States emerge as guardians of reproductive freedom on the anniversary of “Roe”
Today marks the 52nd anniversary of the Supreme Court’s landmark Roe v. Wade ruling–and almost three years since it was overturned. Access to reproductive health services is now almost completely dependent on where you live, since federal protections against abortion have been removed. The decentralized state-by-state system has led to a confusing and dangerous patchwork of laws that forces millions of Americans into medically unnecessary restrictions and legal uncertainty. In some cases, their basic rights are outright banned. While some states have taken swift action to restrict reproductive rights, others have stepped in to protect and expand access. This shows that state leadership has become the frontline of the fight for reproductive liberty. Some women have had to flee their states to get medical treatment because of these laws. Mylissa Farmers was denied emergency abortion in Missouri and Kansas, and she left Missouri to seek treatment. Amanda Zurawski, who was refused medical care in Texas after her water broke when she was 18 weeks pregnant, nearly died from sepsis. Kate Cox, a woman from Texas, had to leave her state to have an abortion, despite the fact that her fetal condition and her health were grave. Josseli and Porsha Barnica in Texas, and Amber Nicole Thurman from Georgia died not by accident–they suffered the predictable consequences of life after Roe. In 2023, the Reproductive Freedom Alliance was formed. It is the first nonpartisan coalition of state governors dedicated to protecting and expanding reproductive rights. Through the Alliance, governors are coordinating efforts, sharing resources, and acting as the first line of defense against attacks on reproductive rights.
In the wake of the overturn of Roe, we’ve seen real progress in Alliance states, demonstrating the power of governors to take decisive action in protecting reproductive freedom through executive actions, budgetary authority, legislation, and regulation.
Since 2022, governors have enacted shield laws in 20 states, protecting patients and providers from out-of-state penalties and prosecutions. Governors recognize the important role that pharmacies play in providing access to medication abortion. They have urged major U.S. drugstore chains to not bow to political pressure by dispensing mifepristone. This reinforces their commitment to maintain access to care. Fast-approaching Alliance states have used Medicaid expansion, under the Affordable Care act, to cover contraception and increase access for low income individuals. States are also investing in training programs for providers to ensure that reproductive services remain accessible and available to patients, despite mounting restrictions elsewhere. Meanwhile, states such as California, Connecticut, Illinois, and Washington are strengthening privacy protections to prevent sensitive health records from being accessed or weaponized by anti-abortion states, ensuring that people seeking care can do so without fear of surveillance or retaliation.
Despite these actions, the threats to reproductive freedom are only growing. Anti-abortion politicians wielding majority influence in the White House, Congress, and the Supreme Court could push for a national abortion ban, override state protections, or weaponize obscure laws to restrict care nationwide.
That’s why the work of the Reproductive Freedom Alliance is more critical than ever. Governors can take decisive action to ensure Americans have access to care in their state, even if federal protections are uncertain. They can uphold shield laws to protect health-care providers and patients from out-of-state investigations, defend providers from politically motivated prosecutions, expand access to medication abortion and critical delivery points like telemedicine, and fight back against efforts to limit access to contraception and in vitro fertilization.
The post-Roe patchwork is chaotic, cruel, and unsustainable. Alliance governors have shown that there are ways forward. State leaders stand up for their residents, and they set an example of what reproductive freedom looks like. This battle is far from over. With bold leadership we can build a world where reproductive rights are respected and everyone has the freedom to choose the best decision for them and their family.
