Access to Medication Abortion in States Where Abortion Is Illegal

After the U.S. Supreme Court reversed Roe v. Wade, many women in the United States are facing threats to their abortion access rights. One of the most common family planning options is medication abortion. Medication abortion is a safe, non-surgical option that women can choose without an in-person visit to the doctor’s office. Unfortunately, many states are trying to restrict medication abortions as part of total abortion bans.

Abortion access rights depend on where you live. Abortion restrictions are changing based on legal challenges to abortion care. For questions about access to medication abortions, talk to a reproductive rights lawyer.

What Is a Medication Abortion?

Medication abortion is a non-surgical abortion using prescription medication. The most common type of medication abortion is a two-drug regimen of mifepristone followed by misoprostol. The U.S. Food and Drug Administration (FDA) approved mifepristone for early abortion in 2000.

For most people, a medication abortion is safe. It can be self-administered in the first trimester. Medication abortion can also be used after 12 weeks of pregnancy under the supervision of an abortion provider. The FDA approved abortion pill access at any pharmacy with a special certification. This includes brick-and-mortar and online pharmacies.

According to the Centers for Disease Control and Prevention (CDC), the majority of reported abortions in the United States were medication abortions. Most medication abortions are early abortions at a nine-week or earlier gestational age.

What States Ban the Abortion Pill?

As of July 1, 2024, 14 states have near-total bans on mifepristone. States restricting access to the abortion pill include:

• Alabama
• Arkansas
• Idaho
• Indiana
• Kentucky
• Louisiana
• Mississippi
• Missouri
• North Dakota
• Oklahoma
• Tennessee
• Texas
• South Dakota
• West Virginia

Some states haven’t banned medication abortion but have other restrictions to limit access for patients. These restrictions include prohibiting telehealth prescriptions for the abortion pill, requiring in-person counseling, or requiring an ultrasound.

Do You Need a Prescription for the Abortion Pill?

In most states, you can get abortion medication through the mail or in person. Over 20 states allow people to get an abortion pill prescribed by a non-physician health care clinician. This includes a nurse practitioner or physician’s assistant.

Several states require people to get a prescription after an in-person visit before getting the abortion pill. States with stricter prescription restrictions include:

• Alaska
• Arizona
• Florida
• Georgia
• Iowa
• Michigan
• Nebraska
• Nevada
• North Carolina
• Ohio
• Pennsylvania
• South Carolina
• Utah
• Wisconsin

How Can Women Get Medication Abortions When They’re Against the Law?

Women in several states have limited access to medication abortions. These states have enacted bans or restrictions on women’s abortion rights. After the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, states have restricted abortion access, including the abortion pill.

People who need family planning care may still be able to get the abortion pill despite their state bans. Those who can travel outside of their state to visit a pharmacy in another state can get an abortion pill prescription. Others have had success getting telemedicine appointments in other states. They can then get mifepristone and misoprostol delivered through the mail.

Does Health Insurance Cover Medication Abortion?

Healthcare insurance coverage for abortion depends on state law. Some states require all private health insurance companies to cover abortion and maternity care, including medication abortions. This includes California, New York, Oregon, and Washington.

A few states require abortion coverage for certain insurance plans, but not all. Most states don’t need your health insurance provider to cover any abortion. Check with your insurance plan to see if it covers abortion medications.

How Can a Reproductive Rights Lawyer Help?

Your healthcare decisions should be made between you and your doctor. Unfortunately, many states are enacting restrictive laws on maternity care and abortion medication. If your state laws make it more difficult for you to get the care you need, talk to a reproductive rights lawyer. An experienced lawyer can explain your legal options and represent you if your state is trying to take away your rights. For more information about protecting your rights and medication abortion access, contact a reproductive rights lawyer for legal advice.