Posted July 2, 2026
On June 24, 2022, thanks to three Trump-appointed Justices, the U.S. Supreme Court overturned Roe v. Wade with Dobbs v Jackson Women’s Health Organization. The effects have been profound and catastrophic.
But four years later, something else is evident: we need to stop with the Roe nostalgia and build something better. We need to stop with the calls to “restore Roe” and instead create a patient-centered health care system that responds to the modern needs of individuals and advances in medical care — like medication abortion — since Roe.
Colorado is on that path, and other states should follow our lead.
Coloradans put abortion rights in the state constitution with Amendment 79 in 2024 with 62% of the vote statewide. We also lifted a 40-year ban on public insurance coverage for abortion care, so as of Jan 1, 2026, it’s now included as a covered service for both public and private insurance. We’ve passed shield laws so that providers can offer abortion care without fear of state persecution, especially for medication abortion by mail and telehealth. The next phase will be enhanced data protection for providers and patients alike.
We need to stop with the calls to “restore Roe” and instead create a patient-centered health care system that responds to the modern needs of individuals and advances
Even before Dobbs, because of the gestational abortion bans allowed by Roe, Colorado was a haven state for patients seeking later abortion care. Basically, we’ve done it “wrong” for decades, according to the political experts urging “moderation” on abortion rights, as if bodily autonomy is subject to compromise. Coloradans have repeatedly rejected abortion bans at the ballot by landslide margins, most recently a 22-week ban, Initiative 115, that lost by almost 20 points in 2020, pre-Dobbs and during a pandemic.
Roe was always a floor, not a ceiling. It was never good enough. Every pregnancy and its timeline are different. By establishing a trimester test allowing political interference by the states, Roe discriminated against the ability of pregnant people and medical professionals to decide for themselves on abortion care. It put barriers to care in front of entire communities, especially under-resourced areas, low-income patients, and rural Americans.
Colorado is one of a handful of states without gestational limits of the kind allowed by Roe. We’ve never had them. Coloradans and their belief in personal freedom and individual autonomy meant we trusted decisions about abortion to be left between patients and doctors.
For more than 50 years, abortion care has operated in our state without some arbitrary, random political dividing line between when a patient is able to make decisions about their own health care and when they’re not. It’s why we never ran a “codify Roe” bill or ballot measure and didn’t want one at the federal level — because what Colorado had was better than Roe.
Politicians making determinations about abortion care causes immense physical, psychological and medical harm. So many of the horror stories we’ve heard and read about have been in states with gestational restrictions of the kind allowed by Roe — arbitrary cutoffs of 12 weeks, 15 weeks, 20 weeks, definitions that make no medical sense whatsoever. Florida’s 15-week abortion ban, officially allowed to take effect in July 2022 because of Dobbs, meant Deborah Dorbert was forced to carry her doomed pregnancy to term and watch her son Milo suffer and die painfully 90 minutes after his birth.
We don’t want or need to go back to that. The path forward is maximalist and beyond Roe. We need to remove politicians from decisions about abortion care nationwide. Since Dobbs, the public is absolutely moving in that direction. In 2023, the polling firm Perry Undem conducted a survey on a Michigan abortion rights ballot measure with and without gestational limits. The one without limits was more popular by double digits.
At the federal level, we must get rid of the Hyde Amendment, which denies insurance coverage for abortion care to people on federal Medicaid. Abortion is health care. Your health care should be covered by your insurance, whether public or private.
The Dobbs decision was awful, but it was also an opportunity to create something better nationally — and together we can and should make it work. The template is right here in Colorado.
Karen Middleton is a nationally recognized leader on abortion rights. She has led Cobalt since 2013, building the organization into a powerhouse advocacy, public policy, and political operation. The organization also runs the independent Cobalt Abortion Fund, which has seen patient needs skyrocket since the Dobbs decision. This commentary is republished from Colorado Newsline under a Creative Commons license.
