The possible post-Roe roadmap

With help from Myah Ward

HURDLES, RISKS, DECISIONSIf the Supreme Court overrules Roe v. Wade entirely, as the draft opinion published on Monday by POLITICO suggests, patients who want to terminate a pregnancy but live in a state that outlaws doing so will have three choices: travel outside the state, manage their own abortion at home using FDA-approved pills or less-safe methods, or carry an unwanted pregnancy to term.

To make that decision, they would have to sift through an ever-shifting mountain of state laws ranging from outright bans to full-throated protections, overcome financial and logistical hurdles, and decide how much legal risk they would be willing to shoulder should they choose to undergo the procedure.

The first step for patients who wanted an abortion in a post-Roe paradigm? Figuring out whether they would still allowed to get an abortion in their state.

— 18 states have so-called trigger bans that would kick in if Roe is overturned, pre-Roe bans that haven’t been enforced for decades but that could be resurrected, or both.

— Four states (Georgia, Iowa, Ohio and South Carolina) may revive court-blocked bans on abortions after six weeks of pregnancy, a point at which many people don’t know they’re pregnant. (The Iowa Supreme Court has, however, recognized the right to abortion in the state’s constitution.)

— Florida would ban the procedure after 15 weeks starting in July, though its Supreme Court has also recognized a state constitutional right to abortion

— Three states (Indiana, Kansas and Nebraska) allow the procedure until 22 weeks.

— Seventeen states allow abortions until the point of fetal viability or 24 weeks.

— Virginia allows abortions until the third trimester.

— Four (Colorado, New Jersey, Oregon and Vermont) allow abortions throughout pregnancy.

— New Mexico and Alaska have no laws on their books either limiting or protecting the right to an abortion at any point in a pregnancy, though the Alaska Supreme Court has interpreted the state’s constitution as recognizing a right to “reproductive choice.”

Adding to the confusion, these thresholds aren’t static. Conservative states are already trying to pass more restrictive bans, and laws may continue to change as legislative power shifts between Republicans and Democrats in swing states this fall.

If the patient can’t get an abortion at a clinic in their home state, they have three choices.

Option No. 1: Travel. Traveling out-of-state to obtain an abortion can be costly, from the procedure itself to travel, lodging, childcare and lost wages from missed work. Additional barriers for some vulnerable patients include immigration status and disabilities that make travel more treacherous.

Some abortion-supportive states are looking at using state dollars to help both residents and non-residents obtain abortion care regardless of the Supreme Court’s final decision. Oregon lawmakers established a $15 million Reproductive Health Equity Fund this spring to provide grants to local organizations to help pay for the procedure, and California is considering similar legislation.

States could also require health plans to cover abortion care, use state dollars to cover abortions and abortion-related travel for people on Medicaid, or allow nurse practitioners and physician assistans to perform abortions, as Connecticut and Maryland recently did.

And that’s just the tip of the iceberg. In December, a coalition of abortion advocates in California published a lengthy list of policies to improve access to the procedure in the state, many of which have already been adopted. But other blue states likely to receive a flood of patients if Roe falls are far less prepared.

“If California has come up with 45 recommendations … then other states also have a long way to go,” said Elizabeth Nash, interim associate director of state issues at the Guttmacher Institute.

Welcome to POLITICO Nightly. Read more below on the options available in a possible post-Roe world. Reach out with news, tips and ideas at [email protected]. Or contact tonight’s author at [email protected] and [email protected], or on Twitter at @meganmesserly and @AliceOllstein.

Option No. 2: Order abortion pills by mail or resort to other at-home options. Mail-order pills could help millions of people privately terminate a pregnancy, but many patients don’t know they exist — and could end up in legal jeopardy if they obtain them.

Groups like Plan C, Aid Access and others will help patients obtain abortion pills via telemedicine through a doctor outside of the U.S. and an international pharmacy. Guides also exist to advise patients on how to obtain pills via telemedicine in the U.S. by lying or omitting their location.

Some people unable to access the pills are expected to resort to other unsafe methods to terminate a pregnancy, such as herbal remedies, inserting objects into the body or inflicting trauma on the abdomen. According to the World Health Organization, about 30 people die out of every 100,000 unsafe abortions in developed nations.

Option No. 3: Carry an unwanted pregnancy to term.

Evidence from Texas, which has had a 6-week ban on abortion in place since September, indicates that most women who want an abortion will either obtain pills or travel out of state should the draft Supreme Court ruling become final. But researchers like the University of Michigan’s Lisa Harris are sounding the alarm that states are not ready to handle the likely thousands of additional births that will result from the people unable to access either option.

“We estimate an additional 8,000 to 20,000 births per year just in Michigan alone,” she told POLITICO. “We don’t have the maternity care capacity for that.”

— Fed launches fresh assault on inflation in new era for economy: At a meeting today, the Fed announced a supersized, half-point increase in interest rates and laid out plans to shrink its massive bond holdings starting on June 1, in a bid to put the brakes on the economy and kill the highest inflation since the Reagan administration. But the central bank, which said in a statement that it’s “highly attentive to inflation risks,” won’t stop there. Rates this year could reach their highest levels since before the 2008 Wall Street crash if surging prices continue. That prospect has sent stocks sliding this year and pushed mortgage rates above 5 percent for the first time in a decade.

— Donald Trump Jr. interviews with Jan. 6 select panel: Donald Trump Jr., the son of the former president, interviewed with the Jan. 6 committee on Tuesday, according to two people familiar with the matter. He’s the latest member of the Trump family to provide testimony to the select committee probing the Capitol attack, following the panel’s interview last month with Ivanka Trump. Trump’s son-in-law and former adviser Jared Kushner, as well as Trump Jr.’s fiancée Kimberly Guilfoyle, have also talked to investigators.