18 Ways the Supreme Court Just Changed America


Even within the Democratic Party, it’s hard to make the case that this is a motivating issue. A month after the draft opinion was leaked — arguably at the height of the public debate over abortion this year — Texas Democrats were asked to pick between the last anti-abortion Democrat in the House, Henry Cuellar, and his abortion rights supporter challenger, Jessica Cisneros. Cuellar won. If this issue can’t even motivate Democratic voters within their own primary to vote out someone who disagrees with them on the issue — either by unexpectedly turning out to vote in the primary or by changing their vote from one Democrat to another — then it’s hard to see how the issue will do much at the national level.

Democrats have seen this problem before in which polling says that Americans are with them but results at the ballot box tell another tale. Gun control measures such as expanded background checks routinely receive more than 80 or 90 percent support in polling, but even when the question is put to voters as an initiative or referendum instead of through candidates — and even in left-leaning states like Maine, California, Washington and Nevada and even when they outspend the gun-rights proponents — they lose. As New York Times correspondent Nate Cohn pointed out in a recent article, “Hillary Clinton fared better at the ballot box than expanded background checks in the same states, most on the same day among the same voters.”

Abortion, like guns, has been at the center of our culture war debates for decades. The data suggest that voters who were going to be motivated by those issues — for or against — have already been voting and have already sorted themselves into their respective parties. It’s hard to see how a Supreme Court decision will change that.

This decision will ‘place the reproductive health of Black women and other women of color at great risk.’

Keisha N. Blain, a 2022 Guggenheim Fellow and Class of 2022 Carnegie Fellow, is professor of Africana Studies and history at Brown University. She is the author of Until I Am Free: Fannie Lou Hamer’s Enduring Message to America.

One of the outcomes of the Roe v. Wade decision that concerns me most is how the removal of Roe‘s protections will worsen maternal health conditions for Black women.

The Centers for Disease Control and Prevention estimates that more than one-third of abortion patients in the United States are Black women, meaning that post-Roe, Black women will be most impacted by the ban on abortion in most red states. As a result, the decision to end legal access to abortions will also further exacerbate the disproportionately high maternal mortality rate among Black women and place their reproductive health at greater risk.

The United States already has a high maternal mortality rate with an average of 23.8 deaths per 100,000 live births in 2020, according to the CDC. The same report revealed that Black women died at nearly three times the rate of women from other races, averaging 55.3 deaths per 100,000 births. This grim reality is the result of decades-long racist and discriminatory practices in healthcare. It is a structural issue that remains at the core of the medical profession — and one that deeply impacts Black women’s lives.

Abortion allows women to terminate pregnancies that are potentially dangerous for the mother. As state legislatures push for greater restrictions on abortion, there are some efforts to narrow the health-of-the-mother exceptions. These bans will increase the maternal mortality rate of all women, and in particular Black women, who already have a higher rate.

Relatedly, the overturning of Roe will exacerbate Black women’s economic instability. At a moment when Black women and other women of color have been pushed out of the U.S. workforce at a higher rate than men, restrictions on abortion access deepen economic inequality. Those who are denied access to abortions are not only more likely to be in poor health, but they are also more likely to live in poverty. While overturning Roe is an overall blow to women’s rights and autonomy, one of its unfortunate outcomes is how it will significantly worsen Black women’s social and health conditions in the United States.

‘The American people will be forced to talk to one another, reason together.’

O. Carter Snead is professor of law and director of the de Nicola Center for Ethics and Culture at the University of Notre Dame, and author of What It Means to be Human: The Case for the Body in Public Bioethics (Harvard University Press 2020).

What will the American legal and political landscape look like in 10 years, now that Roe v. Wade, Planned Parenthood v. Casey, and related precedents have been overturned and the issue of abortion has been returned to the democratic process? Likely Americans will be accustomed to governing themselves on this vexed matter through the deliberative work of the political branches as our friends and neighbors in nations around the world have always done, rather than by submission to the fiat of unelected judges. This will mostly take place at the state level, creating a patchwork approach to regulating abortion, with some states enacting strong restrictions and others adopting permissive regimes, or even promoting access to the procedure. This patchwork landscape will be complex but ultimately more democratic, easing polarization and bringing on more civic peace to U.S. politics.

People will realize that the post-Roe parade of horribles claimed by abortion rights advocates was never a serious threat. Women won’t be prosecuted for seeking an abortion (and it will still be true that the last recorded instance of such a case was 1922). Women will still be able to get treatment for ectopic pregnancies and miscarriages. In those states where abortion is prohibited, there will be exceptions for medical emergencies. In vitro fertilization will not be illegal. Neither will contraception, same-sex marriage, or interracial marriage, as some activists claim are next to be on the chopping block after abortion rights.

And contrary to the overheated claims of some, we will see that in a post-Roe world, women continue to rise in their quest for full and equal participation in the economic and social life of the nation — just as they have done in recent decades as abortion rates have simultaneously declined. Since 1990 as abortion rates have dropped precipitously, women’s participation in the workforce has, by contrast, dramatically increased, they have continued to increase their pay as a percentage of men’s income, and the percentage of businesses owned by women has soared (including among women of color). It will thus become clear that women don’t need abortion to flourish as equal participants in the economic and social life of the nation.

While it will be hard to govern ourselves on the question of abortion, given the strongly held views and conflict of great goods at stake (namely, reproductive freedom vs. the equal dignity of every human life), there will be more civic peace. The judicial confirmation process will no longer be a no-holds-barred proxy war over abortion. Personal harassment or even the assassination of justices will no longer tempt radical activists as a ready tool to work their will.

Unlike submission to raw judicial decree untethered to the text, history or tradition of the Constitution, self-governance involves a well-defined process of persuasion and compromise, where even the political losers feel heard, and are comforted that they can continue to make their case to the winners in the years to come. Both sides are forced to understand and respond to the arguments of their fellow citizens. The resulting laws of the states will more closely track the views of the people within their borders.

But best of all, without Roe and Casey, over the next 10 years, the American people will be forced to talk to one another, reason together and learn that their political opponents are not enemies, but people of good will who are trying to care rightly for those they love. And unlike under Roe and Casey, as the political process unfolds, we will at least have the chance to find common ground and come together to care for mothers, babies (born and unborn) and families in need.

Expectant parents will not be able to fully use the powerful tools and knowledge of genetic testing and prenatal screening.

Joanne Kenen, Politico’s former executive health care editor, is the Commonwealth Fund journalist in residence at Johns Hopkins Bloomberg School of Public Health.

Genetic testing and prenatal screening have given expectant parents powerful tools and knowledge. Access to legal abortions has also meant that those expectant parents can use that information — which can inform them of a severe fetal health problem — to decide whether to carry the pregnancy to term. The end of Roe v. Wade will mean they may no longer be able to make that decision.

Not if they live in certain states. Not if they can’t travel. Not if they can’t afford the tens of thousands of dollars it costs to do IVF and preimplantation testing of an embryo — which lets a family with a known risk of having a child with a severe or fatal disease use only embryos screened for that condition before they are placed into the womb. The procedure isn’t being outlawed — but it’s too costly for many people and not routinely covered by insurance.

It’s not accurate to assume that everyone who discovers a severe fetal health problem opts to terminate a pregnancy, Josephine Johnston of the Hastings Center on medical ethics told POLITICO. But some do. And it’s a highly personal decision, best made with the help of physicians, genetic counselors and other trusted advisers.

Testing and screening have come a long way in recent years, and it’s done earlier in pregnancy (though definitive diagnoses usually come during the second trimester). The ability to glean that knowledge is likely to continue to grow. As is the inability to fully use it.

The decision will ‘exacerbate the partisan and regional division on abortion that is already in place.’

Daniel K. Williams is a professor of history at the University of West Georgia and the author of Defenders of the Unborn: The Pro-Life Movement before Roe v. Wade.

The reversal of Roe v. Wade will probably confirm and exacerbate existing trends rather than substantially change them. If these trends continue for the next decade, regional variations in abortion policy will merely be exaggerated versions of those that we already see today.

Opponents of abortion anticipate that the reversal of Roe v. Wade will reduce the number of abortions in the United States, but any impact of the decision on the abortion rate will be quite modest. That is partly because the states that are most likely to ban abortion have already made it so difficult for abortion providers to operate that most shut down or fled these states several years ago. Of the 13 states with trigger laws that would ban most abortions as soon as Roe v. Wade is reversed, three (Texas, Idaho and Oklahoma) have enacted policies during the past year that already effectively prohibit the vast majority of abortions. The other 10 have so few abortion providers — and so few abortions provided — that a near-complete ban on abortion would affect fewer than 5 percent of the abortions performed in the United States each year and would shut down only 50 of the nation’s more than 1,500 abortion providers.

Even if an additional 10 states restrict abortion over the course of the following year, the number of abortion providers affected would still be very limited; approximately 85 percent of the nation’s abortion providers would still be in operation. Furthermore, the reversal of Roe v. Wade will almost certainly prompt some liberal states to expand abortion services and government funding for abortions, which will make it easier for people in conservative states to cross state lines to obtain abortions. In addition, the use of abortion pills — which now account for more than half of all abortions in the United States — will likely increase and will be very difficult to regulate, especially when they are ordered over the internet from an off-shore provider.

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