- The Supreme Court overturned Roe v. Wade Friday.
- Roe v. Wade was the legal precedent from 1973 that makes abortion legal in the US.
- Overturning Roe triggers a domino effect of social, legal, and economic changes.
The Supreme Court overturned Roe v. Wade on Friday, a landmark case that recognized a pregnant person's 14th Amendment right to an abortion.
"The Constitution makes no express reference to a right to obtain an abortion,"the majority opinion, authored by Justice Samuel Alito, said. "It is time to heed the Constitution and return the issue of abortion to the people's elected representatives."
Overturning Roe v. Wade will have broad ramifications for people seeking abortions and those promoting access. The legal, economic, and social landscape surrounding abortion will change drastically in many states.
Here's what to know about a post-Roe reality.
The state of abortion in the US
Abortion access varies widely from state to state right now.
The most restrictive current rules — recently enacted in Texas — essentially ban abortion by making it illegal after six weeks, which is often before people know they are pregnant.
In the other 49 states, abortion access is a broad patchwork, with some of the most liberal states guaranteeing access to abortions for all pregnant people for at least six months (or longer for medical emergencies), while other states make it nearly impossible to access care.
The abortion case that was before the court, Dobbs v. Jackson Women's Health Organization, was brought by the last remaining abortion clinic in Mississippi, challenging a new law that would essentially make any abortion there illegal after 15 weeks.
Abortion most likely becomes illegal in at least 21 states
Twenty-one US states — most of them in the Midwest and in the South — have amendments, pre-Roe rules, or so-called 'trigger laws' on the books that could effectively ban abortion swiftly if Roe is overturned.
The list has grown rapidly in recent months and now consists of Alabama, Arizona, Arkansas, Georgia, Idaho, Kentucky, Louisiana, Michigan, Mississippi, Missouri, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, and Wyoming.
20 states, along with Washington, DC, become 'sanctuary states' or have legal protections in place for abortion at the state level
After the court's decision came down, US Attorney General Merrick Garland released a statement that said states must be allowed to "keep abortion legal within their borders."
At least eight coastal states are set to expand abortion access, according to the Center for Reproductive Rights. They include California, Connecticut, Hawaii, New Jersey, New York, Oregon, Washington, and Vermont, along with Washington, DC.
Gov. Gavin Newsom of California has been among the most vocal legislative proponents of abortion rights. In May, he announced on Twitter that his state was proposing an amendment to its constitution that would "enshrine" the right to abortion in California.
Abortion access will be upheld in at least 12 additional states, which have amendments and laws in place at the state level that guarantee people the right to an abortion. Those states are Alaska, Colorado, Delaware, Illinois, Iowa, Kansas, Nevada, Maine, Maryland, Massachusetts, Minnesota, and Rhode Island.
"Under bedrock constitutional principles, women who reside in states that have banned access to comprehensive reproductive care must remain free to seek that care in states where it is legal," Attorney General Garland said, while also acknowledging that "traveling to obtain reproductive care may not be feasible in many circumstances."
9 states are up in the air
At least two states — Indiana and Nebraska — are considered "hostile" territory for abortions, as determined by the Center for Reproductive Rights, meaning abortion could easily become illegal in those states too.
Florida and Montana have recent abortion restrictions on the books, suggesting they could decide to ban the practice.
That leaves just five US states as neither sanctuary states nor primed to overturn abortion access. Those are New Hampshire, New Mexico, North Carolina, Pennsylvania, and Virginia. In those states, abortion is accessible today but doesn't have any legal protections in place, so it's unclear what could happen there now that Roe has been undone.
Officials across the US could 'activate' decades-old bans that were unenforceable under Roe v. Wade
As the Center for Reproductive Rights reported, some pre-Roe state laws were rendered unconstitutional by Roe v. Wade but they could be reactivated now that the right to an abortion has been struck down. For instance:
- Before Roe, some states banned abortions before a fetus is viable.
- There were also bans on abortions using methods such as dilation and extraction or dilation and evacuation. Those could be enforced now that Roe has been scrapped.
- Pre-Roe, some states banned self-managed abortions, meaning it was illegal to perform an abortion at home.
How much an abortion might cost in a post-Roe US
The cost of an abortion varies, from free access in some places to hundreds or thousands of dollars in others.
Planned Parenthood estimates that abortion can cost "up to $750." In some places abortion access is free for those who can't pay or don't have insurance. There are additional "hidden" costs, however, including traveling over state lines, taking time off work, and getting childcare.
Surgical abortions are more expensive than medical ones, with prices ranging from several hundred dollars to over $10,000, depending on several factors, including how advanced the pregnancy is.
Network of abortion funds and practical support groups will fill in some gaps
While some states have public funding baked into their abortion protections, many do not. That's where abortion funds come in.
Abortion funds consist of more than 90 grassroots organizations across the US providing resources for specific communities. That could mean accessing and funding procedures, abortion pills, travel and lodging, emotional support, and childcare. They do not check immigrant or legal status.
While abortion funds cannot cover the full cost of an abortion, people who need support can get help from more than one fund at once. (Some abortion clinics also offer discounts for certain people, depending on their circumstances).
The National Network of Abortion Funds website crashed within hours of Politico reporting that the Supreme Court would scrap Roe v. Wade, flooded by donations.
In a post-Roe United States, abortion funds will have to support abortion bail funds in places where abortion is criminalized, according to the Brennan Center.
Some businesses say they will fund employees' out-of-state abortions
Many companies have been setting up policies and protections ahead of the legal changes, as Insider's Marguerite Ward and Dominick Reuter have reported.
Some companies, like Amazon, are expanding healthcare benefits to cover travel expenses for non-life-threatening medical care. Others, like Salesforce, are covering relocation costs so employees can leave restrictive states.
Uber and Lyft are offering free rides for people in Texas and Oklahoma to travel to abortion clinics and are covering legal fees for drivers who are sued for participating in abortions.
Experts predict rising rates of poverty and unemployment disproportionately affecting Black and Latino people
Experts say a federal upheaval of the landmark 1973 Roe v. Wade decision will widen existing racial and socioeconomic inequities in abortion access.
According to the decade-long Turnaway Study, people denied abortions are more likely to suffer poor health and stay in abusive relationships. They were also four times as likely to fall below the poverty line — a finding backed up by another study that found high unemployment rates following denied abortions.
These socioeconomic risks are elevated for Black and Latino people who are more likely to work in industries that pay the minimum wage and have limited paid time off — barriers to traveling for out of state care.
The next battleground: Attempts to ban access to mail-order abortion pills
If Roe is overturned, access to mail-order abortion pills is expected to become the next legal battleground.
Some states have already made it difficult or impossible to obtain abortion pills by mail. Mifepristone is approved by the Food and Drug Administration for use up to 10 weeks into pregnancy, which allows abortions to take place at home and promotes access in medically understaffed areas.
Attorney General Garland said on Friday that "states may not ban Mifepristone based on disagreement with the FDA's expert judgment about its safety and efficacy."
Arizona, Arkansas, and Texas, however, have bans on mailing abortion pills to patients. Similar restrictions have been attempted and blocked by courts in Montana, Oklahoma, and South Dakota.
Other policies may restrict access to abortion by mail in a more roundabout way. In 19 states, a medical provider must be present for the procedure, so telemedicine is not an option. Some states have limited what kind of healthcare provider may prescribe abortion medication, effectively banning abortion pills in underserved areas.
Several state legislatures have introduced similar bans on abortion by telemedicine, by medication, or by mail this year.
Update: This post was originally published in May, when a draft of the Supreme Court's decision was leaked to Politico. It has been updated with the high court's final verdict.