Voters backed abortion rights in seven of the 10 states where the issue appeared on the ballot Tuesday; at first glance, seemingly reshaping the country’s patchwork of abortion rules.
Colorado, Maryland, Montana and New York (states where abortions are already allowed at least up to fetal viability) will add anti-abortion protections to their state constitutions. Nevada voters were also in favor of the protections and can enshrine them by approving the measure again in the next general election.
Meanwhile, voters in Florida and South Dakota failed to approve abortion rights amendments, and Nebraska voters essentially affirmed the state’s existing ban on abortions after the first trimester, while rejecting a measure that would have protected abortions in later stages of pregnancy.
The biggest changes came in Arizona, where, in 2022, abortion after 15 weeks was banned, and in Missouri, which had a near-total ban. Voters in those states approved constitutional amendments to protect the right to abortion through fetal viability, opening the door to repeal those states’ restrictions and increase access to abortion services.
But when Alison Dreith, director of strategic partnerships for the abortion fund Midwest Access Coalition, which has helped people in Missouri and 27 other states get abortions, was asked before the results how her organization was preparing for the logistical changes. , she simply said: “We are not.”
This is because actual access to abortion in the country remains largely unchanged, despite the November 5 results. The web of pre-existing state abortion laws will likely remain in place while they are challenged in court, a process that could take months or even years.
Dreith said he doesn’t think many voters understood all that before they went to the polls. “It may not give them the results they want, especially right away,” Dreith said.
To further complicate these state results: the election victories of Donald Trump as president-elect and Republicans in the US Senate, giving their party control, have raised the question of whether a national abortion ban will be on the table. . Republicans had raised objections during the election campaign. Enacting such a law would also take time.
The abortion landscape changed dramatically when the U.S. Supreme Court struck down federal abortion protections with its 2022 decision in Dobbs v. Jackson Women’s Health Organization. That left abortion rules in the hands of states, leading 14 of them to enact bans with few exceptions and several others to limit access.
The ruling also led to a series of ballot measures: Voters in 16 states have already weighed in on abortion-related ballot measures. Thirteen have in some way favored access to abortion. And although Florida’s amendment to protect abortion access did not meet the 60% threshold needed to pass, it did receive the majority of votes.
Abortion opponents like Susan B. Anthony Pro-Life America praised the votes that rejected the amendments in Florida and South Dakota and lamented the amendments passed in states, such as Missouri, with restrictive abortion rules and bans.
“We mourn the lives that will be lost,” Sue Liebel, its director of state affairs, wrote in a statement. “The disappointing results are a reminder that battles for human rights are not won overnight.”
The states that passed abortion rights amendments in 2022 and 2023 offer a glimpse of the long legal road ahead for abortion policies to take effect. It took nine months after Ohio voters added anti-abortion protections to their state constitution for a judge to strike down the state’s 24-hour waiting period for abortions. And some of Michigan’s abortion restrictions, including its own 24-hour waiting period, were only lifted in June, 19 months after Michigan voters approved their state’s abortion rights amendment.
Missouri has an extensive set of such rules. Legal abortions had all but ceased even before the state’s ban was triggered by the dobbs decision. For three decades, state lawmakers passed a series of restrictions on abortion providers that made it increasingly difficult to operate there. In 2018, only one clinic offered abortions in the state, a Planned Parenthood affiliate in St. Louis. Anticipating even tighter restrictions, it opened a large facility 20 miles away in Illinois in 2019.
Those laws that reduced the number of abortions registered in the state from 5,772 in 2011 to 150 in 2021 remain in effect, despite the recently passed amendment protecting the right to abortion.
Abortion services are often talked about as if they were a light switch, according to Kimya Forouzan, senior state policy advisor at the Guttmacher Institute, a nonprofit that supports abortion rights. But the infrastructure needed to perform abortions is not so easy to turn on and off.
North Dakota’s abortion ban was overturned by the courts in September, for example, but the only abortion provider in the state before the ban went into effect has no plans to return, having moved its operations to five minutes away. drive to Minnesota.
And even as clinics rapidly ramp up their services, legal disputes over abortion rules can lead to violent politics, with patients caught in the middle.
The Georgia law banning most abortions after about six weeks spent years in the courts after its passage in 2019. For two brief periods after the dobbs decision, once in 2022 and again in 2024, court rulings meant clinics in the state could perform abortions up to 22 weeks of pregnancy.
Demand for abortions increased during those times and clinics were able to quickly offer services again. But when state courts later said the ban should be enforced, those windows slammed shut. During 2022, some patients scheduled for abortions were left sitting in waiting rooms, according to Megan Cohen, medical director at Planned Parenthood Southeast.
The various abortion rights amendments that passed on Nov. 5 could also face challenges.
In Missouri, the Republican-dominated state legislature has previously attempted to ignore voter-approved amendments. After Missouri voters added Medicaid expansion to the state constitution in 2020, the state legislature refused to fund the program until a judge ordered the state to begin accepting applications, causing significant delays in enrollment. .
The presumptive speaker of the state House of Representatives, Republican Jon Patterson, has said the legislature must respect the outcome of the Nov. 5 ballot measure vote, while others have pledged to bring the issue to voters. again.
Meanwhile, Dreith of the Midwest Access Coalition said people seeking abortions in the Midwest will do what they typically do in the region for everything from food to medical care: drive.
“We hope that the resources we need are not in our communities,” Dreith said, “and I think that has served us well in this crisis.”
Renuka Rayasam and Sam Whitehead of KFF Health News in Georgia and Arielle Zionts in South Dakota contributed to this report..
