State Policy Trends: More Supportive Legislation, Even as Attacks on Abortion Rights Continue


The 2014 legislative session got off to a fast start, with legislators introducing a combined 733 provisions related to sexual and reproductive health and rights in nearly all the states that have legislative sessions this year (legislatures in Montana, Nevada, North Dakota, and Texas will not meet in 2014). See here for the full analysis of the first quarter of 2014.

Significantly, legislators quickly showed a clear interest in protecting or expanding access to sexual and reproductive health care. Some 64 provisions have been introduced so far this year to expand or protect access to abortion, more than had been introduced in any year in the last quarter-century. And only three months into the year, two new provisions protecting abortion rights have been enacted, and three others have passed one legislative chamber. Similarly, seven measures designed to expand access to other sexual and reproductive health services have passed at least one legislative body in six states and the District of Columbia.

As in recent years, however, state legislatures continued to take aim at abortion rights. Legislators in 38 states introduced 303 provisions seeking to limit women’s access to care. By March 31, three new abortion restrictions had been enacted, and 36 had passed one legislative chamber.

Expanding Access to Sexual and Reproductive Health Care

In 2013, California and Colorado enacted the first state laws since 2006 to protect and expand access to abortion services. The California law allows appropriately trained nurse-practitioners, physician assistants, and certified nurse midwives to provide first-trimester abortion services, while Colorado repealed its pre-Roe abortion ban. Building on that momentum, governors in two other states have already signed measures protecting abortion rights into law this year. Vermont repealed its pre-Roe abortion ban and Utah waived its counseling and ultrasound requirements when an abortion is necessary to protect the woman’s life or health or in cases of severe fetal impairment.

In addition, proactive measures have passed at least one legislative chamber in three additional states, including bills that would establish a 25-foot buffer zone around abortion clinics (NH); permit abortions until 24 weeks of pregnancy when the woman’s life or health is at risk (NY); and require insurance plans to cover abortion services if they cover maternity care (WA). Legislators in other states have also taken steps to expand access to sexually transmitted infection (STI) and family planning services (see the full analysis for details).

Restricting Access to Sexual and Reproductive Health Care

In sharp contrast, but mirroring the trend in recent years, legislators moved quickly to reduce abortion access as this year’s sessions opened: three laws were enacted in the first three months. Indiana accounted for two of these measures, banning nearly all abortion coverage in private insurance plans and also requiring inspections of abortion clinics at least once a year; South Dakota banned abortion for the purpose of sex-selection (see the full analysis for details).

Legislators in 16 states have introduced provisions that would conflict with U.S. Supreme Court holdings by banning at least some abortions prior to viability. Five of these measures have passed at least one legislative chamber. One of these five, a measure in West Virginia that would have banned abortion at 20 weeks post-fertilization (the equivalent of 22 weeks past the woman’s last menstrual period) was approved by the legislature only to be vetoed by Gov. Earl Ray Tomblin (D). This runs counter to the recent trend of signing so-called 20-week bans into law, which has occurred in 12 states over the last four years.

Several states have continued their attempts to enact burdensome and unnecessary requirements aimed at shutting down abortion providers (known as TRAP [targeted regulation of abortion providers] laws), which would require an abortion provider to have admitting privileges at a hospital within 30 miles and direct the state to develop standards for abortion clinics (OK).

In addition, five measures to expand existing counseling and waiting period requirements have passed at least one legislative chamber so far this year. These measures would lengthen existing waiting periods (AL and MO); mandate that pre-abortion counseling take place in person at least 24 hours in advance of the procedure, meaning that a woman would have to make two separate trips to obtain an abortion (KY); and require counseling about perinatal hospice care for women who are seeking an abortion because of a diagnosed fetal impairment (AL and OK). In addition, legislative chambers in three states that already require parental consent approved measures designed to make it even more difficult for a minor to obtain an abortion (AL, AZ, and MO).

Legislators have sought to limit access to abortion services in other ways by attempting to reduce access to medication abortion (OK and IA); banning abortion coverage in plans sold on the insurance exchange (GA); and requiring an ultrasound before a woman may obtain an abortion (KY).

Finally, legislators in several states have moved to impede access to other sexual and reproductive health services; some examples include measures that would: disqualify independent family planning clinics, such as those operated by Planned Parenthood, from receiving any family planning funds that flow through the state, including federal Medicaid reimbursement (MO); require minors younger than 17 to have a prescription to obtain emergency contraception (OK); and expand the ability of health-care providers to refuse to provide services (AL and MO).

See the full analysis for additional details.

Gewndolyn Rathbun and Yana Vierboom also contributed to this analysis.

For more information:

Guttmacher State Center
State Policies in Brief
State Policy Developments in 2013
Analysis: A Surge of State Abortion Restrictions Puts Providers—and the Women They Serve—in the Crosshairs

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