Connecticut Democratic Attorney General William Tong speaks at a public meeting in Stamford, Conn., after this month’s election. Tong and other blue-state officials are vowing to build a “firewall” of reproductive health protections as they anticipate federal and state attacks on abortion access under the Trump administration. (John Moore/Getty Images)

Read more Stateline coverage about how states either protect or restrict access to abortion.

Officials in blue states are vowing to build a “firewall” of reproductive health protections as they anticipate federal and state attacks on abortion access under the Trump administration.

“We’re cracking down,” Connecticut Attorney General William Tong, a Democrat, told Stateline. “We are in an unprecedented war against American women and patients. State attorneys general, especially my colleagues and I who support abortion rights and reproductive freedom, have been building this firewall for some time now.”

President-elect Donald Trump has said he would leave abortion access to individual states in the wake of the US Supreme Court’s 2022 ruling in Dobbs that overturned Roe v. Wade and dismantled the federal right to abortion.

But even in states with strong abortion protections, such as Connecticut and Massachusetts, lawmakers and other officials are already debating ways to fend off legal challenges from various quarters, including federal authorities under a Trump administration and anti-abortion lawmakers in conservative states.

“What we’re looking at is this interplay between protective states and the Trump-Vance administration, and what impact that administration will have on state laws and access to sexual and reproductive health care,” said Candace Gibson, director of state policy at the Guttmacher Institute, a research and policy organization focused on promoting reproductive rights.

“It’s going to be an interesting time.”

Targets abortion pills

Tong said one of his biggest concerns is that legislative efforts and legal challenges by anti-abortion lawmakers in red states could lead to nationwide restrictions on the drug mifepristone. It is one of two drugs most often used in medical abortion, which now accounts for almost two-thirds of all abortions.

“If you ban it, it will be nothing if not a nationwide ban on abortion,” he said.

Conservative-led states could follow the example of Louisiana, which passed a law in its last legislative session to classify mifepristone and the drug misoprostol as controlled substances. Both are used in medical abortions as well as to treat other conditions, such as life-threatening bleeding after childbirth. Since Louisiana’s law went into effect, hospitals in the state have been phasing out mifepristone and misoprostol from obstetric bleeding carts and instead stored them in password-protected cabinets outside labor and delivery rooms. It’s a move some doctors worry could waste precious time in emergency situations.

Last week, Republican state representative Pat Curry elected left a similar bill in Texas. Conservative lawmakers in North Carolina hastily passed a law in 2023, overriding Democratic Gov. Roy Cooper’s veto, that included further restrictions on the dispensing of abortion drugs. That law has been bogged down in lawsuits.

But last month, Democratic attorneys general in 17 states and the District of Columbia asked a federal appeals court upholding a ruling that North Carolina cannot impose restrictions on mifepristone that the US Food and Drug Administration has said are medically unnecessary.

Meanwhile, anti-abortion groups released a “Make America Pro-Life Again Roadmap” last week, outlining their plans to hammer abortion access at the federal and state levels, including an emphasis on challenging access to mifepristone.

“We have a siege engine ready for these legal walls that we’re going to face at some state legislatures and legislative levels, and also at the federal level,” Kristan Hawkins, president of the anti-abortion organization Students for Life Action, said in a media call last week.

Hawkins said lawmakers in nine states — Arizona, Kentucky, Louisiana, Mississippi, Oklahoma, South Carolina, South Dakota, West Virginia and Wyoming — would file bills targeting the sale or distribution of drugs that can be used for abortions.

Arizona State Representative Rachel Jones, a Republican, said on a recent call with the media that she plans to target abortion pills in her fight against Arizona’s new constitutional amendment protecting access to abortion, which voters approved earlier this month.

“There are other ways, at the forefront of this, to encourage women to make another decision before they even walk into that abortion clinic, before they order the pills, to stop the ability to be able to do it so easily through the mail,” said Jones. She said she plans to educate her legislative colleagues on how to combat the “big push” for medication abortion.

Strengthens shield laws

A number of states have enacted “shield” laws designed to minimize the legal risks for people who obtain or use abortion. But only eight states — California, Colorado, Maine, Massachusetts, New York, Rhode Island, Vermont and Washington — protect abortion providers from legal action regardless of where their patient is located.

For example, telehealth providers in states such as California, Massachusetts and New York prescribe abortion drugs to patients in states where abortion is prohibited. Shield laws attempt to protect these providers from prosecution.

State shield laws haven’t seen many challenges yet, but they could come, says Gibson, of the Guttmacher Institute.

Attorneys in the reproductive justice division of the Massachusetts attorney general’s office are exploring ways to further strengthen the state’s shield law. With the incoming Trump administration, they expect more efforts by conservative prosecutors and attorneys general to mount legal challenges in anticipation of a friendlier federal atmosphere.

“My office, including through our Reproductive Justice Unit, will continue to ensure that Massachusetts remains a leader in advancing access to care, protecting our health care rights, and addressing disparities, while working collaboratively with my counterparts across the country,” Massachusetts Democratic Attorney General Andrea Joy Campbell said in a statement to Stateline.

“Regional Impact”

Officials in blue states also support protections for birth control, digital privacy and emergency abortion care in hospitals. For example, in Maryland, Democratic lawmakers passed one comprehensive online data protection legislation in April, in an effort to limit how tech platforms and phone apps can collect and use consumers’ personal data, including reproductive health data.

Policymakers understand that these state bans on access to abortion are not just state bans, that they also have a regional impact.

– Candace Gibson, Guttmacher Institute

Connecticut and Massachusetts are among the states looking for ways to strengthen their laws to protect reproductive emergency care if the Trump administration changes current federal guidelines that say abortion is covered by the Emergency Hospital Care Act, known as EMTALA.

If the Trump administration says hospitals are no longer federally required to provide abortions as part of emergency reproductive care, Tong said, even patients in a state like Connecticut could be affected. Without government requirements, for example, religiously affiliated hospitals could refuse to terminate pregnancies in situations where a patient’s life or health might be in danger.

Gibson said she expects to continue to see more state lawmakers file contraceptive coverage bills in upcoming legislative sessions. In Virginia’s last session, Democratic lawmakers passed a bill to guarantee access to birth control, even if vetoed by Republican Governor Glenn Youngkin.

Earlier this year, Campbell, Massachusetts, organized a working group by Democratic state attorneys general and others to collaborate on how to use shield laws and other legal and legislative tools to protect abortion rights.

“There has been an increase in collaborative conversations between different state policymakers,” Gibson said in an interview with Stateline. “I think policymakers understand that these state bans on abortion access are not just state bans, that they also have a regional impact.”

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