Richard Payerchin is associate editor of Medical Economics.

Richard Payerchin

 has overturned the landmark Roe v. Wade case that legalized abortion in 1973.

The ruling means states will govern abortion rules, which could lead to abortion being outlawed in half the country, according to one organization that advocates for reproductive rights.

On June 24, the Supreme Court issued 213 pages with its ruling and opinions in the case known as Dobbs v. Jackson Women’s Health Organization, which the court heard on Dec. 1, 2021. The Supreme Court considered the state of Mississippi’s appeal of a lower court ruling that struck down as unconstitutional the state’s law banning abortion after 15 weeks of pregnancy, according to the 

A summary in the ruling syllabus stated: “The Constitution does not confer a right to abortion; Roe and Casey are overruled; and the authority to regulate abortion is returned to the people and their elected representatives.”

The ruling also referred to the 1992 case Planned Parenthood of Southeastern Pa. v. Casey, another landmark case in U.S. abortion law.

“We hold that Roe and Casey must be overruled,” the ruling said. “The Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision, including the one on which the defenders of Roe and Casey now chiefly rely—the Due Process Clause of the Fourteenth Amendment.”

Citing case law, the draft ruling said the Due Process Clause “has been held to guarantee some rights that are not mentioned in the Constitution, but any such right must be ‘deeply rooted in this Nation’s history and tradition’ and ‘implicit in the concept of ordered liberty.’

“The right to abortion does not fall within this category,” the draft ruling said.

A 98-page draft by Justice Samuel Alito circulated to fellow justices on Feb. 10. That document was leaked to the news site Politico, which published the ruling on May 2, sparking a firestorm of reaction and demonstrations from abortion supporters and opponents.

Based on the ruling, at least half the 50 states are poised to ban abortion, according to CRR.

That organization called Dobbs v. Jackson Women’s Health “the most consequential abortion rights case in generations” and analyzed the various state laws that regulate abortion in the study, 

CRR categorized the states, the District of Columbia and the five most populous U.S. territories in four ways, based on analysis of current laws in a post-Roe legal environment:

Nine states are considered in the “expanded access” category, with abortion protected by state laws or constitutions, with other laws and policies for additional access to abortion care: California, Connecticut, Hawaii, Illinois, New Jersey, New York, Oregon, Vermont, and Washington

12 states and Washington, D.C., were considered “protected,” with abortion protected by state law, with limits on access to care: Alaska, Colorado, Delaware, the District of Columbia, Florida, Kansas, Maine, Maryland, Massachusetts, Minnesota, Montana, Nevada, and Rhode Island

Three states and two territories are “not protected,” meaning abortion may continue to be accessible but would not be protected by state and district law: New Hampshire, New Mexico, Puerto Rico, U.S. Virgin Islands, and Virginia

26 states and three territories are “hostile,” meaning they could immediately ban abortion: Alabama, American Samoa, Arizona, Arkansas, Georgia, Guam, Idaho, Indiana, Iowa, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Nebraska, North Carolina, North Dakota, the Northern Mariana Islands, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, and Wyoming

In 2020, there were 930,160 abortions in the United States, an 8% increase from 862,320 abortions in 2017, according to The Guttmacher Institute, which conducts three-year surveys of abortion providers.

That group said the figures showed a reversal of a long-term decline in U.S. abortions that began about 1990, but noted trends varied across states from 2017 to 2020 with “no clear patterns to explain why some had increases or decreases.”

The Guttmacher Institute map of states that will or are likely to ban abortion generally matched that of the Center for Reproductive Rights.

Since the May 2 publication of the draft ruling, physicians groups have lined up in support of abortion rights, publishing statements and member advisories.

In its annual meeting June 10-15, before the Supreme Court ruling, the American Medical Association AMA members adopted a 

 “recognizing that it is a violation of human rights when government intrudes into medicine and impedes access to safe, evidence-based reproductive health services, including abortion and contraception.”

“A growing number of current and pending laws insert government into the patient-physician relationship by dictating limits or bans on reproductive health services and while also aiming to criminally punish patients for their health decisions,” AMA President 

, said in a published statement. “The new policy also calls for AMA to seek legal protections for patients who cross state lines to receive reproductive health services, as well as legal protections for physicians and others who support or provide reproductive health services or referrals to patients who cross state lines.”

This month, outgoing AMA President Gerald E. Harmon did not mention the Supreme Court, but noted “increased government interference in the patient-physician relationship and the practice of medicine,” in his address to AMA’s annual meeting.

“Whether the issue is women’s reproductive health, care for transgender persons, or appropriate treatments for COVID … the AMA demands that politicians get out of the exam room,” Harmon said in his speech.

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Abortion bans are expected to take effect in more than half of states.

Breaking: Supreme Court overturns Roe v Wade abortion ruling

Lingering COVID-19 effects could add 22 million people or more to America’s population of disabled people, posing a new challenge for the nation’s Social Security disability program, says an analyst citing data from the American Academy of Physical Medicine and Rehabilitation (AAPM&R).

The Rosemont, Illinois-based organization has called for a national plan to address long COVID-19, or PASC, for the formal name Post-Acute Sequelae of SARS-CoV-2 infection.

 estimates more than 23.58 million patients are dealing with at least one COVID-19 symptom that persists up to six months after the virus left their bodies.

It appears long COVID-19 effects could be disabilities as defined by the federal Centers for Disease Control and Prevention, said Laura Mauldin, PhD. She analyzed potential effects on Social Security Supplemental Income, the federal program that provides cash benefits to people with 

“But since long COVID symptoms involve different systems in the body, and there is no simple way to test for it, getting a diagnosis can be difficult,” Mauldin wrote. “This adds an extra challenge to qualifying for Social Security.”

An associate professor at the University of Connecticut, Mauldin’s analysis was published in The Conversation, a nonprofit news organization.

This month, the White House and Congressional lawmakers began 

 for patients dealing with, said a news release by AAPM&R.

Long COVID-19 has become a “crisis within a crisis,” said Rep. Ayanna Pressley, D-Massachusetts. She cited AAPM&R in her 

 calling on Congressional leaders to approve another 

 with more attention and resources to it.

“Across the country, in every Congressional district, people are suffering from Long COVID,” Ayanna’s March 8 letter said. “It is incumbent upon the federal government to be responsive to their needs with investments in educating the medical community and broader public on the illness, expanding access to multidisciplinary treatment, and funding inclusive research into long-term health outcomes with robust data collection.”

The letter came four days after President Joe Biden released the 

. One of its goals is to “help Americans with long-term impacts” of the disease.

Doctors may see more patients, but diagnoses difficult.