As the political landscape shifts with the inauguration of President-elect Donald Trump and the commencement of state legislative sessions, significant alterations to abortion policies across the United States are anticipated. This follows the transformative events of 2022, when the U.S. Supreme Court’s decision to overturn Roe v. Wade empowered individual states to impose bans on abortion procedures.
Throughout the country, lawmakers have already introduced upwards of 400 bills related to abortion.
With President Trump set to take office once again on Monday, his administration is expected to bring a different approach to abortion compared to the current administration of President Joe Biden, who has consistently supported abortion rights.
Recent developments show that three states—Idaho, Kansas, and Missouri—are working to limit access to the abortion pill. This is noteworthy as an increasing number of abortions in the U.S. are now conducted via medication rather than surgical methods. A recent legal case aiming to restrict the availability of mifepristone, one of the two key drugs used in medication abortions, gained traction this past week. A federal judge ruled that the three states may continue their efforts to challenge the federal approval of mifepristone. They propose limiting its use to the first seven weeks of pregnancy, as opposed to the current threshold of ten weeks, and insist on requiring three in-person consultations with a doctor instead of permitting telehealth prescriptions. The states argue that these measures are necessary to uphold local abortion laws and support law enforcement initiatives.
Previously, the Supreme Court dismissed a similar challenge, asserting that anti-abortion doctors lacked the legal standing to contest the U.S. Food and Drug Administration’s decisions.
Additionally, abortion rights supporters are increasingly concerned over the potential for enforcement of the Comstock Act, a law from the 19th century that prohibits the mailing of materials related to abortion—a law that has not seen enforcement for nearly a century. Although Trump indicated he has no intention of limiting access to medication for abortion, he did leave the door open for future changes.
In a recent move, New Jersey joined the ranks of Democratic-led states that are accumulating stocks of abortion pills. States like California and Massachusetts have also begun similar stockpiling efforts. Conversely, an Indiana lawmaker has proposed legislation to make it illegal to ship abortion drugs to individual residents, a trend seen in several other states as well, aligning with the objectives of anti-abortion advocates.
In response to emerging ballot measures on reproductive freedom, seven states successfully passed amendments in November, indicating that more states might consider similar initiatives in upcoming years. Hawaii and Virginia have introduced proposals for reproductive freedom amendments slated for 2026, with Virginia’s measure recently passing the House of Delegates and awaiting Senate approval. Missouri, despite currently enforcing a total abortion ban, adopted an amendment supporting abortion rights last November, although a judge invalidated this ban, leaving clinic operations in question as advocates seek to remove additional restrictions.
As conservative legislators in states where abortion is currently banned are contemplating even stricter laws, proposals include serious consequences for women seeking abortions. For instance, an Oklahoma lawmaker is advocating a bill that could classify abortions as murder, a notion also previously proposed in South Carolina but which failed to advance. Meanwhile, Mississippi has moved forward with a bill that would penalize individuals assisting minors in obtaining abortions without parental consent, threatening up to life imprisonment—a harsher punishment compared to similar laws in Idaho and Tennessee.
In the realm of emergency healthcare related to abortions, the future remains uncertain. Biden’s administration had previously filed a lawsuit against Idaho to contest the enforcement of its abortion ban during medical emergencies. The Supreme Court ruled that abortions under such circumstances can proceed while legal discussions continue. However, the Trump administration is expected to withdraw from this lawsuit, while Idaho’s largest healthcare provider, St. Luke’s Health System, has initiated a legal challenge on related matters to keep this critical discussion alive.
