The year 2023 was riddled with post-Dobbs abortion bans, attacks on gender-affirming care, near government shutdowns, and states striving to legislatively and judicially strip women of their bodily autonomy. And the spotlight on state policy action only intensified with a federal void on policies protecting reproductive health and securing paid leave. On many policy fronts, it was a regressive year for gender equity, but while some states went low, others went high. Some states actually enacted policies that will benefit women in the new year—and for years to come—underscoring the importance of state legislative leadership on gender equity.
Looking ahead to 2024, allow us to indulge in some much-needed optimism and uplift promising state policy progress for women taking effect this year.
Legislators in Washington, California, and Illinois each took steps to expand access to abortion care and protect patients and providers, all of which went into effect January 1. All health insurance plans in Washington are now prohibited from participating in cost-sharing for abortion services, effectively reducing out-of-pocket costs, deductibles, and copays for patients seeking abortion care. Abortion care providers in California are now shielded from litigation for providing abortion services to out-of-state patients, building capacity for the Golden State to triage patients traveling from abortion deserts for care. This year will also see a significant limitation on California’s crisis pregnancy centers (CPCs) through a new law that requires all ultrasounds to be performed by a licensed provider. Patients seeking abortion care and related resources at CPCs are too often subjected to unsolicited ultrasounds followed by undue anti-abortion influence over the patient’s decision about the pregnancy.
Last year, the number of out-of-state patients seeking abortion care in Illinois sharply increased, as abortion is banned in all of its bordering states. To protect patient privacy and thwart litigation attempts by neighboring state governments, lawmakers enacted a new measure that prohibits law enforcement from sharing license plate data captured in Illinois with other states. For patients traveling hundreds of miles for care, this has the potential to alleviate some of the fear stemming from the criminalization of abortion care in their home state.
In addition to the highly anticipated over-the-counter availability of OPill (oral contraception), 28 states and Washington, DC, have taken the lead on pharmacist-prescribed contraceptive care, making even more options available to consumers without the need for a doctor’s visit. New Jersey is the latest state to join the effort to expand access to hormonal contraceptives by empowering pharmacists to prescribe them. Rightfully, these states aren’t taking for granted birth control access and its vulnerable place on the GOP’s agenda.
The year 2023 saw an onslaught of legislative attacks on gender-affirming care, but two states enacted legislation to push back. In Maryland, Medicaid coverage is now available for gender-affirming care, and in Vermont, insurers are prohibited from cost-sharing on gender-affirming care, providers are shielded, and patients’ health data and privacy are protected.
Already in the new year, federal paid family and medical leave (PFML) is gaining traction. But states have long been working to fill federal voids on some of the most fundamental needs among workers, starting with paid sick and safe time. As of January, Minnesotans are eligible for two days paid sick and safe leave, and workers in California and Illinois are eligible for five days. Safe leave, which is not yet included in many state PFML programs and sick time guarantees, allows workers to take leave related to incidents of domestic violence, thus prioritizing workers’ safety and well-being while expanding access to paid time off for women, who are disproportionately victims of domestic violence. Paid family and medical leave benefits also began for workers in Colorado, where rulemaking processes and implementation have been underway since voters made it the first and only state to enact PFML via ballot initiative.
Pay equity seems to progress at a glacial pace, particularly for women of color, and presents a grim economic outlook for women. The new year, however, shepherds in salary transparency measures in three states that will chip away at those pay inequities. Employers in Colorado are now required to announce, post, and make known all job opportunities under the Equal Pay for Equal Work Act. Hawaiian employers with 50 or more employees now must disclose hourly rates or salary ranges in job listings. A new law took effect in California that will protect workers from retaliation for discussing wages, asking colleagues about earnings, and encouraging requests for raises. Each of these approaches will empower workers and promote mutual understanding of expected compensation among employers, employees, and prospective candidates.
Amid continued gridlock at the federal level and court reversals of long-held rights to women’s bodily autonomy, many states have resolved to protect and expand fundamental rights where possible and advance gender equity within their own borders. This patchwork quilt of state policies on issues of gender equity emphasizes the power in directing advocacy toward and closely following the work of state legislatures. As we enter the 2024 presidential election year with a conservative Supreme Court and a minimally functional Congress, the road toward progress on gender equity winds through each of the fifty states.
