Magnificent News: The Health 202: What a post-Roe America looks like

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By <a href="https://www.washingtonpost.com/people/rachel-roubein/">Rachel Roubein</a>

By Rachel Roubein

with research by McKenzie Beard

Good morning. Abortion access in America changed overnight. Tell us what you're seeing on the ground at rachel.roubein@washpost.com.

Today's edition: We dive into the five looming battles over abortion, from what President Biden can do to abortion pills. The latest on the patchwork of abortion rules across the 50 states. But first …

It's a new era in the abortion wars

An abortion rights supporter protests outside the Supreme Court. (Elizabeth Frantz/Reuters)

Women in the United States no longer have a constitutional right to an abortion. The procedure is now tightly restricted in roughly 10 states. In even more, providers have stopped performing abortions out of fear they may soon be prosecuted.

Across a divided nation, thousands of demonstrators — some protesting the decision, some celebrating it — have hit the streets. Staff at clinics are working weekends, answering calls and telling patients how to seek care elsewhere. There's now an online marketplace where clinic operators can sell equipment they no longer need.

This is what a post-Roe America looks like. On Friday, the nation's highest court upended a nearly half-century of legal precedent when a majority of the justices voted to overturn Roe v. Wade. The ruling ignited a wave of restrictions; sparked confusion and legal battles; and left abortion providers struggling to grasp their new normal.

And it jolted supporters and opponents of abortion rights to plot their next steps. Today, we dive into the path ahead for both movements.

'A generational project'

It's a precarious moment for the abortion rights movement, which is gearing up for the biggest fight of its political life since the 1973 ruling legalizing abortion. Groups involved are grappling with determining how to divide resources and money, all while realizing there's little they can do to circumvent the Supreme Court's decision, I reported over the weekend with Brittany Shammas.

Here are the three strategies movement leaders have homed in on:

Electing political leaders up and down the ballot who support abortion rights
Helping women living in conservative states maintain access to the procedure through funding and travel
Devising legal strategies to challenge abortion restrictions and shore up existing protections

Not everyone in the movement is aligned on which to prioritize, according to interviews with several people close to the movement who spoke on the condition of anonymity to be candid. Some argue the focus on states should have intensified years ago.

But others — like Mini Timmaraju, the head of prominent abortion rights group NARAL Pro-Choice America — contend groups are in "remarkable sync with each other." The Liberate Abortion Campaign has frequently held calls, daily in some cases, with more than 150 abortion rights groups to plan and mobilize for when the court struck down Roe's decades-old protections.

Abortion rights advocates know they're in for a lengthy battle: "This could be a generational project," said Jessica Arons, senior policy counsel for the American Civil Liberties Union. "It could take a lifetime to get back to where we were."

Alexis McGill Johnson, head of Planned Parenthood:

Not the end

Antiabortion activists are in agreement. Their 49-year crusade to fundamentally alter the nation's abortion laws won't stop with Friday's decision.

On the heels of their greatest victory, antiabortion lawmakers are gearing up to push for a spate of restrictions at both the state and federal levels, The Post's Caroline Kitchener reports.

Several dozen state legislators brainstormed new strategies Friday at the National Association of Christian Lawmakers conference in Branson, Mo. At this moment, the ideas are like "popcorn in a popcorn popper," one Oklahoma Republican said.

Here are the proposals some antiabortion lawmakers are pushing:

Enshrining abortion bans into their state constitutions
Pushing Congress to pass a national prohibition on the procedure
Blocking medication abortion, which accounts for more than half of all abortions
Limiting patients' abilities to obtain abortions across state lines

Most legislative sessions have adjourned for the year, but several Republican governors have suggested they may hold special sessions to pass antiabortion legislation. That includes Nebraska Gov. Pete Ricketts, who indicated his interest in calling lawmakers back before 2023. And South Dakota Gov. Kristi Noem announced plans for a special session, even though her state already has a "trigger ban" in place that excludes protections for rape and incest.

"An entirely new pro-life movement begins today," Marjorie Dannenfelser, the head of prominent antiabortion group Susan B. Anthony Pro-Life America, said in a statement Friday. "We are ready to go on offense for life in every single one of those legislative bodies, in each statehouse and the White House."

Reproductive wars

Big questions remain in a post-Roe world

Much of the nation's abortion debate and future was thrown into flux following the Supreme Court ruling overturning Roe v. Wade. (Jeff Roberson/AP)

The Supreme Court's decision to nix Roe leaves a cascade of looming questions and brewing fights. Here are four battles to come that stuck out to us over the weekend.

1. A showdown over medication abortion.

This is one of the biggest looming fights. Several Republican-led states have moved swiftly to restrict access to medication abortion.

The efforts so far have focused on regulations around the pills, such as prohibiting them from being shipped or prescribed. The Food and Drug Administration has approved the pills, so outright bans from states could face lawsuits from the federal government.

Attorney General Merrick Garland appeared to threaten as much on Friday. States, Garland said, "may not ban Mifepristone based on disagreement with the FDA's expert judgment about its safety and efficacy," The Post's Devlin Barrett notes. Yet, whether federal approval of the pills preempts state restrictions on them remains unclear.

2. The Biden factor.

President Biden has seized on the demise of Roe v. Wade as a way to re-energize Democrats' electoral prospects and revive his presidency, saying his administration will do everything in its powers to protect abortion rights, The Post's Cleve R. Wootson Jr., Tyler Pager, Ashley Parker and Yasmeen Abutaleb report. (However, Biden doesn't support expanding the Supreme Court.)

Biden's initial plan includes protecting the right to travel over state lines for an abortion and access to medication abortions, but stressed that the voting booths are the real way to enact change. Some senators are urging him to use more creative avenues, like declaring a public health emergency or through other executive actions.

3. The right to digital privacy.

Years of warnings from privacy advocates about digital surveillance have become a reality in many states, where suddenly information gleaned from Google searches, text messages and period-tracking apps could be used as evidence of a crime, The Post's Geoffrey A. Fowler and Tatum Hunter report.

Such data has already been used to prosecute people for feticide and neglect of a child, and experts are now warning these tactics could be used on a wider scale. Some tech companies have already moved to shield their users' data, but advocates and congressional Democrats are pressing for more action to safeguard Americans' private reproductive health data.

4. In Congress, a fight over next steps.

Senate Democrats have tried — and failed twice this year — to enshrine abortion rights into federal law. Most recently, all 50 Republicans and Sen. Joe Manchin III (D-W.Va.) voted against the measure, which fell far short of beating the Senate's 60-vote threshold needed to advance legislation. Even if Democrats could codify Roe, experts say there's no guarantee the Supreme Court wouldn't strike that down too, our colleagues Kate Wheeler and Hannah Good note.

As for Republicans, Rep. Christopher H. Smith (N.J.) said he is planning to reintroduce his proposed 20-week nationwide abortion ban, but lower the limit to 15 weeks.

Chart check

The Supreme Court's ruling is already leading to a patchwork of rules across the country, with the procedure illegal — or soon to be banned — in many red states but still permitted in blue ones.

Republican states rushed to ban the procedure:

Abortions are banned or mostly banned in roughly 10 states, per The Post's tracker.
Roughly 10 states will have bans implemented within 30 days or are likely to ban the procedure.
In 10 states, the future of abortion remains uncertain. In several of those states, the procedure's fate is largely hinged on the outcome of November's midterm elections.

States with abortion bans that will take effect within one month

Source: Guttmacher Institute, Center for Reproductive Rights, Post reporting

Democratic and some moderate Republican governors are protecting abortion access:

There's been a spate of new actions since Friday's ruling. For instance: Washington's Democratic governor pledged $1 million to support abortion providers handling an influx of patients.
Over the last few days, governors in several states have pledged to sign executive actions to forbid law enforcement or state agencies from cooperating in out-of-state abortion investigations to protect people traveling to access the procedure. This includes the Democratic governors of Minnesota and Oregon, as well as Massachusetts's Republican governor.
As many as 16 states and D.C. have passed laws to explicitly protect the right to abortion.

States where abortion is legal and likely to be protected

Agency alert

Federal agencies are grappling with how to respond to the abortion ruling

Attorney General Merrick Garland said the Justice Department would work to defend and expand reproductive rights. (Carolyn Kaster/Pool/AFP/Getty Images)

Federal agencies are scrambling to manage the fallout of Friday's ruling and protect access to abortions. Here's the latest:

The Department of Homeland Security is warning of a heightened risk of "domestic violent extremist activity" targeting judges, abortion providers, churches and public demonstrations, The Post's Maria Sacchetti reports.
Attorney General Merrick Garland said the Justice Department is gearing up for legal battles on a host of related issues, like protecting women traveling to states where the procedure is legal and access to medication abortions, our colleague Devlin Barrett writes.
The Pentagon is evaluating its policies to ensure service members and their families continue to have "access to reproductive health care as permitted by federal law," The Post's Alex Horton reports.

Lloyd Austin, secretary of Defense:

The political response

Lawmakers on Sunday reacted to Roe overturning with mixed sentiments. 🎥 Watch below:

In other health news

After a tumultuous road through the Senate, Biden on Saturday signed a bipartisan gun control bill into law, breaking nearly three decades of congressional inaction on gun violence, our colleagues Cleve R. Wootson Jr. and Marianna Sotomayor report.
The World Health Organization decided against declaring monkeypox a global emergency despite the virus's quick spread across the globe, electing instead to describe it as an "evolving health threat," The Post's Rachel Pannett and Annabelle Timsit report.
A federal appeals court on Friday issued a temporary stay on a government ban on electronic cigarettes made by Juul, which were banned by the FDA last week, per Adela Suliman.