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      Sajid Javid ridiculed for likening NHS to ‘Blockbuster in the age of Netflix’

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      Sajid Javid has been criticised for likening the NHS to a defunct video rental chain, calling it a “Blockbuster healthcare system in the age of Netflix”.The health secretary said changes were needed in the use of technology and data to help workers care for patients and that it was “no longer simply an option to stick with the status quo”.But one senior doctor said the comments show Mr Javid is “out of touch” and NHS leaders warned they need more support to turn tech ambitions into reality.David Nicholls, from the Doctors’ Association UK told The Independent: “Blockbuster famously went bust, for Mr Javid to fail to even acknowledge the workforce and staff retention issues shows how out of touch he is with the crisis the NHS and social care system faces through his lack of investment over the last decade.“Does he actually care or is he more concerned about soundbites than patient care?”Shadow health secretary Wes Streeting said: “I think it’s slightly absurd that 12 years into a government we have ministers who talk in the biggest generalities without plans to deliver anything.”A spokesperson for No 10 said Mr Javid made the comments at Tuesday morning’s cabinet meeting.“The health and social care secretary updated cabinet on the scale of the challenge post-pandemic, saying we had the Blockbuster healthcare system in the age of Netflix. He said it was no longer simply an option to stick to the status quo,” the spokesperson said. “He said the government had set the NHS a target of dramatically improving productivity to save £4.5bn a year.”Asked if Mr Javid saw the NHS as a business disaster that could go bust, the spokesperson replied: “I think he’s saying that it needs further changes in order to make it sustainable for the long term.“It’s very much the view that the government wants to support the NHS to become fit for the future. Some of that work the NHS has already undertaken. You’ve seen that with the diagnostic centres, with the surgical hubs, which have been great successes. But clearly there is more work to do to ensure the NHS is there for us in years to come.”The spokesperson said there would be no further announcement of investment in the NHS beyond what has previously been set out.Saffron Cordery, interim chief executive of NHS Providers, which represents NHS trusts, said: “Trusts accelerated technological innovations and digital ways of working during the pandemic. We’ve seen a sea change in how services are being delivered, enabling new ways of working and freeing up clinicians so that they can spend more time with their patients.“But trusts will need much more support to turn the secretary of state’s high-tech ambitions into reality. They need more staff with the right skills, and more support from the centre, in areas such as coordinating commercial expertise.” More

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      in US Politics

      Will anti-abortionists use ‘uterus surveillance’ against women in the US? | Arwa Mahdawi

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      Will anti-abortionists use ‘uterus surveillance’ against women in the US?Arwa MahdawiIf, as is expected, Roe v Wade is overturned by the US supreme court, 26 states are certain or likely to ban abortion – and data tracking could mean there’s nowhere for women to hide If you are looking for a cheerful column that will make you giggle and distract you from everything that is wrong with the world, click away now. This week I have nothing but doom, gloom and data trackers for you. If you are hoping to sink into a well of existential despair, maybe let out a few screams into the void, then you’ve come to the right place.Here goes: the US supreme court, as you are no doubt aware, is expected to overturn Roe v Wade and the federal right to an abortion very soon. At least 13 Republican-led states have “trigger laws” in place, which means that the moment Roe is overruled, abortion will be fully or partly banned. Other states will follow suit. According to the Guttmacher Institute, a pro-choice research organisation, 26 states are certain or likely to ban abortion when Roe falls.Perhaps you are the glass half-full sort. Perhaps you are thinking: “Well, at least people can travel to a state where abortion is legal.” Unfortunately, it’s not that simple. There are the obvious logistical and financial constraints, for one thing. Then there’s the fact that we live in a world of mass surveillance: pretty much everything we do these days leaves a digital footprint – one that anti-abortion extremists will not hesitate to weaponise. One Democratic senator has described the potential of new technology to track down and punish anyone who might even be thinking of having an abortion as “uterus surveillance”. Expect to see a big rise in this, not least because some anti-abortion states are providing financial incentives to snitch on your fellow citizens. Texas, for example, has passed “bounty hunter” laws promising at least $10,000 to individuals who help enforce the abortion ban by successfully suing an abortion provider.To be fair, there’s nothing new about uterus surveillance. Anti-abortion activists may be stuck in the past when it comes to reproductive rights, but they have always been adept at using modern technology to further their goals. One tactic they’ve used for decades is standing outside clinics and recording the licence plates of anyone who enters. As far back as 1993, extremists were tracing the people connected to those licence plates, obtaining their phone numbers, then calling up to harass them. Years ago tracing someone took a bit of time and effort. Nowadays, you can look up someone’s personal information with the click of a button and a small fee.The wonders of the modern world mean there are a mind-boggling number of ways in which you can now identify anyone who might be thinking about an abortion. To begin with, there’s location data. Vice media recently reported that a data location company is selling information related to Planned Parenthood facilities (many of which provide abortions). The data shows where groups of people visiting the locations came from, how long they stayed and where they went afterwards. That data is aggregated so it doesn’t provide the names of individuals; however, de-anonymising this sort of information is not very difficult. There is plenty of evidence that location data is almost never anonymous.Period-tracking apps, which are used by millions of people, are also a worrying source of potentially incriminating information in a post-Roe world. Experts have warned that rightwing organisations could buy data from these apps and use it to prove that someone was pregnant then had an abortion. Your text messages could also be used against you, as could your browser history. Indeed, authorities in Mississippi have already used a woman’s online search for abortion pills to indict her for second-degree murder after she miscarried. That happened in 2018; imagine what is going to happen in a post-Roe world. Speaking of which, I’ve just realised I Googled the word “abortion” 100 times while researching this. I’m off to scrub my search history.
      Arwa Mahdawi is a Guardian columnist
      TopicsRoe v WadeOpinionAbortionUS politicsWomenHealthUS supreme courtLaw (US)commentReuse this content More

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      in US Politics

      Arkansas Republican admits abortion trigger law would cause ‘heartbreak’ if Roe is reversed

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      Arkansas Republican admits abortion trigger law would cause ‘heartbreak’ if Roe is reversedGovernor Asa Hutchinson signed near-total abortion ban bill, even though he disagreed with the lack of exceptions for incest and rape The Republican governor of Arkansas, Asa Hutchinson, has admitted that an anti-abortion trigger law that he signed on to the books would lead to “heartbreaking circumstances” if Roe v Wade is overturned, in which girls as young as 11 who became pregnant through rape or incest would be forced to give birth.Hutchinson’s remarks give a revealing insight into the twisted human and political quandaries that are certain to arise should the US supreme court, as expected, destroy the constitutional right to an abortion enshrined in Roe v Wade when it issues its ruling next month. The governor told CNN’s State of the Union on Sunday that in 2019 he had signed the Arkansas trigger law, Senate Bill 6, which would ban almost all abortions the instant Roe were reversed, even though he disagreed with its lack of exceptions for incest and rape.Asked why he had put his signature on the law, despite the fact that it would prohibit all abortions other than in cases where a pregnant woman’s life were in imminent danger, he said: “I support the exceptions of rape and incest … I believe that should have been added; it did not have the support of the assembly.”Under intense questioning from the CNN host Dana Bash, the governor was asked why an “11- or 12-year-old girl who is impregnated by her father, or uncle or another family member be forced to carry that child to term?”He replied: “I agree with you. I’ve had to deal with that particular circumstance even as governor. While it’s still life in the womb, life of the unborn, the conception was in criminal circumstances – either incest or rape – and so those are two exceptions I think are very appropriate.”He added that if the supreme court does throw out the constitutional right to an abortion, then “these are going to become very real circumstances. The debate and discussion will continue, and that could very well be revisited.”But Bash pressed Hutchinson on what would happen if the absence of rape and incest exceptions can’t be revisited in the law that he had personally approved, pointing out that his term as governor comes to an end in January. “If you can’t change [the trigger law], that means girls who are still children, 11- and 12-year-olds, might be in that situation in a very real way in just a couple of months,” Bash said.“Those are heartbreaking circumstances,” Hutchinson replied. “When we passed these trigger laws we were trying … to reduce abortions, but whenever you see that real-life circumstances like that the debate is going to continue and the will of the people may or may not change.”A report by the Guardian this month found that at least 11 US states have passed laws that ban abortions without any exceptions for rape or incest. Such trigger laws are legally written in such a way that they would come into effect the second that the constitutional right to an abortion embodied in Roe were overturned.Earlier this month, a draft majority opinion of the supreme court written by Justice Samuel Alito was leaked to Politico. With the apparent backing of five of the six conservative justices on the nine-member court, it would eradicate federal abortion rights in the most aggressive terms.The court has insisted that the draft is not final and that changes to its wording or outcome are still possible. But the country on both sides of the abortion divide are bracing now for Roe to be undone and power over women’s reproductive choices to be handed to individual states like Arkansas.TopicsArkansasRoe v WadeAbortionUS politicsHealthRepublicansUS supreme courtnewsReuse this content More

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      in US Politics

      Ending Roe v Wade could badly backfire on Republicans during elections this year | Lloyd Green

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      Ending Roe v Wade could badly backfire on Republicans during elections this yearLloyd GreenThe Democrats now have a fighting chance to maintain control of the Senate. Their odds of retaining and flipping seats have improved overnight On Monday night, Politico reported that a majority of the US supreme court is poised to overturn Roe v Wade, eviscerate a half-century of precedent, and leave the issue of abortion to the states. Five of the court’s nine justices are prepared to give the Republican base exactly what it demanded. The remaining question for the Republican party is whether answered prayers are the most dangerous.Through the Trumpian looking glass, forcing women to die from illegal abortions is ‘pro-life’ | Marina HydeRead moreIf the leaked draft of the majority opinion in Dobbs v Jackson Women’s Health Organization is close to the final cut, the court stands to energize otherwise dejected Democrats and put Republican members of Congress in Democratic-leaning states at risk. Expect the anticipated Republican House majority in the midterms to be smaller than currently projected.Indeed, the Democrats also now have a real shot to maintain their control of the Senate. Overnight, their odds of retaining seats in Arizona, Nevada, Georgia and New Hampshire, while flipping Pennsylvania and Wisconsin, improved.Beyond federal offices, fights will now be waged this fall over governorships and legislatures in Michigan and Pennsylvania, where Joe Biden narrowly won in 2020, but where the incumbent governor is a Democrat, and the legislature is in the hands of the Republican party. In a post-Dobbs world, look to the states to emerge as roiling battlegrounds.Make no mistake, the draft opinion is sweeping. “We hold that Roe and Casey must be overruled,” Justice Samuel Alito writes for himself and four of his colleagues. “It is time to heed the constitution and return the issue of abortion to the people’s elected representatives.” Along the way, the ruling also offers implicit criticism of the court’s prior decisions on personal autonomy.Prior precedents on contraception, interracial marriage, consensual sex and gay marriage are now at risk. At a February debate among Michigan’s prospective Republican candidates for attorney general, all three men, including Matthew DePerno, Donald Trump’s choice, criticized Griswold v Connecticut. In that case, the US supreme court struck down a state law that barred the sale of contraceptives to married couples.DePerno, an advocate of election conspiracy theories, framed his understanding of this this way: “The supreme court … has to decide, mark my words, that the privacy issue currently is unworkable. It’s going to be a states’ rights issue on all these things, as it should be.” DePerno is also the state Republican party’s officially preferred candidate.Elissa Slotkin, a moderate Michigan Democrat, tweeted on Monday night: “If tonight’s news is true, Michigan’s 1931 state law banning abortion would snap back into effect, making any abortion illegal in our state – even if the mom will die, or if she was raped by a family member. No exceptions.”A former member of the US intelligence community and the wife of a retired army helicopter pilot, Slotkin added: “My poor mother is turning over in her grave. The House has already voted to codify Roe – let all Senators be on record on this one in an up or down vote.”In the same neo-Confederate spirit as Michigan’s DePerno, the Indiana senator Mike Braun offered up his benighted take on interracial marriage. Braun argued that like abortion, interracial marriage should be left to the states to decide – not the federal judiciary. Said differently, he was arguing that the supreme court got it wrong in Loving v Virginia.“When you want that diversity to shine within our federal system, there are going to be rules and proceedings, they’re going to be out of sync with maybe what other states would do,” Braun announced.“It’s the beauty of the system, and that’s where the differences among points of view in our 50 states ought to express themselves.”After the ensuing uproar, Braun walked his words back. But in light of Politico’s reporting, the Democrats now have names, faces and an issue. Think ready-made campaign ad.To be sure, clearer Republican heads viewed the wholesale gutting of Roe as a threat to the Republican party’s elected officials. In the summer of 2021, they attempted to guide the court’s hand; they failed.Last July, 228 Republican members of Congress, 44 senators and 184 House members, filed an amicus brief in support of the Mississippi abortion law in question. Nowhere did the Republican submission refer to contraception, interracial marriage, or individual autonomy. Likewise, the word “privacy” only appeared as a part of a title of a footnoted law review article. Mitch McConnell, Kevin McCarthy, Marjorie Taylor Greene and Lauren Boebert couched their arguments in pastels. Words like “previability” filled the page, as did polling data.Justices Alito, Clarence Thomas, Neil Gorsuch, Brett Kavanaugh and Amy Coney Barrett, however, were having none of that. For them, it is time to return to what they consider the original constitution.More than seven in 10 Americans oppose overturning Roe even as the public is split over where to draw a line. In Texas, 77% support legal abortions in case of rape and incest. Not all restrictions are the same. America’s cold civil war just got really hot.
      Lloyd Green is an attorney in New York. He was opposition research counsel to George HW Bush’s 1988 campaign and served in the Department of Justice from 1990 to 1992
      TopicsUS politicsOpinionAbortionHealthUS supreme courtLaw (US)Roe v WadecommentReuse this content More

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      in US Politics

      There’s rage at this Roe v Wade mess – and those on the left who didn’t see it coming | Emma Brockes

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      There’s rage at this Roe v Wade mess – and those on the left who didn’t see it comingEmma BrockesFrom anti-Hillary Democrats to Ruth Bader Ginsberg, who clung on at Supreme Court, unlikely targets are being identified for blame After the initial shock, the blame. On Monday, when news broke of the leaked US supreme court draft opinion overturning Roe v Wade, millions of horrified Americans sought emotional release. “I am angry,” said Elizabeth Warren, voice shaking, leading a pack of reporters straight over a flowerbed outside the supreme court. Her face ignited with rage as she reminded them that 69% of Americans are against overturning the abortion legislation. “The Republicans have been working towards this day for decades,” she said. In the background, a man shouted, “You want to dismember children in the womb!”For many of us, that man – the you-want-to-kill-babies guy – and his ilk were not the first target for righteous abuse. It’s hard, in moments of duress, to get much satisfaction from reiterating an existing and long-held revulsion, particularly when its subject is beyond reasonable reach. When considering the rightwing architects of this moment, there was no “what if” in attendance; all the what ifs belonged to the left. Political purists who in 2016 urged Democrats to avoid voting for Hillary Clinton (hi, Susan Sarandon) were the first in line, and social media echoed to the sound of, “We told you this would happen.”Biden condemns efforts of extremist ‘Maga crowd’ to overturn Roe v Wade abortion protections – as it happenedRead moreSacrificing the good in pursuit of the better and winding up with the absolute worst – a dynamic as familiar to British as to American leftwing politics – was, in this moment of horror, a more enraging consideration than flat hatred of the right. From revived outrage at the Bernie bros, it was a quick descent into rage against various champions of the left. “You know who I blame for this?” said a friend. “Ruth Bader Ginsburg.” The late supreme court justice’s vanity in hanging on to her seat, her overconfidence that Clinton would win, her refusal to listen to warnings from the Obama White House that, should the unthinkable happen and the Republicans regain the presidency, the first casualty would be Roe v Wade – her fundamental enjoyment, one assumed, of being RBG when she could have ceded her seat to an Obama appointee – twisted us up into pretzels. I love Ginsburg, so all this had about it the extra and extremely female zing of self-harm.Oh, and Clinton wasn’t off the hook either. “If she’d bothered to campaign in Michigan,” said another friend sourly, “none of this would’ve happened.” All the terrible, bad-tempered fights of that election flew back up into the air, like a water column after a bomb. The only Republican who came in for similar ire was that idiot Susan Collins, senator from Maine, a supporter of abortion rights who had nonetheless voted in line with her party to confirm both Neil Gorsuch and Brett Kavanaugh to the supreme court. Both had assured her, she said at the time, that they wouldn’t go after Roe v Wade. Shocked! Shocked, she was, this week to discover these were not men of their word.Of course, all this fury was mere displacement for the fundamental truth that rightwing forces were smarter, more organised, disciplined and talented in prosecuting a digestible narrative – “don’t kill babies” – than the fractured and dissembling left. Progressives tried to rally towards concrete solutions. There were things to be done – in the first instance, register to vote. (After less than a year of citizenship, I hadn’t. This weekend, I will). There was the call for fundraising. Celebrities started throwing around $10,000 matching donations to anyone giving to local abortion funds.And both Alexandria Ocasio-Cortez and Bernie Sanders, as well as senators Kirsten Gillibrand and Chuck Schumer, hyped the necessity of codifying Roe v Wade in Congress, a move backed by President Biden that would enshrine the right to abortion in federal law irrespective of actions taken by the supreme court. It sounds good, and has the advantage of generating political action. But it is also a long shot, a case of last-resort measures, and too little too late. Earlier this year, Democrats tried to codify Roe, and while it passed the House it failed in the Senate, overcome by a filibuster. (Then “we must end the filibuster”, tweeted Sanders. None of this can happen quickly, if at all.)The fact is that if, as Warren said, the Republicans had been planning this moment for decades, rigging composition of the supreme court with precisely this endgame in mind, there was, irrespective of the scale of public outrage, no immediate way to turn back. In this first week of shock, before anger might become effectively organised, there was only the tiny compensation of the blame spiral.
      Emma Brockes is a Guardian columnist
      TopicsRoe v WadeOpinionAbortionElizabeth WarrenUS politicsUS supreme courtLaw (US)WomencommentReuse this content More

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      in US Politics

      Is Biden willing to go against the supreme court to save Roe v Wade? Politics Weekly America – podcast

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      According to a draft majority opinion published by Politico this week, the US supreme court has voted to overturn Roe v Wade in the clearest sign yet that the constitutional right to abortion will probably be taken away from millions of Americans very soon.
      This week, Jonathan Freedland speaks to Moira Donegan about what it will take to stop the majority conservative bench, whether Democrats are willing to pull rank, and if they don’t, whether it is even accurate to call the US the land of the free

      How to listen to podcasts: everything you need to know

      To enter our prize draw, Worthy Winners, nominate someone who you think deserves to win one of 10 pairs of tickets to this year’s Glastonbury festival. Entrants and nominees must be 18 and UK residents. Listen to Thursday’s episode of Today in Focus on abortion rights Sign up to First Edition for free at theguardian.com/firstedition Send your questions and feedback to podcasts@theguardian.com Help support the Guardian by going to gu.com/supportpodcasts More

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      After victory in the US, now the far right is coming for abortion laws in Europe | Sian Norris

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      After victory in the US, now the far right is coming for abortion laws in EuropeSian NorrisThe attack on Roe v Wade has roots in well-funded organisations whose tentacles have spread across the Atlantic For those of us who have been watching the assault against abortion in the US for years, this week’s leaked supreme court draft opinion – which could pave the way for an overturning of Roe v Wade – came as no surprise.Roe v Wade protects the right to an abortion in the US up to the point a foetus can survive outside the womb, and the religious and far-right have been gunning for it since it was introduced in 1973. Evangelical ideologues, far-right actors and radical-right billionaires have organised to undermine women’s right to safe, legal abortions through a combination of violence against clinics and doctors, dark money and political influence.‘Unnecessary suffering and death’: doctors fear for patients’ lives in a post-Roe worldRead moreSo, how did the US get here?After years of legal assaults that restricted abortion access and targeted clinics in Republican states; years of disinformation spread by “crisis pregnancy centres”, where women are persuaded to not have abortions; and years of burdensome demands on women to endure ultrasounds, gain parental consent and put up with counselling in order to have a termination, Trump’s election opened the door for abortion rights to end in the US.Ultimately, it required courts, not politicians, to end abortion. That’s where the Federalist Society comes in. Headed by Leonard Leo, the legal organisation supported anti-abortion lawmakers across the US into positions of influence where they could draft laws to ban abortion after 15 weeks … 12 weeks … six weeks … and completely. The end goal was for anti-abortion states to try to implement one of these laws, where it would be challenged again and again until it reached the supreme court.To do that, the anti-abortion movement needed supreme court justices who would enact its agenda. They got their way with the help of the leader of the Senate, Mitch McConnell, who blocked President Obama from nominating a supreme court judge, leaving the field open for Trump to promote the anti-abortion Neil Gorsuch. After that came two more Trump-appointed justices: Brett Kavanaugh and Amy Coney Barrett.That was the judicial assault on abortion rights. But that assault could only happen with the help of money … and lots of it. Luckily for the anti-abortion movement, there are plenty of wealthy foundations keen to fund the cause. They include the DeVos, Prince, and the Templeton Foundation, which have helped to support organisations such as the Alliance Defending Freedom (ADF), the Heritage Foundation and Focus on the Family.Backed by billionaire funding, organisations such as the ADF took the fight against abortion rights to the courts – helping to secure a ban on buffer zones and so-called “partial birth abortion”, and supporting the notorious Hobby Lobby case, which stated that employers should not have to cover birth control on employees’ healthcare plans if it was against the owner’s religious beliefs.These organisations and their billionaire backers have transatlantic reach. Take the DeVos and Koch Foundation-supported Heritage Foundation, which has welcomed a range of Conservative MPs to discuss free speech – including Oliver Dowden, Priti Patel and Liam Fox. It was announced on the day of the supreme court leak that Lord David Frost would soon be addressing the organisation.Then there’s the ADF, which spent $23.3m in Europe between 2008 and 2019, when its European arm’s youth conference played host to the Conservative MP Fiona Bruce.ADF International intervened in Belfast’s notorious “gay cake” case and is allied with organisations that lobbied to further restrict abortion in Poland. The US anti-abortion legal organisation, the American Center for Law and Justice (ACLJ), a second religious freedom organisation that takes on legal cases to challenge abortion and LGBTQ+ rights, has also operated in Europe. Set up by the Republican Pat Robertson, who famously accused feminism of turning women into lesbians, ACLJ’s chief counsel is a former Trump defence attorney, Jay Sekulow. ACLJ spent $15.7m in Europe from 2008-2019.So far you can see how big money, the judiciary and religious freedom movements have come together in the US and Europe. But there’s another active force that has pushed us towards the end of Roe: the far right.Across the far-right infosphere, men discuss the need to ban abortion in order to reverse what they term the “great replacement” – a conspiracy theory that posits white people are being “replaced” by migration from the global south, and that, in the US in particular, this replacement is aided by feminists repressing the white birthrate via abortion.Conspiracy theories such as the “great replacement” sound extreme. But when it comes to the US abortion row, such views are mainstream. Take this quote from the former Republican congressman Steve King, who represented Iowa between 2003-2021. He claimed “the US subtracts from its population a million of our babies in the form of abortion. We add to our population approximately 1.8 million of ‘somebody else’s babies’ who are raised in another culture before they get to us.” Far-right theories circulate globally – that’s why people outside the US shouldn’t just act in solidarity with American women at this time, but prepare to stand up against the possible erosion of their own hard-won rights.
      Sian Norris is the chief social and European affairs reporter at Byline Times. She is writing a book about the far-right attack on productive rights called Bodies Under Siege
      Do you have an opinion on the issues raised in this article? If you would like to submit a letter of up to 300 words to be considered for publication, email it to us at guardian.letters@theguardian.comTopicsRoe v WadeOpinionAbortionUS supreme courtWomenHealthUS politicsLaw (US)commentReuse this content More

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      How soon could US states outlaw abortions if Roe v Wade is overturned?

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      How soon could US states outlaw abortions if Roe v Wade is overturned?If the draft supreme court decision is not substantially altered it would result in 26 states banning the procedure An unprecedented leak of a draft supreme court decision shows a majority of justices support ending federal protections for abortions in arguably the most controversial court case in generations.‘It will be chaos’: 26 states in US will ban abortion if supreme court ruling standsRead moreWhile the draft could still change, if it is not substantially altered it would result in 26 states immediately or as soon as practicable banning abortion, a sea change in the American legal and political landscape.Why would half of the US outlaw abortion?If the draft decision remains substantially unchanged, it would return the issue of abortion to the states, 26 states stand poised to ban or greatly restrict it. Until the court issues a final decision, the right to abortion is protected under federal law.That right was established in the landmark 1973 case Roe v Wade. Roe found pregnant people have a constitutional right to terminate a pregnancy up to the point a fetus can survive outside the womb, roughly considered 24 weeks gestation, and a legal principle called “viability”.graphicThe court’s finding in Roe invalidated dozens of state abortion bans, and made it illegal for states to outlaw abortion before viability. The case that was the subject of the leak on Monday, called Dobbs v Jackson Women’s Health Organization, considered a Mississippi law that banned abortion at 15 weeks. Even though this is not a total ban, it strikes at the heart of the holding that established a federal right to abortion.Do Americans support abortion?A recent poll found 70% of Americans think abortion is a choice that should be left to a woman and her doctor, and polling over time has shown support for legal abortion has changed little since Roe v Wade was decided. Only a small minority think abortion should be completely illegal.If most Americans support the right to abortion, can Congress intervene?The federal right to abortion hangs on a supreme court decision because, in the nearly 50 years since Roe v Wade was decided, congressional leaders failed to protect the right in statute.While there are Democrat-led efforts to protect abortion, they are stalled in the Senate. That’s because any new statute would need 60 votes to pass, and the 100-member Senate is evenly split. Democrats broadly support abortion rights, while Republicans almost universally oppose efforts to protect abortion rights.Some Democrats have proposed ending the 60-vote rule, called the filibuster, to move legislation on abortion and other key items on Joe Biden agenda’s forward. The president has endorsed such a change.However, two key Democratic senators, Joe Manchin and Kyrsten Sinema, oppose such a change. It is unclear how the leaked opinion may change their position. Sinema has said she supports abortion rights, while Manchin has issued conflicting messages.Biden has called on Americans to elect more members of Congress who support reproductive rights in the upcoming midterm elections in November.How soon would abortion become illegal?If the issue of abortion were to return to the states, 26 would immediately or as soon as practicable ban abortion.States would do so through a mix of abortion bans that were invalidated by Roe v Wade but remained on the books, abortion bans “triggered” if Roe is overturned, and laws that limit the gestational age at which a person can terminate a pregnancy. All will probably be the subject of court challenges.For example, an abortion ban enacted in 1931 could go back into effect in Michigan. There, the Republican-led legislature supports the ban, but the state’s Democratic governor is challenging it in state court.In Arkansas, the state legislature has enacted a “trigger” ban. There, the state attorney general would need to certify the central holding of Roe was indeed struck down. The attorney general, a Republican, would likely seek to do so quickly.Trigger bans vary from state to state. While Arkansas requires an attorney general certification, Wyoming requires the governor to certify Roe has been overturned before the law goes into effect five days later.Other bans, once blocked by the courts because of Roe, could also go into effect. Enforcement of a six-week abortion ban in Iowa could go into effect. Because that is just two weeks after a pregnant person might miss a period, and before most people know they are pregnant, it is effectively a near-total ban.In all cases, laws will probably be challenged by reproductive rights groups, and it will take time for cases to move through state and perhaps federal courts. Some experts have estimated it could take between six months to two years for most cases to be settled.What is certain is in that time, Republican-led states would probably seek to push the envelope in terms of criminalizing abortion, and seek to enforce the bans they already have on the books.How will people terminate pregnancies in states where it is banned?Making abortion illegal will not stop abortions. People who live in states where abortion is outlawed but want to terminate a pregnancy may seek to travel to states where it remains legal, or obtain medication to end a pregnancy.Medication abortion can safely end pregnancies up to 10 weeks gestation using a two-pill protocol. However, in states where abortion is illegal, those pills would need to be obtained illicitly, perhaps through through the mail.Patients who want to go to clinics, or whose pregnancy is too far along to be self-managed with medication, would need to travel potentially hundreds of miles to states where abortion is legal. That may be an impossible hurdle for women whose finances are strained or who cannot find childcare.People who live in states where abortion remains legal would also be impacted, because they would face longer wait times for appointments as patients flood into clinics from out-of-state. This could create a secondary wave of travel.Even more broadly, outlawing abortion would substantially undermine care for basic obstetric procedures, such as miscarriage and ectopic pregnancies, in a country which already has among the highest maternal mortality rates in the developed world.Nearly half (44%) of all future obstetricians and gynecologists are trained in states that would outlaw abortion, making it impossible to train all new doctors in the skills needed to manage induced or spontaneous abortion. Even more doctors may be frightened to provide evidence-based care to women who face life-threatening complications, if their condition is not imminently emergent – but may become so.How are liberal states responding?Some Democrat-led states, such as Oregon, are working to protect abortion by providing funds for people who travel to their states to obtain abortions. Others, such as California, are working to build capacity for the thousands of woman who could suddenly find the nearest abortion clinic there.But in all cases, these efforts will be incomplete. Not all people will be able to travel or obtain medication abortions, and may forced to carry an unwanted pregnancy to term.TopicsRoe v WadeAbortionUS politicsHealthexplainersReuse this content More