What to know about abortion policy across the U.S. heading into 2024

Abortion is going to remain a major issue in politics, policy and the courts in the U.S. in 2024, even though most of the states that were expected to impose restrictions have already done so.

The abortion landscape has been in flux since the June 2022 U.S. Supreme Court ruling that overturned Roe v. Wade, which touched off a round of abortion policy changes and new litigation about them.

There are still looming ballot questions and court decisions. And lawmakers could tweak current abortion laws.

Here’s a look at what to know.

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Abortion will be on the ballot in 2024

Since Roe was overturned, abortion-related questions have been on the ballot in seven states – and the abortion rights side has prevailed on all of them.

Legislatures in the East Coast blue states of Maryland and New York have already put questions on the November 2024 ballot to amend the state constitutions to include rights regarding reproductive health care.

Both states already allow abortion through viability, which is generally considered to be about 24 weeks gestational age.

While those are the only states where ballot questions are a sure thing, they’re possible in several others.

There are pushes to add constitutional rights to abortion in Minnesota, Montana, Nevada and Virginia, where it’s legal in most cases already; and in Arizona, Florida, Nebraska and South Dakota, where heavier restrictions are in place.

In Missouri, where abortion is banned throughout pregnancy, there are dueling ballot measures to expand abortion access. One would bar the government from banning it during the first 24 weeks of pregnancy. Another, from moderate Republicans, would make it legal but for fewer weeks.

In Colorado, where abortion is legal in most cases, there are pushes for ballot measures both to enshrine abortion rights and to roll them back.

Lawmakers in Iowa, where abortion restrictions have been put on hold by a court, are pushing for an amendment that would clear the way for a ban. There could be a similar effort in Pennsylvania, where abortion is legal until viability.

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And it’s still in the courts

For nearly 50 years, abortion legal questions were waged mostly in federal courts.

But the U.S. Supreme Court finding that there’s no national right to abortion directed the latest generation of legal battles over abortion mostly to state court.

Some of the big issues that are yet to be decided:

Women in Idaho, Oklahoma, Tennessee and Texas are suing over being denied abortion while facing harrowing pregnancy complications. The Texas Supreme Court heard arguments in a similar case in November, and this month it denied a woman’s request for an immediate abortion, finding that her life was not in danger, so she did qualify under the exceptions in state law.

The U.S. Supreme Court has agreed to take up the question of whether the U.S. Food and Drug Administration’s approval of the abortion drug mifepristone was appropriate.

State courts are considering several challenges to abortion bans and restrictions, including in Iowa, Montana, Utah and Wyo­ming, where courts have blocked enforcement of the measures.

In Idaho, a federal judge in November blocked enforcement of the state’s first-in-the-nation “abortion trafficking” ban while courts sort out the constitutionality of the measure.

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Abortion could also be on the legislative agenda

Legislative sessions begin in January or February in most states, and there haven’t been many abortion-related bills filed yet.

But activists on both sides anticipate that bills will emerge.

Inrgid Duran, the legislative director at National Right to Life, said other states could pursue provisions like Idaho’s to make it illegal to transport a minor for an abortion without parental consent. Enforcement in Idaho is on hold.

She also said there could be more efforts to fund organizations, sometimes called crisis pregnancy centers, that seek to dissuade abortion, and more measures to clarify abortion definitions.

“The pro-life movement has faced challenges before and will continue to face challenges,” she said. “But it’s not going to deter us from continuing to do what is right by advocating for the vulnerable.”

Some conservative groups are also prioritizing providing more resources to support women during pregnancy and after birth, including with tax credits or grants to boost organizations that encourage women not to seek abortions.

Missouri lawmakers have introduced measures that would make it possible to file homicide charges against women who have abortions. Most major anti-abortion groups oppose that approach, which has been introduced in other states but never gained traction.