52 Years After Roe, Reproductive Rights Group Launches Abortion Justice Playbook

Wednesday marked 52 years since the U.S. Supreme Court affirmed in the Roe v. Wade decision that Americans have the right to obtain abortion care, but as the reproductive justice group All* Above All said as it released its Abortion Justice Playbook, marginalized communities across the U.S. faced barriers to necessary healthcare "even before the fall" of Roe in 2022.

With Republican-controlled states given free rein to pass abortion restrictions and bans, said All* Above All, "those inequities have only deepened, with millions denied the healthcare they need."

The threat to abortion access has only "escalated" as President Donald Trump returns to the White House, said the group, "as his administration continues to push for even more restrictive abortion laws at the state level."

While the U.S. government is now in the hands of a president who has bragged about overturning Roe, mocked the family of one Georgia woman whose death was caused by the state's six-week abortion ban, and whose vice president has backed a nationwide abortion ban, All* Above All emphasized that Trump's views do not represent those of the majority of Americans.

"The American people remain committed to protecting abortion access with Pew Research finding 63% support for abortion rights nationwide," reads the Abortion Justice Playbook. "Since 2022, voters in 13 states have enacted state constitutional protections for abortion care. State legislatures across the country have also sprung into action to protect abortion access in their states and mitigate the effects of restrictions in others."

"There is still an incredible amount of work left to be done in order to achieve abortion justice in this country, and we hope this playbook serves as a guide to realizing that goal," reads the 21-page document.

The organization was established in 2013 with the goal of repealing the Hyde Amendment, the federal restriction passed in 1976 that bars federal funding from being used for abortion care. The policy blocks abortion care for low-income people who are covered by Medicaid, even in states where abortion remains legal.

"This isn't just about policies—it's about people. It's about transforming a broken system to ensure that everyone, no matter who they are or where they live, can access the healthcare they deserve with dignity and without barriers."

All* Above All's playbook calls for the repeal of the Hyde Amendment through the passage of the Equal Access to Abortion Coverage in Health Insurance (EACH) Act, which would ensure the "basic right to abortion care is extended to every person who receives care or insurance through the federal government. Additionally, it will prohibit political interference with decisions by private insurance companies to offer coverage for abortion care."

But with Republicans controlling both chambers of Congress for at least the next two years, reads the playbook, "states can step up to serve as a crucial backstop in providing affordable abortion care" as abortion rights advocates continue to push for the repeal of the Hyde Amendment.

The group called on states to repeal all bans on insurance coverage of abortion, which exist in 35 states, and to require all health insurance plans to cover abortion care without cost sharing.

All* Above All said states should also expand access and affordability by:

• Mandating insurance providers to produce consumer-friendly information about covered services;
• Eliminating restrictions on telehealth abortion services to ensure accessible, timely, and equitable care; and
• Working with providers to ensure sustainable and equitable reimbursement rates.

"The Abortion Justice Playbook is a bold and necessary blueprint for building a future where abortion access isn't just restored but reimagined to address the systemic inequities that have long denied care to Black, Brown, LGBTQIA+, and low-income communities," said Lexi White, director of state strategies at All* Above All. "This isn't just about policies—it's about people. It's about transforming a broken system to ensure that everyone, no matter who they are or where they live, can access the healthcare they deserve with dignity and without barriers."

To further protect medication abortion—which accounts for 63% of all abortions in the U.S.—after the Supreme Court ruled last year that the abortion pill mifepristone can maintain its federal approval, the group called on states to repeal any in-person dispensing requirements for medication abortions.

Physician-only dispensing requirements should also be repealed, the group added, and state legislatures should pass shield laws to protect providers from out-of-state criminalization of prescribing and dispensing abortion pills.

In December, Republican Texas Attorney General Ken Paxton filed a first-of-its-kind lawsuit against a doctor in New York who prescribed abortion pills to a patient in Texas.

All* Above All applauded 14 state governors who have issued 18 executive orders to protect abortion rights since Roe was overturned, and called on governors to take further steps.

Governors should use state budgetary powers to ensure providers can care for patients who need abortions, including by supporting abortion funds; protect medication abortion, especially at universities, through executive action; and direct state health authorities to affirm state and federal requirements to provide emergency abortion care, said All* Above All.

While many of the more than 90,000 local governments in the United States have used their authority in recent years to restrict abortion rights through "arbitrary permit denials, zoning restrictions, reductions in funding, and more," said All* Above All, local leaders can also "fight back against restrictions."

The group called on local governments in states with abortion bans to restrict funding so local funds can't be used in abortion investigations and ensure that criminalization of abortion care is local law enforcement agencies' "lowest priority."

Local governments in all states can work to repeal any abortion travel bans, remove arbitrary restrictions that limit where and how clinics can operate, prohibit local police from taking part in federal or state abortion investigations, and speak out against reproductive injustice by publicly supporting the EACH Act and other legislation.

"The Abortion Justice Playbook," said All* Above All president Nourbese Flint, "is our blueprint for a future where abortion access is equitable, universal, and free from discrimination."