CNN
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Two years after the overturning of Roe v. Wade, Republicans are still wrestling with the political downsides of leaving abortion policy up to the states.
Nationwide, the question of when or whether patients should be able to get abortions is far from settled. The 2022 Dobbs decision has opened a new battlefront for abortion opponents, forcing Republicans to respond to a wave of new developments and raising Democratic electoral hopes.
Republican lawmakers in heavily Republican states are still pushing for abortion restrictions, testing new strategies that could shape next year’s legislative season. Moments seen as victories for abortion opponents, such as the Alabama Supreme Court’s fertilized egg decision and the Arizona Supreme Court’s reinstatement of an 1864 abortion ban, have sent Republicans in hotly contested races scrambling to distance themselves from unpopular positions, such as the threat of IVF and laws with no exceptions for rape or incest. (State Republicans ultimately voted to weaken or overturn those decisions.)
And two abortion cases pending before the U.S. Supreme Court — a mid-June ruling rejecting efforts to deregulate the abortion drug mifepristone and a pending case regarding emergency abortions — continue to keep the issue in the spotlight ahead of the November election.
“States are going to continue to do what they’re going to do, and the Supreme Court is going to do what it’s going to do,” said Mary Ziegler, a law professor and legal historian at the University of California, Davis, who supports abortion rights.[Republicans are] We will have to respond to these developments.”
These cases have become political ammunition for Democrats, who hope that anger over the regulations and enthusiasm for a referendum on abortion rights will give them an edge in the presidential and closely fought congressional elections. Democrats have been pushing a reproductive health bill through the U.S. Senate and aggressively highlighting state-level regulations, tying them to President Trump’s Supreme Court nominations and overturning Roe.
Polls show that abortion remains a politically important issue for Democrats, with most Americans wanting at least some access to the procedure.
Voters are also unconvinced by Trump’s position that abortion policy should be left to the states: A CNN poll released last month found that 49% of voters surveyed want federal abortion protection, while 37% want to leave the issue up to the states. Just 14% support nationwide regulation.
“President Trump was right to say abortion policy should be left to the states,” said Whit Ayers, a Republican political consultant. “The vast cultural differences between states mean there can’t be a national policy that would be considered legitimate in both Mississippi and Massachusetts.”
Ayers said some states have “overdone it” with their abortion restrictions, but he believes states will ultimately come to an agreement on abortion that suits their culture.
The process of reaching the deal has raised tensions between Republicans and anti-abortion advocates, who have rejected the idea that their primary focus would be a political burden for Republicans. Instead, they have pursued their agenda at the state level and urged President Trump and others to push it even harder at the federal level.
“Under the tyranny of Roe, lawmakers were able to check off pro-life boxes and use the Supreme Court as an excuse for their inaction,” said Kristan Hawkins, executive director of the National Student Life Alliance. “Once Roe was repealed, that excuse disappeared.”
Starting in 2022, nearly 20 states will restrict abortion to levels that would not have been legal under Roe, including 14 states that have near-total bans.
Last month, Louisiana became the first state to pass a law designating abortion pills as a controlled substance and making it a felony to possess the drugs without a prescription.
“We’ve had a lot of wins, a lot of victories, but there’s a lot at stake in this election,” said Kelsey Pritchard, state communications director for Susan B. Anthony Pro-Life America. “Republicans need to be just as engaged and committed to this issue as Democrats, otherwise Democrats will define the Republican Party and misrepresent where the Republican Party stands.”
With state election season drawing to a close, Pritchard said the group is now focused on political organizing. A handful of states, including battleground states like Nevada, Arizona and Florida, have abortion rights measures on the November ballot or are actively seeking signatures. Democrats are hoping the measures will boost voter turnout and potentially bring states like Florida into the election.

Abortion opponents are also exploring options to restrict abortion access at the federal level.
Some conservatives argue that the Comstock Act, an 1873 anti-moral rights law that banned the mailing of abortion-inducing materials, could be used to ban the pill through the executive branch. More than 60% of abortions performed in 2023 will be performed via mifepristone, according to the Guttmacher Institute, which supports abortion rights.
The Biden administration argues that the law cannot be enforced if the sender did not knowingly assist in an illegal abortion.The Supreme Court has rejected a lawsuit that would have curtailed access to mifepristone, but the decision left the door open for new challenges from states.
Trump has not said how he would handle abortion pills during his second term. During a visit to Capitol Hill earlier this month, he advised Republicans to follow their hearts on the issue, but made exceptions for cases of rape and incest and called for protecting the life of the mother, CNN reported.
Trump has also criticized state abortion bans that limit or don’t provide exceptions for abortions at the six-week mark, before most women even know they’re pregnant. Some of these bans are still being actively challenged in state courts.
State courts are hearing challenges to near-total abortion bans and other restrictions in more than a dozen states, including battleground states like Georgia and Wisconsin, and abortion advocates are also seeking to put abortion-rights measures on the November ballot in Nebraska and Missouri.
State courts have already seen a big impact this year, in part because of the slow pace of legislation compared to the legislative cycle.
Arizona’s 1864 anti-abortion law, which banned abortions at any stage of pregnancy except to save the mother’s life, had been challenged for nearly two years, but the state Supreme Court ruled in April that the state must abide by the law.
Arizona Democrats repealed the law about a month later, spurred by votes from Republican lawmakers facing tough reelection battles and calls from President Trump and Republican Senate candidate Kali Lake to repeal the ban.

In Texas, the state Supreme Court has ruled against plaintiffs in two cases seeking clarification of the state’s abortion law, which bans abortion unless there is a risk of death or “significant impairment of major bodily functions” if the abortion is not performed.
Amanda Zulawski, the lead plaintiff in a lawsuit filed by women denied emergency abortions in Texas, has since represented the Biden campaign. Zulawski suffered premature rupture of membranes at 18 weeks pregnant and nearly died of sepsis after initially being denied an abortion. She says her fertility has been permanently damaged, and she is now using IVF to expand her family.
“The Supreme Court’s decision overturning Roe v. Wade not only ended federal protections for the right to abortion,” Zulawski said in a recent video for the Biden campaign, “it also opened the door to extreme state laws that threaten access to in vitro fertilization.”
Abortion policy and the role state courts play in interpreting those laws have made state supreme court elections more competitive. Fewer than half of states hold elections for state supreme court justices, but recent races in Wisconsin and Georgia have focused on state abortion laws.
In Texas, a former Democratic congressional candidate has launched a political action committee to oust three state Supreme Court justices who are up for re-election this year.
“Unfortunately, it’s up to the states to decide,” said Gina Ortiz Jones, who launched Find Out PAC in January. “In the case of Texas, that means unnecessary suffering.”
The Biden campaign has followed a consistent strategy when speaking with Trump about abortion policy: They have pointed to the former president’s credit for appointing the three justices who overturned Roe, pinned any state-level policy changes on Trump and argued that the RNC ultimately wants to push for a federal ban.
“Americans across the country vividly remember what happened two years ago when President Trump’s Supreme Court majority overturned Roe, throwing women’s health care into chaos and putting their lives at risk,” Biden campaign manager Julie Chavez Rodriguez said in a statement ahead of the Dobbs anniversary. “Trump got it done. He owns the state of reproductive rights in our country today, and if re-elected, he will go even further.”
Ahead of the anniversary of the Dobbs murder, Senate Democrats are scheduled to vote on bills to protect and expand access to in vitro fertilization and contraception. Republicans who voted against the bills argued that neither treatment is at risk and that the vote was politically motivated. Another Democratic bill, led by Sen. Tina Smith of Minnesota, would seek to repeal the Comstock Act.
“Republicans are saying they have a problem with the way they’re communicating their message on abortion,” Smith, who also serves as vice chairman of the Democratic Senatorial Campaign Committee, said at a press conference Thursday. “No, they have a policy problem.”