In June 2022, the Supreme Court ruled in Dobbs v. Jackson Women's Health Organization to remove the constitutional right to abortion, sending the power back to the states.
Some states, like Massachusetts, passed executive orders to protect patients, including those traveling from out of state. Others, like Kentucky, had trigger bans that immediately restricted abortion access (Kentucky’s is a near-total ban for any stage of pregnancy, except in cases of medical emergencies).
The number of abortions overall has increased in the US, at 1.14 million in 2024 compared to 1.06 in 2023, according to #WeCount, the Society of Family Planning’s national abortion data-tracking effort that started during the fall of Roe.
In November 2024, 10 states asked citizens to vote on whether they wanted abortion protected in local law. Seven of them passed and three did not. But experts told Healthcare Brew the fight for reproductive rights continues whatever the outcome. There are still efforts to add federal restrictions to abortion, though those policy efforts have failed thus far.
Florida’s fight
The three states that didn’t pass abortion ballots were Florida, South Dakota, and Nebraska.
South Dakota declined a state constitutional right to abortion, with 58.6% of voters choosing “no.” Nebraska’s case was a little different, though, as the state rejected (in a difference of 49.01% to 50.99%) establishing the right to abortion until “fetal viability”—which is the point when a fetus can survive outside of the womb—but passed an amendment to protect abortion up to 12 weeks.
In Florida, 57.2% of voters said they wanted the state constitution to include measures to protect patients seeking an abortion.
The problem was the vote needed 60% to pass.
“It feels like the wind has been knocked out of you,” Michelle Grimsley Shindano, director of policy and government affairs at Planned Parenthood of Florida, told us. “You see people just pouring their blood, sweat, and tears into something and literally being 2.8% away from winning. It’s gut-wrenching.”
Florida originally instituted a 15-week ban in 2022, but it was replaced with a six-week ban in May 2024 (with some exceptions), which is now the law of the land in the Sunshine State.
Bans can lead to facility closures, Healthcare Brew previously reported, as well as clinical struggles. In the first 100 days after Dobbs, for example, 66 facilities across 15 states stopped providing abortion services according to data from reproductive health research organization the Guttmacher Institute.
In Florida, there were 54 abortion care clinics in March 2024, but as of August, there were 42 clinics in the state, according to I Need an A, a website dedicated to helping people find reproductive care.
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“This has been extremely difficult for our patient population” and has presented “life-threatening risks,” Michelle Quesada, interim VP of public policy for Planned Parenthood of Florida, said.
Telehealth abortions are also on the rise in the US, as they accounted for about 5% of abortion care from April–June 2022 and a little over 25% by December 2024, #WeCount reported.
On Sept. 19, though, Health and Human Services Secretary Robert F. Kennedy Jr. said the FDA is going to review the safety of mifepristone, which is a drug used in medication abortions, raising alarms that access to abortion could be further limited.
State of care
Voters in Arizona, Colorado, Maryland, Missouri, Montana, Nevada, and New York all passed ballot initiatives to protect abortion in their states. But that hasn’t meant abortion is solidly safe there.
States like California, Colorado, and New York have instituted shield laws to protect providers from out-of-state prosecution. The Guttmacher Institute reported patients are traveling out of state at higher rates for abortions across the US: 155,000 people in 2024 and roughly 170,000 in 2023 compared to 81,000 in 2020.
Lawmakers in Missouri tried to ban abortion by overturning the abortion-rights amendment passed by voters. A federal judge ruled in July for abortion to be legal up to fetal viability.
Arizona passed adding “the fundamental right to abortion” into its state constitution 61.6% to 38.4% during the 2024 elections. After the fall of Roe in 2022, the state went back to a total abortion ban law from 1864 in April 2024, but the state legislature repealed that law a couple of weeks later to allow abortions up to 15 weeks.
In Nevada, ballot initiatives to change the state constitution must pass twice. The right to abortion has been protected in state law since 1990 for up to 24 weeks of pregnancy. The 2024 ballot initiative added a protection for abortion up to fetal viability into the state constitution.
But voters have to show up again in 2026 to make sure last year’s ballot goes through.
That’s what Denise Lopez, director of Nevada campaigns for abortion-rights advocacy group Reproductive Freedom for All, is working on now. It’s a nonpresidential election year and she’s going up against a governor who has vetoed a record number of bills, including those related to IVF and paid family leave, so Lopez has her work cut out for her.
“We’re going to have to educate people. We’re going to have to make sure that people turn out to vote for the ballot again,” she said.