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Fractured access to abortion sets a backdrop for upcoming Supreme Court ruling


Over the weekend, Maryland joined 14 other states when it approved a bill that lets medical professionals other than physicians perform abortions. Other states like Oklahoma have moved toward a near-total ban on abortions. The fractured access sets a backdrop for the Supreme Court as it moves closer to ruling on a Mississippi law that bans abortions after 15 weeks of pregnancy. It's a case that abortion rights defenders fear could undo the precedent set by Roe v. Wade. Joining me now is Elizabeth Nash. She is with the Guttmacher Institute, where she's a principal policy associate following state reproductive rights policies. Elizabeth, good morning.

ELIZABETH NASH: Good morning.

FADEL: So is the apparent momentum behind these state efforts to limit abortion access exclusively about the 6-to-3 conservative majority on the high court? Or is this an indication of a popular groundswell?

NASH: Well, really, what we have been seeing over decades is that state legislatures in particular have become more conservative, and so they've been passing abortion restrictions for a very long time. What really has changed, though, is the Supreme Court. And so all eyes are on the Supreme Court, whether the states are conservative or progressive, and we're seeing that in what's happening right now, right? We're seeing how, you know, the Texas ban has gone into effect, how this Mississippi case is playing a huge role in what's happening in state legislatures. And so - right? So we're looking right now at Idaho. They passed a six-week abortion ban along the lines of Texas.

FADEL: Right.

NASH: You know, that's in court right now. We're seeing states like Arizona, Florida, Kentucky, all look at 15-week bans. Oklahoma is looking at a total ban. So, yes, the Supreme Court is playing an increasing - a very important role here as states look to further limit access to abortion care.

FADEL: And when it comes to access, is this a strict party-line battle?

NASH: It really has become so. You know, what you see in the conservative - really, Republican-controlled state legislatures is very different than what you see in the Democratically controlled legislatures. You know, like you were just talking about in Maryland, the bill that was just - had the veto override, you know, it - yes, it allows advanced practice clinicians to provide abortions, like physician assistants and certified nurse midwives.

FADEL: Right.

NASH: But also, it sets up a fund to help train providers, and it ensures that health coverage, whether it's public or private, covers abortion. You know, other states like California, Colorado - you're looking at states like Delaware, Oregon. All of them are moving bills to help protect abortion rights and abortion access, particularly if people are coming from other states.

FADEL: What's the role of the lower courts in these new restrictions?

NASH: You know, what we generally have been seeing over the past several years is that they are following Supreme Court precedent. They have been enjoining laws. It's when you start getting up to the appellate level - and then, of course, the Supreme Court is where we have been seeing abortion restrictions being upheld.

FADEL: Yeah.

NASH: And this is a real - this is a serious problem because the less access we have means that people's rights are being trampled.

FADEL: So speaking about that, I mean, what are the real-life consequences for pregnant individuals who are confronted by this new legal environment?

NASH: Yeah. So, you know, let's look at Texas for a second. You know, Texas has a six-week ban in effect, as you were talking about with the Lizelle case. You know, that ban has meant that if possible - and not everyone can leave the state. If possible, people are leaving the state to access care. So if you go to Oklahoma before the six-week ban went into effect, you had a wait of maybe 2 to 3 days to get an appointment. Now those waits are looking at more like 3 to 4 weeks.


NASH: And many Texas patients are driving, perhaps, maybe up to a week from their home to the clinic and back. So what you're talking about is adding hundreds of dollars to the cost of an abortion. And abortion on average costs about $550. Then you're talking about taking this extended time off of work - that might not be possible if that is not paid for. So what do people do when they have these additional expenses and may not be able to get the time off? And of course, this obviously burdens people with low incomes and Black and brown people the most, who face the most difficulty in accessing health care.

FADEL: Yeah. Elizabeth Nash with the Guttmacher Institute. Thank you so much for your time.

NASH: Thank you. Transcript provided by NPR, Copyright NPR.