Voters in five Nebraska towns approved local ordinances banning abortion care in this week's midterm elections, but reproductive health care advocates said more significant threats are likely to come in the new legislative session.

Scout Richters, senior legal and policy counsel for the ACLU of Nebraska, said measures that conflict with state law are not enforceable, and abortion remains legal at the state level, but she worries they will create a chilling effect.

"They harm Nebraskans by stigmatizing abortion care," Richters contended. "Really sowing a spirit of fear and confusion among those Nebraskans that live in these places."

Ordinances banning abortion within city limits were passed in Arnold, Brady, Hershey, Paxton and Wallace. A similar ordinance failed in Curtis. Blue Hill, Hayes Center -- which counts itself a member of the group "Sanctuary Cities for the Unborn" -- and Stapleton passed bans before the election.

Proponents argued towns have the power to regulate health and welfare, and believe the ordinances are necessary to protect the culture of communities and to send a message to state lawmakers.

Abortion-rights advocates are concerned about razor-thin margins when senators convene in January. Legislative Bill 933, a trigger-bill banning abortion after Roe v. Wade was overturned, was blocked in the last session through a filibuster, which requires 17 senators.

Richters stressed, while Nebraskans may have different views on abortion, it remains a deeply personal health care decision.

"So regardless of how any one individual feels about abortion, when someone makes that personal decision, they need to be able to access care without government interference," Richters asserted. "That decision needs to be between a patient and her doctor."

A poll conducted in March found 55% of Nebraskans oppose banning abortions, compared with 40% who support a ban.

Richters noted Nebraska's laws already impose significant barriers to abortion care, which disproportionately impact people of color, young people, low-wage workers and people living in rural areas.

"Forcing someone to carry a pregnancy against their will can have devastating and lasting consequences," Richters emphasized. "The bottom line is that a patient's health should drive medical decisions, not a politician's beliefs."

New York pharmacists would be able to dispense abortion medication under newly proposed legislation, and a person could get the prescription from a physician online or by mail.

This comes after the U.S. Food and Drug Administration issued new guidance allowing retail pharmacies to sell abortion pills.

According to the Guttmacher Institute, medication abortions made up 54% of all abortions in the country in 2020.

State Assemblywoman Amy Paulin, D-Scarsdale, the bill's author, said it hasn't been filed yet, but if it passes, it should help people who don't want to visit an abortion clinic.

"If you can walk into a pharmacy and get this medication over the counter, you're much more likely to do it," she said. "Not everybody's going to go to a provider; not everyone feels comfortable. And providers are doing this with telehealth, so it doesn't require an exam."

The bill is part of a larger push by New York elected officials to expand abortion services in the state. In anticipation of the U.S. Supreme Court ruling that ended federal abortion rights last June, Gov. Kathy Hochul signed a far-reaching package of legislation to improve access, as well as $35 million allocated to support abortion providers in New York State's 2022 budget.

While the bill is still in its earliest stages, Paulin said she's ready to meet whatever challenges come when it is filed. Abortion opponents in New York have encouraged such alternatives as better family services and making adoption easier.

Paulin said she knows the work won't end with this bill, adding that she is eager to work on whatever comes next.

"I'm working closely with advocate groups, like Planned Parenthood and ACOG, so if barriers come up, we will immediately address them," she said. "I think right now, we're just exploring some of those barriers and we will be putting legislation in shortly to alleviate them."

Other upcoming legislation would have all SUNY and CUNY colleges and universities offer abortion care, new protections of personal data for anyone seeking an abortion, and increased doctor reimbursement rates for reproductive health-care services.

CVS and Walgreens have announced they will sell abortion medication at pharmacies, after the FDA announced it is allowing mifepristone to be bought over the counter with a prescription. Advocates are applauding the move, and said over-the-counter birth control access would help more women take control of their reproductive health.

Victoria Nichols, project director with a group called Free the Pill, said women often have to take time off from work or school or find transportation or child care to get into a doctor's office to get a prescription.

"Bringing a birth-control pill over the counter would really address some of the unnecessary hoops that folks have to jump through to get to a clinic visit to get a provider to give them a prescription," Nichols said.

Research from KFF finds that overall, contraceptive care is currently falling short nationwide when it comes to access, cost, and patients' needs and preferences.

Nichols added the FDA is currently considering proposals for over-the-counter or "OTC" birth-control pills.

"Right now we know of two companies that are pursuing an RX-to-OTC switch. One is focused on a progestin-only pill, and the other is focused on a combined oral contraceptive," she said.

Last fall, Kentucky voters rejected anti-abortion ballot measure Amendment 2.

Joseph Hammer, a Lexington resident and volunteer for Showing up for Racial Justice, said he talked with Kentuckians from across the political aisle about the right to an abortion, and recounts the story of speaking at length on the phone with one pro-life resident.

"I say, 'So, can you commit to voting no on constitutional Amendment 2 in November?' And he said he would vote no. And so this is a self-identified conservative pro-life guy voting no. And that's why this amendment was defeated," Hammer said.

Volunteers headquartered in Jefferson and Boyd counties made more than 100,000 calls to Kentuckians, and held more than 20,000 thousand conversations with voters.

The Wyoming Supreme Court has decided it will not weigh in on a lawsuit that has temporarily halted a ban on abortions in the state. Citing a state constitutional amendment passed by 70% percent of voters in 2012, a pregnant woman and a law student have argued in a case before Ninth District Judge Melissa Owens that Wyoming's trigger law prevents their ability to make decisions about their health care.

Abigail Fournier, Attorney at Cheyenne-based Steiner, Fournier and Zook, said physicians involved in the lawsuit have a similar concern.

"They are claiming essentially that the new law prevents the physician's ability to practice evidence-based health care when it comes to pregnancy related issues," she said.

The district court asked justices to respond to 12 questions regarding the constitutionality of House Bill 92 banning abortions. The U.S. Supreme Court recently decided that the U.S. Constitution does not protect the right to abortion when it overturned Roe v. Wade. The state has argued abortion is not mentioned in Wyoming's constitution and said the new law is necessary to protect the lives of unborn children.

Advocates for women's reproductive health care have pointed out that banning access to abortions can also lead to the death of the mother. Fournier said Wyoming justices do not have to fall in line with the U.S. Supreme Court, in part because the state's constitution specifically affirms the right of all residents to make decisions related to their health care, so long as they are competent.

"Wyomingites have always really had this ideal of 'we don't want the government in our business.' And so we've passed amendments to our constitution that have created a constitution that actually affords more protection against government infringement than the U.S. Constitution," she said.

Fournier said the impacts of the U-S Supreme Court's decision overturning Roe could extend beyond the state's trigger law. She recalled a bill before state lawmakers that would ban medical treatment for transgender minors, and a law recently passed by Congress ensuring protections for same-sex and inter-racial marriage.

"Because that was a law that followed Roe v. Wade in that line of precedent. There's a lot of laws and a lot of rights that are impacted by the overturning of Roe, and I think that a lot of other issues will likely come before the court," she said.