Friday marks the 43rd anniversary of Roe v. Wade, the landmark Supreme Court decision that legalized abortion in the United States. At this point, many Americans may assume that it’s easier than ever to access abortion services — but nothing could be further from the truth.
Legal abortion, proven to be both life-saving and essential to the economic security of women and their families, was a critical step in this nation’s journey toward gender equity. Roe was profound not only because it affirmed women’s basic right to health care and well-being through abortion care, but also because it ushered in medical standards and regulations that ensured women were safe during the procedure.
Expanding access to abortion care also bolstered the success of the then-newly established Title X program, which provides family planning services to low-income and uninsured families. Women gained unprecedented access to more doctors, enjoyed insurance coverage for the full range of comprehensive reproductive health services, and saw the ability to manage their fertility for the first time. This had a ripple effect on their ability to pursue educational and economic opportunities. In short, Roe gave many women control of their destinies.
However, history shows us that women have been denied the full benefits of Roe for decades.
Just seven years after the Supreme Court affirmed a woman’s right to abortion, the justices upheld the Hyde Amendment, a budget rider approved annually to this day that prevents women covered by Medicaid from using their insurance to pay for abortion services. Then, in 1992, the Supreme Court held in Planned Parenthood vs. Casey that a state could restrict an abortion procedure as long as it did not pose an undue burden on women seeking the service. Ever since, states have increasingly sought ways to encroach upon a woman’s ability to access abortion care. More than 200 state-level abortion restrictions have been enacted since 2010 — almost the same number as the total number enacted in the 15 previous years.
And this year, the Supreme Court will hear Whole Women’s Health v. Cole, the most significant women’s health case since Casey. Whole Women’s Health, a Texas-based reproductive health clinic, is challenging a Texas state law passed in 2013 that requires abortion providers to meet expensive and unnecessary regulations — including complying with the standards of ambulatory surgical centers and obtaining admitting privileges from local hospitals.
Whole Women’s Health amplifies how far we have strayed as nation from the promise of Roe, and how much remains at stake. The Supreme Court could affirm Roe in a manner that enables the right to abortion and ensures access for the most vulnerable women in Texas. Or the Court could deliver another ruling that further strips away this precious liberty for far too many women.
Should the Supreme Court uphold the Texas law, there could be dire consequences not simply for abortion care, but also for other reproductive health services like family planning and pregnancy-related care. States would have the legal cover to restrict other reproductive health procedures through legislation that is neither medically necessary nor grounded in evidence — expanding harmful legislative interference with medicine. Additionally, restrictions imposed on vital health services force women to forgo necessary services or risk their economic security to access services in other places.
Conservatives have already proven they are willing to sacrifice broader health care access for the sake of targeting abortion. For years, laws knows as the Targeted Regulation of Abortion Providers (TRAP) have been enacted under the guise of “protecting women’s health,” despite the fact that abortion is one of the safest and most highly regulated procedures in the United States. In 2015, conservatives at the state level attempted to defund Planned Parenthood, the nation’s largest women’s health service provider, by claiming that Title X dollars were being used to fund abortions rather than family planning and cancer screenings. And upon returning in the New Year, Congress presented a reconciliation bill to the President — which he quickly vetoed — that not only defunded Planned Parenthood but also gutted Obamacare.
Across the country, women are fighting daily for the economic stability and mobility of the families. Their ability to realize their full potential is inextricably linked to their ability to determine for themselves if and when they will parent, as well as whether they have the opportunity to raise their children safely and securely with a full range of comprehensive reproductive health services.
Abortion access cannot simply be a right on paper without also being a practical reality for those women. On this 43rd anniversary of Roe, we must reflect on how far we are from realizing its promise and recommit ourselves to ensuring universal access to reproductive health services that includes abortion access for all women in need — regardless of their race, zip code, region, or source of insurance.
Heidi Williamson is a Senior Policy Analyst for the Women’s Health and Rights program at the Center for American Progress.