Fractured post-Roe landscape leaves questions about cross-border care

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The fall of Roe v. Wade leaves health providers facing a patchwork of standards for reproductive care now that state lawmakers have final say over whether abortions — and potentially other facets of women’s health — are performed within their borders.

Why it matters: Friday’s Supreme Court decision is already deepening divisions between red and blue states and testing alliances that were forged in response to COVID-19 to facilitate telehealth services, obtain scarce medical supplies and fill gaps in the health care workforce.

Where it stands: States already had wide authority to set standards for health providers and payers, but could now opt to prosecute violators of trigger laws and other anti-abortion legislation enacted in response to the Supreme Court decision.

  • Seven Republican-led states have moved to either ban abortions or heavily restrict access to them in the aftermath of the ruling. Penalties vary, from fines and the loss of medical licenses to jail time.
  • Minnesota Gov. Tim Walz (D) and Massachusetts Gov. Charlie Baker (R) moved to deny any extradition request from states pursuing criminal charges against people who obtained or provided reproductive health care that’s legal in their states.
  • Democratic governors in California, Washington and Oregon signed a pact to safeguard patients and providers, including discouraging cooperation with out-of-state law enforcement investigations concerning abortion.
  • Illinois Democratic Gov. J.B. Pritzker is calling for a special legislative session to consider expanding access to abortion in the state.

What they’re saying: The American College of Obstetricians and Gynecologists says states’ prosecutorial powers don’t extend beyond borders — for example, to residents who travel to other states for abortion care, Molly Meegan, the group’s chief legal officer, told reporters Friday.

  • The American Hospital Association cited “practical impacts” the new landscape will have in areas like maternal care, medical education…