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Graphic Truth: Abortion meds in SCOTUS case are crucial
The US Supreme Court heard arguments on Tuesday on whether access to mifepristone, an oral drug used to terminate a pregnancy, should be restricted. The drug works by blocking progesterone, a hormone that’s necessary for a pregnancy to continue. The case centers on whether changes the FDA made in 2016 and 2021, which broadened access to the drug, should be rolled back.
How far does Biden’s executive order on abortion access go?
Having faced mounting criticism from many Democrats for his tepid response to the recent Supreme Court ruling overturning Roe v. Wade, US President Joe Biden hit back Friday, issuing an executive order protecting some abortion rights.
Against the backdrop of the grand Roosevelt Room at the White House, Biden set out his administration’s plan to enhance sexual and reproductive health access for American women and girls, particularly those living in states where the procedure is outlawed in all or most circumstances.
Biden’s plan has a robust legal component. The White House is leveraging the full weight of the national legal apparatus – led by Attorney General Merrick Garland – to ensure lawful protection for women who access abortion pills and contraceptives or travel out of state for abortions.
Along with the White House counsel, the Department of Justice will work with a team of pro bono and private lawyers to protect medical practitioners and third parties involved in facilitating abortion care in states where it is banned – as well as for residents who seek abortions across state lines and face potential legal prosecution when they return to red states.
Still, details of the order remain scarce. The White House has directed the secretary of health and human services to come up with some sort of plan on how to preserve access to medical abortions (pills) and intrauterine devices, a form of reversible birth control, and report back within 30 days.
Moreover, Biden also said that the White House will work to protect user data on period and cycle trackers by cracking down on tech companies selling data to third parties, though it would certainly need Big Tech’s cooperation to work.
Biden’s move is unlikely to placate many Democrats who have been pushing him to go further, including by opening up federal property to abortion providers in states where the procedure is banned, thus shielding them from prosecution.
But Biden – a measured, middle-of-the road politician – has so far rebuffed those calls; he says this would be legally questionable. Besides, such blow-it-up tactics aren’t really his style.
To be sure, Biden himself has acknowledged that this isn’t significantly going to move the needle on enhancing abortion access in America: “Let me be very clear and unambiguous,” he recently said, “the only way we can secure a woman’s right to choose and the balance that existed is for Congress to restore the protections of Roe v Wade as federal law. No executive action from the president can do that.”
So what’s his message to American women? Repeatedly during the Friday press conference, he instructed voters to head to the ballot box this November and vote for pro-choice representatives so that Congress can pass a law codifying abortion rights. Many voters, however, might not take kindly to being told to fix this problem, particularly after Democrats flocked to the polls in droves in 2020, delivering Biden a Democratic-led House and Senate.Mother and daughter outside the US Supreme Court.
Abortion pills are the next frontier
Roe v. Wade is dead, but the abortion debate in America lives on.
Since it became clear two months ago that the demise of the landmark 1973 decision was inevitable, the contours of the abortion debate have shifted.
Even before Roe’s reversal by the Supreme Court on Friday, access to surgical abortions – those involving a vaginal procedure – had already been severely curtailed in many parts of the country. Now they will be very difficult to obtain in at least half of all states. As a result, medical abortions – a less invasive method that involves swallowing a pill – have become the new frontier in the battle over reproductive rights and access in America.
What’s the nature of the increasingly combustible debate over abortion pills and what’s at stake?
Abortion by the numbers. Most abortions performed in the US – at least 90% – occur within the first trimester of pregnancy (up to around 12 weeks gestation). And most performed within the first trimester – around 54% – are medical abortions, meaning a woman takes medication, typically a two-pill regimen of mifepristone and misoprostol, in her home or doctor’s office.
How they work: mifepristone – the first abortion pill approved by the US Food and Drug Administration in 2000 for up to 10 weeks gestation – stops the body from producing progesterone, a chemical needed to maintain a healthy pregnancy. Misoprostol, usually taken around 36 hours later, causes contractions that help expel remaining fetal tissue from the body to avoid sepsis.
Crucially, amid the pandemic, the Biden administration lifted a provision requiring in-person consultations for medication abortions nationwide, allowing doctors to prescribe the pills during telemedicine consults before sending them directly to patients’ homes.
What do red states plan to do about it?
Now that Roe v. Wade has been gutted, giving states the power to decide laws surrounding abortion care and causing the immediate closure of abortion clinics in dozens of states, many Republican lawmakers have their sights set on banning medications that induce miscarriage.
Texas, for instance, passed a law last year banning doctors from prescribing abortion pills to women past seven weeks of pregnancy or from mailing pills to a patient at any time during pregnancy. In total, 19 states have enforced similar laws aimed at severely curtailing access to abortion pills.
Laurence Tribe, a constitutional law professor at Harvard Law School, thinks that states will go after abortion pills with gusto.
“Some states will predictably attempt to intercept FDA-approved pills sent from out-of-state medical providers and will attempt in other ways to thwart access to medical abortions in efforts to give extraterritorial effect to the moral and religious views embodied in their internal anti-abortion laws to substances and services, including telemedical advice,” Tribe tells GZERO by email.
But Tribe notes that many of the efforts “will certainly be subject to challenge under the Supremacy Clause of Article VI, the so-called ‘dormant Commerce Clause’ of the Constitution" that says states can’t place undue burdens on interstate commerce, making future litigation all but inevitable.
Still, enforcement of these rules will be tricky. Looking ahead: a medical provider who prescribes abortion pills to someone in a state where the procedure is outlawed would indeed be violating state law. So, if a Manhattan-based doctor sends abortion medication to a Dallas resident in her ninth week of pregnancy, the physician could be charged with a felony under Texas law.
But there are workarounds, and many women in conservative-leaning states have worked with medical providers in blue states to set up virtual mailboxes, making it harder for authorities to track mail routes and hand out criminal penalties.
To be sure, women living in states with severely curtailed abortion access have already been obtaining pills from European providers that work with pharmacies – many in India – to send abortion drugs to the US. But this is also a risk because, while it isn’t a highly enforced law, it is illegal under federal law for Americans to import drugs from overseas for personal use. So this is far from a foolproof solution.
Many red states say they will crack down on the abortion pill mail trade. But can they? Technically, no. The US Postal Service abides by federal law and therefore can’t seize federally approved medications sent by licensed practitioners. But given the mishmash of legalities nationally, hyper-motivated states will look for ways to produce the legal documents – such as warrants – needed to intercept mail of those suspected of abortion-related crimes.
So, what comes next? “The litigation spawned by these challenges is bound to end in the Supreme Court in the relatively near term, but not necessarily in the coming year or even two, during which the litigation is likely to be winding its way up the judicial ladder,” Tribe says.
In the meantime, the fierce abortion debate will rage on, tearing the country further apart.
US Supreme Court upends Roe v. Wade
The justices have spoken. After weeks of speculation following the leak of a draft opinion in early May, the highest court in the land has reversed the landmark Roe vs. Wade ruling that had legalized abortion in 1973.
“The Constitution does not confer a right to abortion; Roe and Casey are overruled; and the authority to regulate abortion is returned to the people and their elected representatives,” the decision read.
Background. The Supreme Court ruling is the culmination of a decades-long project by the Republican Party and conservative lobbyists to undo Roe and its affirmation in the 1992 Planned Parenthood v. Casey case, which said that states cannot enforce laws that place an “undue burden” on women seeking abortions.
Why now? After Mississippi enacted a law banning abortions in most cases in 2018, the state’s sole remaining abortion clinic took the case to court, saying it violated the premise of Roe v. Wade. The initial ban was blocked by a federal judge before reaching the Supreme Court.
Trump’s court. The conservative majority that overturned the half-century-old precedent on abortion law will be one of Trump’s most enduring legacies. On the campaign trail in 2015 – and hoping to woo Evangelical voters – Donald Trump vowed to appoint Supreme Court justices who would overturn Roe. Unsurprisingly, all three of Trump’s conservative appointees – Justice Neil Gorsuch, Justice Brett Kavanaugh, and Justice Amy Coney Barrett – voted in favor of gutting the law.
The ruling will now kick off an ugly battle within states over abortion rights. While women living in Democratic states – including New York, California, and Illinois – will continue to have access to safe and legal abortions, women in the South and Midwest could have to travel hundreds or thousands of miles to terminate pregnancies. Burdened by financial and family commitments, many women won’t be able to afford to take time off work to travel over state lines for the procedure – a process that can take several days due to onerous state laws.
Already, 13 states have “trigger laws” on the books that will outlaw abortions almost immediately. And the procedure is likely to be outlawed in another dozen states in the near term, pending ongoing legal proceedings.
The regional picture. The timing is remarkable considering that many countries in the Americas – home to some of the most restrictive abortion laws in the world due to the pervasive influence of the Catholic Church – have dramatically liberalized their abortion laws.
The Marea Verde (Green Wave) that swept Latin America in recent years renewed calls for the enhancement of sexual and reproductive freedoms, and the strategy of mass mobilization worked. In Argentina, abortion was legalized in December 2020, marking the first time that women in that country could legally terminate their pregnancies in over a century. Similarly, Mexico’s Supreme Court decriminalized the procedure last fall, giving rise to a host of legal shifts across states, a move recently followed by Colombia's Constitutional Court.
That Green Wave was inspired by Roe, which is now in the past.
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- What happens after Roe v. Wade is overturned? - GZERO Media ›
- Why do Americans get so worked up about abortion? - GZERO Media ›
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Roe v. Wade has been overturned. What does it mean for the country?
Roe v. Wade has been overturned. What does it mean for the country?
The Supreme Court’s conservative majority ruled on Friday to overturn Roe v. Wade, the landmark 1973 decision that enshrined abortion as a federal constitutional right.
“Roe was egregiously wrong from the start,” the decision penned by Justice Samuel Alito in Dobbs v. Jackson Women’s Health Organization to overrule precedent and uphold Mississippi’s 15-week abortion ban reads. “It is time to heed the Constitution and return the issue of abortion to the people’s elected representatives.”
Four other conservative justices—Amy Coney Barrett, Brett Kavanaugh, Neil Gorsuch, and Clarence Thomas—voted with Alito to overturn Roe, while all Democratic-appointed justices—Elena Kagan, Sonia Sotomayor, and Stephen Breyer—plus Chief Justice John Roberts dissented.
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The ruling in Dobbs shouldn’t come as a surprise to anyone who’s been paying attention. Abortion up until fetal viability (now around 23 weeks of pregnancy) has been legal in the entire United States for nearly 50 years, first established in Roe and reaffirmed in 1992 by Planned Parenthood v. Casey. Since then, however, opponents of legal abortion have been diligently working to reverse these decisions, spending billions to lobby for anti-abortion policies, elect anti-abortion candidates, and appoint anti-abortion judges.
Their efforts paid off: the Supreme Court has a 6-3 conservative majority, federal courts are packed with conservative judges, and Republican states have passed a slew of laws curtailing abortion rights. While for years SCOTUS had sidestepped the issue of Roe’s constitutionality despite numerous challenges, abortion opponents got a major win in December 2021 when Texas’s so-called “heartbeat” act outlawing abortion after 6 weeks of pregnancy (enforced by private individuals through civil lawsuits rather than by state officials) was allowed to stand by the highest court. At the time, many legal analysts warned this decision signaled that the end of Roe was near. They were right.
Where Americans stand on abortion
It depends on the question you ask. Polls show the vast majority of Americans (90%) believe abortion should be legal in some circumstances and illegal in others. That includes majorities of both Democrats (65%) and Republicans (79%). Six-in-ten Americans say abortion should be legal in all or most cases, while 37% believe it should be illegal in all or most cases. Fewer than one-in-ten Americans think abortion should always be illegal, while 19% say it should be legal in every case without exception.
In Republican-leaning states, especially in the South and Midwest, support for abortion is low. Women and younger Americans are more likely to support legal abortion. Notably, nearly half (47%) of Republicans under 30 say that abortion should be legal in all or most cases.
Most Americans believe abortion should be legal in the first trimester of pregnancy—which in 2019 comprised 93% of all abortions—after which opposition to abortion rises significantly among even supporters of legal abortion. (Roe legalized abortion up until fetal viability, which is currently around 23 weeks, or well into the second trimester.) And most Americans, including majorities of Democrats and Republicans, say abortion should be legal if the pregnancy threatens the mother’s life or if it’s a result of rape.
Many Americans hold seemingly contradictory views about the issue. For instance, about one-third say that “the decision about whether to have an abortion should belong solely to the pregnant woman” at the same time as they believe that “human life begins at conception, so a fetus is a person with rights.” Among supporters of abortion rights, one-third believe life begins at conception (33%), while a majority believe the timing of abortion should matter in determining its legality (56%). Meanwhile, 41% of those who oppose abortion rights say pregnant women should have some or all the power to decide whether to have an abortion.
The consequences of reversing Roe
For starters, abortion access will be drastically curtailed across large swaths of the nation, especially in the South and Midwest. Because individual states will be allowed to decide whether to protect, restrict, or ban abortion, the implications will be radically different in red and blue parts of the country.
In anticipation of the ruling, many Republican states have spent the last few months passing anti-abortion laws due to come into force as soon as Roe is overturned. For their part, Democratic states have been preemptively enshrining abortion protections in state law. According to the Guttmacher Institute, 13 states already have “trigger laws” on the books that would automatically and immediately outlaw abortion, while another 13 states are likely to heavily restrict or ban the procedure in short order. These 26 states are home to more than half of all women of reproductive age in the United States, nearly all of whom came of age while abortion was legal nationwide.
Studies show that abortion bans don’t reduce the incidence of abortion. Instead, abortions simply become more dangerous for women. According to the World Health Organization, 23,000 women die globally each year from unsafe abortions and tens of thousands more suffer significant health complications. Banning abortion will also lead to an increase in the number of pregnancy-related deaths, as carrying a fetus to term is often lethal for women. The maternal mortality rate in America is two times higher than in any other industrialized country.
Abortion restrictions disproportionately affect poor women and women of color, who account for nearly half of all abortions and experience much higher rates of maternal mortality and morbidity.
Abortion a tailwind for Dems, but GOP still likely to take Congress
Politically, the Dobbs decision could work to the Democrats’ advantage, even if only marginally.
The fact is that most Americans (66%) don’t want to see Roe overturned and are out of step with the policies being enacted by many Republican states. Facing an unpopular incumbent who is seen as weak on the economy, immigration, crime, and cultural issues, Republicans would much prefer to run in opposition to Biden’s policies without having to offer any of their own. That’s why the Republican Party has thus far downplayed the issue, instead choosing to focus on the leak. But Dobbs will inevitably put abortion, one of the least popular issues for them, directly in the electoral spotlight.
No longer shielded by Roe from having to legislate on the issue, Republicans in swing states will be pressured by the far-right to enact abortions policies that are too extreme for much of the GOP base and independents, risking a backlash that potentially depresses turnout and pushes moderates to vote for Democrats. It’s equivalent to what Democrats did when they let their party get captured by the loud few on wokeism, transgender policies, and critical race theory: they overreached and got punished for it. Republicans could well suffer the same fate.
For the midterms, the key variable is turnout. Surveys show that voters overwhelmingly care about the economy, an area where Republicans are strongly favored. Presumably, most people who are animated by abortion were already likely to vote in November. However, polling data released after the leak suggests abortion could energize Democrats more than Republicans, especially young progressives and women who had soured on President Biden and weren’t motivated to vote.
🔔 And if you haven't already, don't forget to subscribe to my free newsletter, GZERO Daily by Ian Bremmer, to get new posts delivered to your inbox.The Graphic Truth: Where can American women now get abortions?
After weeks of speculation, the US Supreme Court has issued a ruling reversing Roe v. Wade, the landmark 1973 decision that legalized abortion. American women will now face a hodgepodge of abortion laws that grant different rights depending on one’s geographical location. While abortion will remain accessible and legal in deep blue states like New York and California, more than a dozen Republican-run states, mostly in the South and Midwest, already have “trigger laws” on the books that will outlaw abortion immediately. Indeed, women living in these states will have to travel long distances in many cases to access abortion care. We take a look at some of their closest options.
Check out the longest distances women will have to travel to obtain legal US abortions below.
What happens after Roe v. Wade is overturned?
The abortion debate, though universal, is also quintessentially American. Over the past 50 years, it has come to represent the increasingly vitriolic culture wars dominating US politics.
The temperature is again super hot after a leaked memo revealed that the US Supreme Court is set to repeal the 1973 landmark Roe v. Wade decision that legalized abortion nationwide.
A late night leak. Late Monday, POLITICO released a draft decision written by Justice Samuel Alito – a staunchly conservative judge appointed in 2005 by George W. Bush – that outlines the court’s intention to overturn Roe, which allows abortions up until the point of viability outside the womb.
It is still unclear who leaked the draft memo, but the Supreme Court says it is investigating, which is a remarkable admission for the notoriously tight-lipped institution. In the leaked decision, responding to a Mississippi law banning the procedure after 15 weeks gestation, Justice Alito writes that “Roe was egregiously wrong from the start.”
Red states are ready. Anticipating this moment (the Supreme Court has been stacked with conservatives in recent years), many red states have already prepared edicts that would allow them to outlaw abortion as soon as Roe is overturned. Legislatures in 13 states have passed “trigger laws” banning abortion that could go into effect immediately, while an additional 13 states have laws in place that would likely ban abortion after Roe, according to the Guttmacher Institute. Florida, for instance, is set to enforce a 15-week ban in July.
But even before the rollback of Roe seemed like a done deal, Republican-run states had introduced a host of TRAP laws, curtailing access for millions of women in the South and Midwest who now have to travel long distances to reach abortion clinics in neighboring states. (In Texas, for instance, doctors performing abortions are required to have admitting privileges at a hospital within 30 miles, which often isn’t possible for physicians from rural clinics.)
This problem will now get much worse. While abortion will remain legal and accessible in progressive states like New York and California, millions of women and girls who can’t afford a plane ticket – or to take days off work to drive across the country – will be left out in the cold. History shows that when rights are curtailed, women don’t stop seeking abortions; they simply find alternative ways to get them, often resulting in botched jobs and deaths.
The politics of it all. The Biden administration has expressed dismay at the news, warning that “a whole range of rights could now be at risk.” But could Democrats also use the gravity and timing of the revelation to their advantage? Indeed, the impending SCOTUS decision – and the culture wars it'll resurrect – could become a welcome pivot for Biden. The US president needs a respite from bad headlines, particularly those focused on surging food and gas prices that have caused his poll numbers to tank.
What’s more, highlighting this emotionally charged issue could be an effective “get-out-the-vote” strategy ahead of November’s midterm elections, particularly in battleground states like Ohio and Pennsylvania, where reproductive rights will be a key electoral issue. Still, even though most Americans back Roe, there’s no guarantee that this will energize Democrats and independents in the right places to decide key races. Winning bigger in deep-blue states and cities is welcome, but it won’t move the needle where it matters.
Democratic lawmakers spanning the ideological divide immediately renewed calls for Congress to codify abortion rights into federal law. But that would require Democrats to get rid of a procedural rule in the Senate known as the filibuster. Jon Lieber, Eurasia Group’s lead US political analyst, says that's a pipedream. “Legislatively, Democrats have almost no options,” he says, adding that “their 50th senator, Joe Manchin from West Virginia, says he’s pro-life, and you would require either changes to the filibuster rules” or to reach the 60-vote threshold needed to pass most legislation. “That’s simply not happening,” he says.
Looking ahead. The Supreme Court won’t officially release its decision until June, but both sides are fired up and in campaign mode. Buckle up, US politics is about to get even uglier.