PHOENIX -- Voters approved ballot measures protecting abortion rights in seven states last fall. Similar measures failed in three others.
But the fight was only starting.
Lawmakers in those 10 states filed at least 168 bills in the last few months 鈥� some to expand abortion access, others to set new restrictions.
In Kansas, Republican legislators overrode a veto and enacted a law requiring child support payments from the moment of conception.
In Arizona, where 61% of voters backed Proposition 139 to enshrine abortion rights through fetal viability, Democratic lawmakers have tried to repeal abortion advertising bans and on telehealth prescriptions for the drug used in two-thirds of U.S. abortions.
With Republicans firmly in control of the Arizona Legislature, both bills have been stuck in committee with no prospect of advancing. The session ends June 30.
鈥淲e still have miles to go,鈥� said state Rep. Stephanie Stahl Hamilton, D-Tucson, who introduced both measures, 鈥渂ut I think we鈥檝e been able to, for now, accomplish as much as our colleagues across the aisle have the political will to stomach.鈥�
Dobbs set off the scramble
The scramble began when the Supreme Court struck down Roe v. Wade in June 2022, sending regulation of abortion back to the states for the first time in nearly 50 years.
Kansas voters were the first to weigh in. Just over a month after the court鈥檚 landmark ruling in Dobbs v. Jackson Women鈥檚 Health Organization, voters resoundingly rejected a Legislature-proposed constitutional amendment that would have banned abortion entirely.
In Missouri, voters approved Amendment 3 last fall, adding abortion rights to the state constitution.
Six months later, Republicans in the Missouri Legislature voted to seek repeal. The proposal will be on the ballot by November 2026, depending on when the governor sets a special election.
鈥淎mendment 3 is opening the door to dangerous, unregulated abortion facilities with zero accountability,鈥� Senate President Pro Tem Cindy O鈥橪aughlin, R-Shelbina, said in March. 鈥淢issouri must fight back against this attack on life and on women鈥檚 health.鈥�
Success of the repeal movement would make Missouri the first state to backtrack on abortion rights approved by voters since the Dobbs ruling.
Will of the people
In Arizona, Republican lawmakers are mostly focused on statutory changes rather than trying to undo Proposition 139 directly.
Rep. Lupe Diaz, R-Benson, said that ballot measure 鈥渢ies legislative hands鈥� and would be hard to undo. Instead, he is pushing a bill that would prohibit state and local governments from funding any facility that provides abortions.
Though it doesn鈥檛 directly target abortion access, it would hit facilities that provide both abortions and other services.
鈥淲e鈥檙e not prohibiting anybody from getting anything, any services, nothing,鈥� Diaz said. 鈥淎ll we鈥檙e saying is that we鈥檙e not going to fund it with state dollars. You have to go to the free market to be able to do that.鈥�
Arizona law already prohibits the use of public funds to cover abortion care. That includes Medicaid and state-provided insurance plans.
Private donors do provide support through groups such as the Abortion Fund of Arizona.
In Missouri, Republicans assert that the ballot measure was unpopular, though voters did narrowly approve it by 1.7 percentage points.
鈥淎 clear mandate has not been sent by the voters of the state,鈥� said state Rep. Justin Sparks, R-Wildwood.
Sparks has filed one bill and a resolution to restrict abortion rights in Missouri. Those would need voter approval.
He expressed doubts that Amendment 3鈥檚 passage indicated a desire for abortion access. He said he鈥檚 heard from constituents who voted 鈥測es,鈥� only to realize it went further than promised.
鈥淥ne was from a lady that said, 鈥業 had to vote for Amendment 3, because if I didn鈥檛, then my ectopic pregnancy could have caused me to have sepsis, and I could have died. 鈥� There was a chance that my health could have been in jeopardy,鈥欌�� Sparks said, adding, 鈥淭hat is patently false.鈥�
In Arizona, Proposition 139 drew 61% of the vote.
Diaz said he will continue to push back on it, asserting that Arizonans were content with the 15-week ban in place before voters amended the state constitution. The new cutoff is viability -- around 24 weeks into the pregnancy, the point at which a fetus can survive outside the womb.
Republicans 鈥減olled the people with four different polls that said, 鈥榃hat do you think about this?鈥欌�� Diaz said. 鈥淎nd they did not want 139.鈥�
Public opinion surveys ahead of the votes tracked closely with the results at the polls.
A September 2024 New York Times/Siena College poll of Arizona voters showed 54% to 62% support. In Missouri, a Saint Louis University/YouGov poll roughly three months before Election Day showed 48% to 56% support.
Advocates fight back
In both Arizona and Missouri, lawmakers who want to remove barriers to abortion care are outnumbered in Republican-controlled Legislatures.
Among the stalled Democratic proposals is one from the Arizona Senate Minority Leader Priya Sundareshan, D-Tucson, Senate Bill 1430. That would undo a law requiring facilities to report details of all abortions to the Department of Health Services.
In Missouri, Sen. Patty Lewis, D-Kansas City, introduced SB 696, which would repeal some restrictions that she believes became unconstitutional when Amendment 3 passed.
That includes requirements for informed consent, waiting periods, facility licensing and reporting.
鈥淎s a nurse, I think these personal, private healthcare decisions are up to the individual and their healthcare provider,鈥� she said. 鈥淧oliticians need to stay out of our doctor鈥檚 office, full stop.鈥�
That bill has stalled in committee, as well.
Mabel Felix, who tracks women鈥檚 health policy as an analyst at KFF, said funding restrictions and onerous licensing rules have an impact.
鈥淭he larger challenge for a lot of 鈥� independent clinics is the attempts that there have been for years to exclude them from Medicaid programs,鈥� she said. 鈥淥nce an abortion clinic closes, it鈥檚 actually really hard for another one to open, because they do require so much investment.鈥�
Missouri currently has no abortion clinics, according to a database at the University of California San Francisco. That鈥檚 down from two in recent years.
Arizona has nine clinics, one of which opened in 2023, according to the database.
A look ahead
Anti-abortion legislators continue to find creative ways to erect obstacles.
The child support bill in Kansas, House Bill 2062, is one example.
Critics say that by requiring child support payments from the day of conception, it would effectively mean the state recognizes 鈥渇etal personhood.鈥� That doctrine, long sought by some abortion foes, would vastly expand legal protections prior to birth. It could open the door to murder charges for terminating a pregnancy.
鈥淭he real thing is about leading to fetal personhood. If you can鈥檛 go directly to the people and have them vote on an amendment, then you鈥檝e got to go through the back door,鈥� said Rep. Susan Ruiz, D-Shawnee.
The obvious goal, she said, is to ban abortion or at least serve as a deterrent.
鈥淚t鈥檚 just adding more and more layers of confusion and restrictions,鈥� Ruiz said. 鈥淭hey hope that women get frustrated and don鈥檛 try to seek abortions and then go ahead and have the baby.鈥�
She accused abortion opponents of caring more about the fetus than the child.
鈥滱fter the baby is born, the Legislature, they鈥檙e like 鈥� that鈥檚 it. You鈥檙e on your own,鈥� she said.
In other states, Democrats have managed to enact some new protections for those who seek abortion care.
In Maine, Gov. Janet Mills signed a law May 29 that allows only the name of the health care facility to be printed on prescription bottles.
The law adds Maine to a growing group of states trying to protect individual practitioners involved in abortion care from pressure or threats.
Some of the legislative proposals are mostly about scoring a political point.
One example: a bill to completely ban abortion in Missouri, HB 2009. The author readily acknowledges that it conflicts with the state constitution.
鈥淢y intent in introducing those bills is sort of just to let people know where I stand on the issue of abortion, that I鈥檓 strongly pro-life, and that ideally I鈥檇 like to basically end abortion,鈥� said state Rep. Brett Fairchild, R-St. John. 鈥淏ut realistically, I know those bills aren鈥檛 going to pass.鈥�