In the aftermath of the U.S. Supreme Court decision overturning Roe v. Wade in 2022, many states have moved to protect the right to abortion, and several have turned to a new tool to do so: abortion shield laws.
The laws are intended to preserve abortion access by protecting multiple classes of people—abortion providers practicing in states where abortion is legal, as well as patients and people who help them access abortion—from civil and criminal actions taken by states with bans or restrictions on abortion. Now, these laws are being tested through two legal challenges in Texas and Louisiana, both involving a New York doctor.
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So what are shield laws exactly, and what does the future hold for them? TIME spoke to experts to find out.
What are abortion shield laws?
Abortion shield laws are “novel protections” enacted in 18 states and Washington, D.C., says Lizzy Hinkley, senior state legislative counsel at the Center for Reproductive Rights, which has helped draft some of these laws. The laws provide protections for doctors providing medication or in-clinic abortions in the shield state, according to Rachel Rebouché, dean and professor at Temple University Beasley School of Law. Every law is different, so the protections offered by each state vary, but can include the shield state refusing to comply with another state’s extradition order for a doctor who has provided reproductive health care that’s legally protected in the shield state, refusing to participate in another state’s investigation into the provider, and refusing to penalize the provider through professional discipline.
Connecticut was the first state to pass an abortion shield law, in May 2022, in anticipation of the Supreme Court’s overturning of Roe. “What we were motivated by was, there is going to be an intense interstate conflict,” says Rebouché, who worked with colleagues to draft the state’s shield law language.
“This is new territory,” Hinkley says. “Shield laws were a tool that states have been using in response to a change in how abortion rights are treated in the country. When there was still a federal protected right to abortion, states did not have to be concerned about whether a provider in their state was going to be criminalized for providing abortion care to a patient or resident of another state because states couldn’t criminalize that care. There was a right to abortion; there were guardrails that were federally protected.”
Of the 18 states that have shield laws, eight of them—including New York—include protections for doctors who are providing abortion pills through telemedicine to patients in other states, according to Rebouché. About 63% of all abortions in the American healthcare system in 2023 were medication abortions, but anti-abortion activists and lawmakers have been trying to restrict access to the pills. After the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, the Biden Administration made efforts to increase access to abortion pills by allowing them to be prescribed via telehealth and received via mail, but reproductive rights advocates are concerned that the Trump Administration will roll back those efforts. Hinkley says telemedicine abortion has been “a lifeline” for many people who live in states that have banned or restricted abortion.
Read More: How the Biden Administration Protected Abortion Pill Access—and What Trump Could Do Next
What are the current legal challenges to shield laws?
Texas, which has banned abortion in nearly all situations, filed a civil suit against New York-based Dr. Margaret Daley Carpenter for allegedly prescribing, via telemedicine, abortion pills to a 20-year-old woman in Texas. Texas alleges that the woman was hospitalized with complications. On Feb. 13, a Texas judge ordered Carpenter to stop prescribing abortion pills to Texas residents, and to pay a fine of more than $100,000. Carpenter and her lawyers didn’t respond to the lawsuit, given New York’s shield law that bars cooperating with other states’ investigations into providers.
Louisiana, which also has a near-total ban on abortion, charged Carpenter with a felony for allegedly prescribing, via telemedicine, abortion pills to a minor who was pregnant. Louisiana officials claim that the patient was taken to the hospital after ingesting the pills because she was experiencing a medical emergency. New York Gov. Kathy Hochul said on Feb. 13 that she won’t extradite Carpenter to Louisiana—“not now, not ever”—per New York’s shield law. Louisiana can’t constitutionally prosecute Carpenter unless she’s physically present in the state for a court appearance, according to Rebouché.
The cases represent the first time shield laws are being tested in court. “I think they point to what we can expect moving forward for intense interstate conflict,” Rebouché says of the two cases. “I don’t think it’s surprising; I think this is where we were always going to land, given that Dobbs returned abortion to the state and a third of the country prohibits abortion from the earliest moments of pregnancy or before six weeks, just as many states have codified abortion rights in their constitutions and their state laws.”
Read More: Here Are Trump’s Major Moves Affecting Access to Reproductive Healthcare
What does the future hold for shield laws?
Because New York won’t cooperate with Texas and Louisiana, the future of the two cases is a little unclear.
“Those [cases] raise really profound constitutional, structural questions about interstate relationships,” Rebouché says. “They’re bound to end up before the Supreme Court because there’s a long, complicated history of mediating disputes between states when they don’t agree on public policy, and that’s where we are now.”
Hinkley says the intent of the legal challenges is to scare doctors who are providing abortion care, but that shield laws are working to provide access to people across the country. She adds that the laws “are squarely within states’ power to enact” and are constitutional.
“I’m sure that there will be continued challenges to the shield laws,” Hinkley says, “but I can say with certainty that [shield laws] were drafted with good care and with these legal challenges in mind, and they stand on solid ground, both within what states are allowed to do, as well as what they’re not allowed to do.”