Center’s 2024 State Legislative Wrap-up Finds Laws Continue to Reflect a Divided Nation

State laws on reproductive health care continue to reflect a divided nation, with access to care in the United States more unequal than ever.  

This is among the trends cited in the Center for Reproductive Rights’ new 2024 State Legislative Wrap-up report, which focuses on bills related to abortion, maternal health care, and assisted reproduction. 

“The relationship between voting rights and reproductive rights is now clearer than ever: states with abortion bans are the same states that have limited voting rights and gerrymandered election districts to favor one-party control,” said Elisabeth Smith, the Center’s Director of State Policy and Advocacy. “But there are now 11 states that have enshrined protections for abortion in their state constitutions—and some of these protections came directly from the people.”

To develop the report, which was released December 13, the Center’s U.S. State Policy and Advocacy team tracked and examined nearly 2,000 bills—proposed and enacted—in legislatures in all 50 states and Washington, D.C. 

Here are six takeaways from the 2024 State Legislative Wrap-up: 

1. Access to reproductive health care in the United States is more unequal than ever.  

State laws on reproductive health care continue to reflect a divided nation—meaning Americans’ access to care is completely dependent on where they live. While anti-abortion states explored new ways to further ban and restrict care, states supporting abortion rights acted to protect rights and expand access. 

2. Anti-abortion lawmakers aren’t just working to ban abortion in their own states—they’re reaching into other states as well. 

Attempts to prevent young people from traveling out of state for abortion care and criminalize those supporting them marked the new trend in anti-abortion legislation. 

3. The outcome of the 2024 federal elections could decimate abortion access nationwide.  

With a second Trump presidency and an anti-abortion majority in both houses of Congress, threats to reproductive freedoms will increase. A federal abortion ban would preempt state abortion protections, including voter-approved state constitutional amendments.

4. Cost continues to be a huge barrier to accessing abortion, in vitro fertilization (IVF) and maternal health care. 

States can act to reduce costs by ending funding restrictions, expanding Medicaid coverage, and mandating insurance coverage for reproductive care. 

5. Interstate shield laws are critical tools—and they’re evolving.  

In states where abortion is legal, interstate shield laws are used to protect abortion providers, helpers, and patient medical records when care is provided to out-of-state residents. Some states strengthened their laws to include protections for data privacy, gender-affirming care providers, and telemedicine medication abortion across state lines.  

6. Americans support reproductive freedom. 

In 2024, millions of people voted to enshrine the right to abortion in their state constitutions, approving measures in seven of 10 states where abortion appeared on the ballot. Since 2022, when the U.S. Supreme Court eliminated the federal constitutional right to abortion, voters in 14 of 17 states have turned out in favor of abortion rights. 

“Americans are sending a clear message: they support reproductive freedom and they won’t tolerate further regression of their rights,” added Smith. “State lawmakers—as well as the incoming Trump administration—should take note.” 

Read the report:

2024 State Legislative Wrap-up