With Future of Roe Uncertain, Report Shows States Rally To Protect Reproductive Freedom: 404 Bills Introduced in 2018 Across 44 States

July 16, 2018
Contact: Stephanie Reichin
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In Midyear Report, National Institute for Reproductive Health Highlights State-Led Efforts to Decriminalize Abortion, Expand Insurance Coverage, and Maximize New Pro-Choice Elected Leadership

Following Trump’s Nomination of Kavanaugh to Supreme Court, Action at the State Level to Advance Reproductive Health, Rights, and Justice is More Important Than Ever

New York, NY – Amid ongoing threats to reproductive freedom at the federal level, the National Institute for Reproductive Health (NIRH) released a report today highlighting the positive momentum of 44 states – both red and blue – and the District of Columbia protect abortion rights and advance access to reproductive health care. ‘Gaining Ground: 2018 Midyear Report,’ details the 404 bills introduced since January 2018 – 63 of which have been enacted, and 56 of which have cleared at least one legislative chamber – reflecting extensive groundwork by NIRH and its state partners.

“The best defense against a hostile President, Congress, and Supreme Court is a strong state-level offense,” said Andrea Miller, President of the National Institute for Reproductive Health. “As Trump and the federal government continue their campaign to restrict women’s access to health care, our midyear report shows that states are stepping up to fight back. Make no mistake: many state legislatures are hostile to reproductive freedom and much work remains to be done. Yet in just six months, elected officials in nearly every state in the nation – from Kentucky and Oklahoma to Connecticut and California – have prioritized access to reproductive health care.”

Gaining Ground’s analysis found that states introduced bills to expand access to abortion and contraception, increase access to pregnancy care, promote comprehensive sexuality education, support parents and families, and prohibit discrimination based on reproductive decisions. Of the 404 bills introduced across 44 states and the District of Columbia, 105 bills focused on improving access to contraception, and 52 sought to expand access to abortion care. NIRH is working with state and local advocacy partners in 23 states in 2018 to achieve policy wins that improve residents’ reproductive lives across all of the focus areas analyzed in the report.

The report identifies four key policy trends that emerged in the first half of 2018, including:

  • The importance and impact of state-level elections: Voters helped shift power in New Jersey, Virginia, and Washington, resulting in immediate changes that restored funding for family planning, expanded Medicaid (which covers much reproductive health care), and expanded insurance coverage for abortion care, respectively.
  • Decriminalizing abortion:Given the real threat that Roe v. Wade could be overturned, states such as Massachusetts, New Mexico, New York, Rhode Island, and West Virginia are working to update their pre-Roe laws so that abortion is protected and regulated as it should be – as a matter of public health, not as a crime.  In Massachusetts and New York, these bills have passed one house, and these two states are primed to join the 10 states that have secured abortion rights (three of them – Delaware, Illinois, and Oregon – just last year).
  • Expanding insurance coverage for reproductive health care:In response to the Trump administration’s attacks, state lawmakers in Colorado, Hawaii, Kansas, Missouri, and New Jersey, introduced laws that would expand reproductive health coverage for residents, and Washington passed such a law – building on last year’s trend advanced in Illinois and Oregon.
  • Protecting women in the criminal justice system, including those who are pregnant:Tennessee passed a new law preventing sentencing courts from taking into account a woman’s willingness to be sterilized or use contraception, responding to a history of reproductive coercion in the state. Connecticut, Kentucky, and Oklahoma sought to bridge criminal justice reform and reproductive justice by passing legislation to ban the use of restraints during childbirth, and shackling pregnant women during transport.

“States know they cannot wait to enact policies safeguarding their residents’ access to abortion and contraception, among other important protections,” Miller continued. “Rather than backing down in the face of ongoing threats at the federal level, state legislators should look to the trends outlined in this report and activate immediately. NIRH will be there to help state partners and state legislators pass the necessary legislation to push forward a bold agenda that prioritizes reproductive health, rights, and justice.”

In January, 2019, NIRH will release its fifth annual year-in-review report, detailing trends and lessons learned through the entirety of 2018, including updates on the laws and trends found here.


The National Institute for Reproductive Health (NIRH) builds power at the state and local levels to change public policy, galvanize public support, and normalize women’s decisions about abortion and contraception.