THURS-016 - State of Play: Current Trends in State-level Legislative Strategies to Restrict Abortion Access

Brief Abstract Summary: Learn why anti-abortion policies often seem to “go viral” from state to state and which legislative strategies may be on the horizon. In the U.S., abortion policymaking largely occurs at the state level, with state lawmakers introducing hundreds of anti-abortion policies each year. But how do these policymakers manage to draft an astonishing number of bills on the same topic? And why do bills in different states often sound so similar? The answer lies in calculated copycatting – a large portion of abortion restrictions nationwide comes from just one anti-abortion lobbying group that mass-produces abortion restrictions by creating pre-written template bills and distributing them nationwide. By analyzing their library template legislation, we may be able to anticipate newly emerging strategies and possibly mitigate foreseeable harm to both individual and public health.

Detailed abstract description:

Objectives: Abortion care is internationally recognized as an essential component of comprehensive reproductive healthcare that must be readily accessible to protect public health. Despite this, access to clinician-managed abortion care is severely restricted or entirely prohibited in much of the country. In the U.S., abortion policymaking primarily occurs at the state level, with state legislators annually introducing hundreds of anti-abortion policies that contradict the best-available scientific evidence. A substantial number of these proposed policies share a common origin: they begin as "copycat" template bills that are strategically filed across multiple states. Previous research has traced a large portion of these template bills to a singular anti-abortion lobbyist organization, Americans United for Life, that mass-produces abortion restrictions by focusing on the creation and widespread dissemination of template bills. Therefore, this study sought to characterize ongoing trends in state-level legislative strategies that aim to restrict abortion access by conducting a content analysis of recent model legislation produced by this organization.

Methods: We collected all state-level model legislation and legislative guides (N=56) that were publicly available on the organization’s website as of November 2024, inductively coded the text using MAXQDA, and conducted a reflexive thematic analysis.

Results: Of the 56 legislative documents, 45 (80%) contained provisions seeking to restrict abortion access. Among the 45 abortion-related documents, 35 (78%) included actions that would directly impose additional barriers to abortion care. We observed six trends in anti-abortion legislative strategies: 1) explicitly designating embryos as legal persons to prohibit abortion entirely; 2) intertwining embryonic personhood into legislation that was not related to abortion; 3) exploiting the legal vulnerability of youth to constrain access; 4) employing scientifically inaccurate information about fetal development to normalize gestational abortion bans; 5) targeting innovative models of medication abortion provision with disinformation about safety; and 6) circumventing judicial rulings that uphold abortion access by imposing onerous regulations designed to close clinics or by targeting clinicians and practical support organizations with civil penalties.

Conclusion: Although some legislative strategies are continuations of long-standing anti-abortion tactics, these findings demonstrate that the anti-abortion movement is also formulating novel strategies to counteract innovative approaches that have facilitated abortion access following the 2022 U.S. Supreme Court ruling that overturned federal protections for abortion care. It is imperative that advocates, policymakers, researchers, health educators, and clinicians are aware of these shifting strategies to best mitigate foreseeable harm to individuals and public health.