Current Status - National

As of April 2026, federal activity has increasingly focused on how existing rights are enforced and funded—particularly in areas like medication abortion and healthcare coverage. In recent months, federal agencies have revisited policies affecting reproductive healthcare access, childcare regulation, and civil rights enforcement—changes that shape how existing protections operate in practice.

At the same time, states are moving in sharply different directions, with some expanding protections such as paid leave or reproductive healthcare safeguards while others pursue new restrictions. As a result, access to healthcare, workplace protections, safety, and voting rights still depend heavily on where a woman lives and how laws are enforced.

What we're watching: Ongoing reviews and proposed legislation related to medication abortion, Medicaid restructuring, Title X's future, and the growing federal involvement in state voter data and systems—all of these decisions could impact healthcare coverage and voter experiences leading into the midterm elections.

Top 5 Things to Know

• Medication abortion is facing increased federal scrutiny.
  New legislation, investigations, and an ongoing FDA review are focusing on how abortion pills are regulated. Medication abortion now accounts for 63% of all abortions in the U.S., making future rulings especially consequential.
• Policy changes continue to reshape reproductive healthcare access.
  Recent federal actions have rescinded guidance protecting pharmacy access to medication abortion and imposed new restrictions on abortion care within the Department of Veterans Affairs healthcare system.
• The Voting Rights Act is still before the Supreme Court.
  A ruling against Louisiana v Callais would weaken federal voting protections designed to prevent discriminatory voting maps and policies ahead of the 2026 elections. A decision was expected in February.
• Federal workplace protections remain limited and uneven.
  DEI requirements have been eliminated in federal workplaces, and there is still no national paid family or medical leave standard for states to follow. At the same time, several states have expanded paid family and medical leave programs, meaning a small but growing share (33%) of U.S. workers now have access to paid leave despite the absence of a national standard.
• State divides are accelerating.
  Some states continue to strengthen protections, others restrict them, and many remain in active legal or political fights where courts and elections will decide what comes next.

Women’s Health

Reproductive Rights

Abortion access remains deeply uneven across the country. While federal inquiries into medication abortion have been delayed, new threats have arisen. A new bill seeks to overturn the FDA approval of Mifepristone, and a related congressional investigation into the drug's manufacturers was launched in March. Any one of these three initiatives could have a substantial impact on abortion access nationwide.

At the same time, a growing number of states have enacted shield laws and expanded protections, becoming access hubs for patients traveling from states with bans or severe restrictions—often straining clinics and providers. Emergency abortion care for miscarriages, ectopic pregnancies, and other complications also remains unsettled as hospitals navigate conflicting interpretations of federal EMTALA requirements and the various state abortion laws.

Federal administrative policy is also beginning to influence reproductive care access. In early 2026, the U.S. Department of Health and Human Services rescinded guidance requiring federally funded pharmacies to provide medication abortion without discrimination, leaving decisions up to individual pharmacists and state law. At the same time, new restrictions within the Department of Veterans Affairs have limited abortion access for veterans, narrowing care options for some patients who previously relied on federal facilities.

Healthcare Access

Recent federal guidance has shifted the direction of the Title X family planning program away from contraception and toward fertility and pregnancy planning. While funding for 2026 has been maintained, the administration’s proposed 2027 budget appears to eliminate the program entirely.

Access to reproductive healthcare is increasingly constrained by funding and infrastructure. Threats to Medicaid and ACA subsidies are straining clinics and hospitals already under pressure by reducing coverage and leaving providers to absorb more unpaid care. Some of these impacts are beginning to appear, as providers and states prepare for funding changes and increased administrative requirements that could affect coverage and access later this year.

At the same time, hospital and clinic closures (Planned Parenthood) and obstetric provider shortages—especially in rural areas—are creating healthcare deserts where contraception, cancer screenings, prenatal care, and postpartum services are difficult or impossible to access.

In several states, restrictions on gender-affirming care have further narrowed access for transgender women and girls, contributing to provider shortages and increasing barriers to routine, preventive, and mental healthcare.

Immigration enforcement activity in some regions has also raised new concerns about access to prenatal care and preventive reproductive services, as fear of detention or deportation discourages some patients from seeking care.

Workplace Rights

National workplace protections for women remain limited and are weakening in some areas. The federal government has eliminated DEI requirements in its own workplaces, and many large employers are scaling back equity programs tied to fair pay, promotion, and discrimination protections. There is still no national paid family or medical leave law, leaving protections to vary widely by state and employer.

Federal childcare policy may also shift. The administration has proposed changes to the Child Care and Development Fund rules adopted during the previous administration, which were designed to stabilize childcare providers and improve payment reliability. If finalized, these changes could affect childcare availability and costs for working families.

At the same time, state-level paid leave programs continue to expand. As more states implement or extend paid family and medical leave laws, roughly one-third of U.S. workers now live in states with some form of paid leave coverage.

Violence & Safety

Legal protections addressing domestic and sexual violence largely remain in place, but the systems supporting survivors are under strain. Funding shortages, staffing challenges, and limited capacity have reduced access to shelters, counseling, and legal support in many areas. As a result, safety increasingly depends on local resources, creating gaps between formal protections and the help women can reliably access.

Voting & Civic Participation

Congress continues to debate new federal voting requirements. The Safeguard American Voter Eligibility (SAVE) Act, legislation that would require documentary proof of U.S. citizenship—such as a passport or birth certificate—to register to vote in federal elections, has stalled in the Senate. Keep in mind that additional identification requirements disproportionately impact women and minority groups. However, additional attempts to push citizenship legislation through at both the federal and state levels continue, including a new Executive Order and a proposed bill that, among other things, seeks to amend the National Voter Registration Act of 1993 to include proof of citizenship.

Meanwhile, the Department of Justice continues to request voter data from states. While some states, like Tennessee, have provided voter data as part of this effort, others have declined or raised concerns about privacy and legal authority. This uneven participation highlights ongoing questions about how voter data is used, who oversees it, and how voter rolls may be reviewed ahead of future elections.

Finally, women continue to play a growing role in elections and civic leadership, but federal safeguards for fair participation face renewed pressure. Ongoing challenges to the Voting Rights Act, combined with state-level voter ID laws and redistricting changes, could reshape access and representation ahead of the 2026 elections.

Education

Gender equity in education is increasingly shaped by state and local policy rather than consistent federal oversight. Weakened enforcement of Title IX has left protections uneven for pregnant students, LGBTQ+ students, and those facing harassment.

At the same time, many states have enacted or proposed laws restricting transgender girls’ participation in sports or access to bathrooms and school facilities, creating inconsistent rules and heightened scrutiny within schools. New federal degree-classification changes have also raised concerns about the devaluation of women-dominated fields, with impacts varying widely across states and institutions.

A recent Government Accountability Office report also raised concerns that staffing cuts and reduced resources within federal civil rights enforcement offices may be limiting the government’s ability to investigate discrimination complaints in schools.

Related WRDI Reporting

Congress and federal agencies turn attention to medication abortion (Apr 26)
Tennessee shares voter data with the DOJ, raising questions about privacy and oversight (Apr 26)
Birth control is still legal. So why is access changing? (Mar 26)
The SAVE ACT is back. Here's why women should pay attention (Jan 26)