortion services. But this is not a realistic solution for many.

We can no longer count on the Supreme Court to confirm Roe deer. Roe deer was never enough to protect abortion rights for all anyway. For that to happen, we need to do more than keep abortion legal on paper; we must ensure the practical capacity to exercise abortion rights. This is something Congress can do by passing new laws, two of which are currently pending. The Women’s Health Protection Act ensure that access to abortion is a reality for all, free from medically unnecessary restrictions and prohibitions, no matter where they live. The Equal access to abortion coverage in the health insurance law would repeal the Hyde Amendment and restrictions on abortion coverage.

Theoretically, at least for now, abortion remains legal in the United States. It is true whether the Supreme Court invalidates or not Roe deer.

Bridget Kelly is a research director at the Population Institute, a Washington, DC-based nonprofit that supports reproductive health and rights.

The opinions expressed in this article are those of the author.

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