With Congress stripping Medicaid funding for reproductive health care, states must act now to protect abortion access and stem the deepening post-Roe crisis. That means safeguarding patients, defending providers, and funding care directly.
Congress’s recent reconciliation bill, signed by President Trump, delivers a devastating blow to reproductive health care nationwide. It blocks providers like Planned Parenthood from seeking Medicaid reimbursement for basic care like STI testing, cervical cancer screenings, and contraception. Even in states where abortion remains legal, the law will force clinics to close. Rural communities, which are already underserved, will suffer the most.
The consequences are not theoretical. Even before this law passed, abortion bans were already fueling a public health crisis. We’ve seen rising rates of sepsis and maternal mortality, especially in the South. In fact, eight of the 11 states with the highest maternal death rates also have abortion bans in place. This is no coincidence: It’s the direct result of policy choices that deny people care.
The economic fallout is just as stark. New data shows that abortion bans are driving people out of states: one in 10 adults — and one in five people planning to have children — have moved or know someone who has moved because of abortion restrictions. Younger, highly educated workers are avoiding states with harsh laws, leading to declining workforce participation, especially among women in their prime working years.
Meanwhile, states that protect abortion access are faring better. Fourteen of the 17 states with above-average per capita GDP protect reproductive rights. These states also have stronger labor force participation and greater economic stability. The message is clear: Reproductive freedom is not just a health issue — it’s an economic one.
Congress’s attack on Medicaid funding will only deepen these disparities. While federal lawmakers should reverse course and pass legislation that expands access to maternal health care, including abortion, state leaders cannot wait. They must act now. Here’s how:
First, protect patients and providers. As clinics close and others become more vulnerable to harassment and violence, states must step in to safeguard patients and providers. Michigan state Senator Mallory McMorrow, a NewDEAL Leader, introduced legislation mirroring the federal FACE Act, which protects clinics from intimidation and threats. Her bill comes at a critical moment: Congress is moving to repeal the FACE Act, even as incidents like a recent clinic bombing in California remind us what’s at stake.
With fewer physical clinics, medication abortion via telehealth will become a lifeline, particularly in rural areas. But that access must be protected. Shield laws (now in place in 18 states and Washington, D.C.) prevent anti-abortion states from reaching across borders to prosecute providers or patients. Yet only eight of these laws explicitly protect telehealth services regardless of a patient’s location. Expanding those protections is urgent.
Some states have also passed prescription privacy laws that help protect the identity of providers, an added safeguard against threats and doxxing. States like Colorado, Maine, New York, and Vermont now allow prescriptions for abortion pills to list the clinic instead of the provider’s name.
Second, enshrine reproductive health protections in state law. Without Roe v. Wade and without federal statutory protections, abortion access depends entirely on state policy. Colorado offers a national model: Its legislature passed a suite of reproductive health protections, including a bill co-sponsored by NewDEAL Leader Senator Lindsey Daugherty, which was signed into law and will require state employees and those on Medicaid to have abortion services covered by their insurance.
Third, fund abortion care and the costs around it. The financial burden of abortion care is growing, especially for uninsured or underinsured patients. Maryland is helping lead the way, using surplus insurance fees to cover the cost of abortions. But the need doesn’t stop there. Patients often travel long distances, take unpaid time off work, arrange childcare, or pay for lodging. Some municipalities have stepped in to help with those costs, and more should follow.
Protecting abortion access is about more than defending a right. It’s about ensuring health, dignity, and economic opportunity for millions of Americans. In this moment of federal retreat, state lawmakers must lead.
Rachana Desai Martin is chief U.S. program officer at the Center for Reproductive Rights, where she leads the organization’s domestic advocacy and legal strategies.
Debbie Cox Bultan is CEO of NewDEAL, a national network of state and local elected leaders advancing innovative, forward-looking policy solutions.
