When college students head back to campus for the fall semester, more of them will have guaranteed access to abortion medication.

Colorado recently joined California, Illinois, Massachusetts and New York in requiring public colleges and universities to provide abortion medication to students on campus or arrange to make it available to them through an off-campus provider.

Unlike the other states, Colorado’s new law also applies to private colleges and universities. However, Colorado schools are exempt if offering the medication would be “contrary to the institution’s sincerely held religious beliefs or practices” or if doing so would jeopardize a federal grant. Federal dollars cannot be used to pay for abortions except in limited circumstances.

All five states have enacted laws to expand access to abortion in recent years, both before and after the 2022 U.S. Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization, which cleared the way for states to fully deny abortion access for the first time in 50 years. Since that decision, more than a dozen states have enacted near-total abortion bans.

“In a post-Dobbs era where patients and providers navigate a frightening national landscape, Colorado has stepped up to safeguard reproductive healthcare,” Colorado Democratic state Rep. Kenny Nguyen, who cosponsored the measure in his state, said in a statement. “While abortion is legal, it’s not always accessible, and this law makes it easier for college students to access abortion medication on campus.”

The new Colorado law states that if an institution has an on-campus pharmacy, it must make abortion medication available to enrolled students. If not, health care providers on campus are required to submit a prescription for abortion pills to a pharmacy off campus.

California’s law, which has been in effect since 2023, was the first such measure. It requires every student health clinic on a California State University or University of California campus to offer abortion medication, funded by the state.

California is now considering expanding that law to include community colleges. A proposed bill would require community colleges with health centers to offer access to medication abortion beginning in 2029, if the legislature provides funding.

California campus health center directors have cautioned that many community colleges might not have the money, staff or clinical capacity to provide the service. But the bill’s supporters say offering abortion medication on campus would make it much more accessible to lower-income students who might not have sufficient insurance coverage or a car to procure it elsewhere.

“We are closing a critical gap by ensuring that community college students, one of the most diverse and economically vulnerable populations in our state, have the same access to care as their peers at four-year institutions,” said Democratic Assemblymember Catherine Stefani, the lead author of the bill, during a health committee hearing in April.

Massachusetts, which approved its campus abortion accessibility law in 2022, this week took another step to expand abortion access when Democratic Gov. Maura Healey signed legislation making it the 10th state (plus the District of Columbia) to allow abortion at any point in pregnancy. Most abortions occur in the first trimester; beyond the second trimester, abortions are rare and sometimes related to fetal or maternal health issues.

New York enacted its law requiring public college and university access to abortion medication in 2023, and Illinois started enforcing its mandate on public schools last fall, becoming the first state in the Midwest to do so.

Stateline reporter Sofia Resnick can be reached at sresnick@stateline.org.

When Rob Stone finished high school in Bethesda, Maryland, in 2018, he was asked to identify three goals for his life. Stone loves art and baseball. He’s cheerful, sports a cheeky mustache, and he’s always up for an adventure.

Stone has a rare genetic movement disorder, dystonia-parkinsonism, that limits his mobility and speech. Setting specific goals would help him construct the life he wanted, and help his family identify the services he would need to live it to the fullest.

His parents suggested goals like “going on lots of walks” or “visiting state parks.” Stone just looked at them like they were ridiculous, said his mom, Jeneva Stone.

“We eventually discovered, through the right series of questions, that Robert wanted to protest,” she said. He’d watched disabled protesters dragged out of their wheelchairs from then-Senate Majority Leader Mitch McConnell’s office at the U.S. Capitol the year before, as they demanded the preservation of the Affordable Care Act.

Now 29, Rob has been a fixture on Capitol Hill and at the Maryland State House ever since, advocating alongside his parents for disability rights and healthcare. Earlier this year, he joined with other advocates to lobby the state legislature not to cut funding for services that help him and others live in their communities.

They weren’t able to prevent the cuts, but they did succeed in limiting them.

Disability advocates around the country are fighting a surge of federal and state actions that have eroded protections meant to keep people with disabilities living and working in their communities, rather than in institutions.

The federal government has walked away from decades-old requirements that states deliver disability services to people where they live. At the same time, state leaders, citing budget shortfalls, have rolled back community services the feds don’t require them to fund.

“It’s really hard,” said Rob Gorski, an Ohio father of three sons with autism who runs a popular social media account called TheAutismDad. “You try to wrap your head around one thing, and by the time you even figure out a path forward from there, they’ve thrown more stuff at you.”

In Maryland, state lawmakers were weighing cuts to Medicaid, the joint federal-state program that covers much of Rob’s care, which he receives at home. The federal government will be reducing its share of Medicaid funding as part of the One Big Beautiful Bill Act, the broad tax and spending measure President Donald Trump signed last summer.

Maryland ended up cutting $126 million from the agency that administers Medicaid for people with developmental disabilities — but that was less than the $150 million reduction that Democratic Gov. Wes Moore originally proposed. The final budget also scrapped a proposed cap on how much state funding a person in the program could receive per year.

“Medicaid itself isn’t just a budget line item,” Jeneva said. “It’s the mechanism through which the federal government ensures that people with disabilities have the civil right to live in their communities.”

Other threats to community-based disability services have emerged in Washington, D.C., and across the nation.

In June, the U.S. Department of Justice issued an opinion memo that says states don’t have to fund in-home or community-based services for people with disabilities who don’t want to live in institutions. The memo is a significant reinterpretation of federal law and represents a shift away from decades of civil rights protection.

The memo doesn’t change federal law, but it does signal a new focus for the DOJ, which is the primary enforcer of disability rights. Without enforcement, advocates worry, the civil rights protections they rely on could become moot.

In July, the DOJ published another notice saying it would no longer enforce its longstanding guidance on how to implement a landmark U.S. Supreme Court decision, Olmstead v. L.C., that requires public entities to provide community-based services, rather than institutional care, to people with disabilities whenever possible.

The federal spending reductions in the One Big Beautiful Bill Act are likely to spur more cash-strapped states to cut home- and community-based services, since the federal Medicaid law only requires them to provide institutional care. More than half a dozen states have already moved to limit such services for people with disabilities, according to an analysis of state actions by researchers at George Washington University.

And at least three states are suing to dismantle a section of disability law that requires states to provide community-based services.

Defenders of the changes say they will allow states to refocus their limited dollars on people with the most serious medical needs.

New Medicaid work requirements in the Trump law, which are expected to drop between 3 million and 7 million people from the rolls, “will free up more state funding for (home- and community-based services) recipients,” said Rachel Barkley, director of the Able Americans disability policy think tank, which is housed inside the conservative National Center for Public Policy Research.

But Jeneva Stone says the cuts in Maryland threaten her son’s ability to get the nursing and other services he needs to be able to live at home. She worries families like hers will be the first to face forced institutionalization.

“More and more burden falls on family caregivers to fill in the gaps, and that leads to unsustainable economic situations for families,” she said. “Once your job situation falls apart, your savings are gone, you’re faced with this ugly choice: I believe strongly in my son’s civil right to stay in his community, but I can’t keep a roof over his head.”

Everything feels uncertain, she said, as longstanding protections seem to be dissolving for her son and others like him.

“They’re happy, they’re living great lives,” she said. “Are they medically complicated? Yeah. But do they deserve to spend the rest of their lives lying in a bed in a facility just because it’s easier to care for them in a congregate setting?”

‘That’s what people want’

In the middle of the 20^th century, disabled activists and their family members demanded an end to systemic abuses suffered by many of the hundreds of thousands of disabled people who were hidden away in sprawling state institutions around the country.

In the following decades, presidents and lawmakers of both parties championed a national shift away from segregating disabled people in huge facilities and toward the provision of services — such as home health nurses, physical therapy or adaptive tools — that would enable them to live at home or in their communities.

The two most consequential landmark federal disability rights laws were signed by Republican presidents: Richard Nixon signed the Rehabilitation Act in 1973, and George H.W. Bush signed the Americans with Disabilities Act in 1990. Then, in its 1999 Olmstead ruling, the U.S. Supreme Court ruled that the unjustified institutionalization of people with disabilities was a form of discrimination.

“For decades we have very intentionally been shifting resources away from institutional care and into the community, because that’s what people want, and it’s more cost effective,” said Alison Barkoff, a health law and policy professor and director of the Hirsh Health Law & Policy Program at George Washington University.

“We can serve, generally, three people in the community for every one person in an institution. And it leads to better outcomes.”

More than 8 million Medicaid users receive such home- and community-based services across the country, while 1.5 million get services in institutions, such as nursing homes. Federal law requires state Medicaid programs to provide medical care and other support for people with disabilities.

People who live in institutions cost Medicaid an average of $54,462 per year, compared with $17,298 for people who get home and community services, according to the most recent Medicaid data.

State investments in home- and community-based services often result in short-term spending increases, but over time lead to long-term cost savings and a reduction in institutional spending, according to research from Brandeis University’s Community Living Policy Center.

The national shift to community-based services has been overwhelmingly popular. About 82% of people who receive community-based services prefer to live at home rather than in an institution, according to the most recent survey by the Medicaid and CHIP Payment and Access Commission.

That’s why, said Barkoff, “it is incredibly shocking, the approach that this administration is taking to something that has been so bipartisan and so much a part of American culture for decades.”

Some Republican-led states now want courts to adopt the Trump administration’s new interpretation of the Olmstead decision. Texas has already used the June DOJ memo in its lawsuit challenging federal requirements to provide community-based services. Florida also has used the memo as part of its appeal of a case involving medically complex children who were forced into nursing homes because the state refused to pay for in-home services.

Conservative state leaders say the federal government shouldn’t dictate how states offer support for people with disabilities, and argue that nursing shortages and other issues make it too difficult for states to care for some people outside of institutions.

Left behind

Barkley of Able Americans supports the shift away from institutionalization, but she says there should be more public investment in group homes or smaller facilities that can provide 24/7 oversight for people with more complex needs who can’t live safely at home.

“Unfortunately, it’s only when somebody with a serious mental illness hits the criminal justice system that they’re able to receive care,” she said. “And so for this sliver of the serious mental illness population, this movement has left them behind.”

VOR, a national disability rights nonprofit that supports “a full continuum of care options” for people with disabilities, argues that overly aggressive enforcement of the Olmstead decision and related federal law has, in some cases, resulted in people with disabilities being moved into community settings without adequate support. That broad-strokes application has contributed to poor outcomes, including homelessness, for some people.

The DOJ memo and other federal actions reducing community care have been driven in part by the Trump administration’s push to address homelessness, said Barkoff. Trump issued an executive order last July giving states a green light to commit people experiencing homelessness to treatment centers or hospitals, whether they want to go or not.

“They have created this narrative that Olmstead created this problem” of not enough beds for people who need higher levels of care, said Barkoff. But without Olmstead, “there was just a hollow promise to close institutions,” she said.

“What Olmstead did was create a tool to require states to follow through on that commitment.”

Gorski said it’s been more apparent this year than ever that there are people and families, particularly those with complex care needs, who feel that the shift away from institutional care hasn’t helped them.

Recent efforts by the Trump administration to roll back protections are “exploiting where we’ve failed to ensure that we’re taking care of our own people,” he said. “Everyone in this community should feel seen and heard and like they have a place at the table.”

But even VOR warned in a June statement that the DOJ memo “substantially weakens” protections and federal pressure on states to fund the community-based services many people with intellectual or developmental disabilities depend on.

States on their own

In June, Republican lawmakers in Ohio swiftly backtracked on a proposal that would have barred Medicaid recipients’ family members from being paid as caregivers. They pulled the controversial portion of the bill after backlash from residents who said it would hurt people with developmental disabilities whose caregivers are often relatives whose caregiving duties prevent them from taking other jobs.

Some states have recently expanded home and community-based services, including Georgia, Illinois, Ohio and Wyoming, according to George Washington University’s analysis. Others, including California, Idaho, Indiana, Maryland, Minnesota and Nebraska, have limited services.

Some, like Kansas and Virginia, have done both.

Ultimately, as the feds back away from enforcing civil rights protections, states are left to figure out how to offer services for people with disabilities in a way that balances civil rights with budget realities.

“At this point it’s kind of a state-by-state effort,” said Illinois state Sen. Julie Morrison, a Democrat who sponsored a bill this year, now law, that turned Illinois’s state disability commission into a cabinet-level agency.

“But at the end of the day we are obligated, morally I believe, to make sure we are taking care of people who need these services and who want to live in an independent environment.”

Rob Stone and his parents plan to continue meeting with state legislators in Maryland to push back against deeper cuts to services that help him remain with his family. His mother said she’s been doing a lot of explaining to lawmakers about how civil rights for people with disabilities fit into existing law.

“There’s a tremendous need for advocates to educate legislators at the state level about this because they’ve never had to think about these things before,” she said.

“It’s always been something the federal government takes care of.”

Stateline reporter Anna Claire Vollers can be reached at avollers@stateline.org.

WASHINGTON — A proposed federal commission on artificial intelligence ethics could help address moral questions associated with the rapidly developing technology, but there are still some areas in which they believe the proposal falls short, experts say.   

Sens. Ted Cruz, a Texas Republican, and Raphael Warnock, a Georgia Democrat, introduced a bill last week that would create a cross-party body of experts to “advise Congress on the ethical and policy implications of emerging technologies” such as artificial intelligence. 

According to a summary of the bill, titled the Human Dignity and Emerging Technologies Act, the federal government lacks an institution dedicated to studying the deeper ethics of AI and the threats it poses to human dignity.

“Emerging technologies have the potential to improve everyday life and strengthen America’s position on the global stage,” Cruz said in a joint press release announcing the bill’s introduction. “But as these technologies continue to evolve, we should carefully consider the ethical questions they raise and ensure human dignity remains at the center of our policymaking.”

The commission would inform “both Congress and the American people on the best path forward,” Warnock added.

“As artificial intelligence continues to become a larger part of our society, we need to be clear eyed about addressing the potential problems and perils of this technology,” Warnock said.

The bill was referred to the Senate Committee on Commerce, Science and Transportation, which Cruz chairs.

The proposed commission would have a wide focus but a narrow function, largely serving as a researcher and advisor for lawmakers. The legislation would authorize $2 million per year to the commission for the next five fiscal years. The panel would sunset in 2032, according to the bill summary, allowing Congress to reconsider its function and effectiveness.

AI bioethics

The proposed commission would focus on examining AI advancement as it relates to bioethics, a decades-old area of research that considers the ethical questions raised by emerging technologies. 

Vardit Ravitsky, president and CEO of the Hastings Center for Bioethics, a nonpartisan think tank, said bioethics is an effective foundation for AI policy. It can help shape a regulatory structure from the outset of a developing technology, giving regulators and courts guiding principles.

“When we do the thinking ahead of time, and we have principles to guide the implementation, the rollout of the technology works better, more responsibly, more wisely, and then we can reap the benefits without running into so many problems,” she said in an interview.

Ravitsky said she is “fully in favor” of the commission outlined in the Human Dignity and Emerging Technologies Act, especially because such a body could help address high-stakes concerns related to AI use in the medical field. 

Ravitsky teaches bioethics at Harvard Medical School, where she specializes in emerging technologies including genomics, reproductive technologies and health AI. 

Ethical questions in medicine include the level of disclosure owed to patients when AI is involved with their care and what to do about people treating chatbots like their personal therapists. 

“You quickly understand why this has to do with humanity, because we need to ask ourselves: ‘Are we going to allow AI to take over any kind of role in the health context, or do we want to limit AI to roles that don’t involve care,’” she said. 

Developers needed

The Human Dignity and Emerging Technologies Act outlines four main features for its proposed ethics commission. 

First, according to the bill summary, the committee would be bipartisan, consisting of 17 experts in fields including philosophy, ethics, religion, civil rights, social sciences, medicine, technology and science. Members would be appointed by “the President, congressional leaders and relevant congressional committees.”

Ravitsky said she is in favor of having ethicists on the commission and believes maintaining bipartisanship is key. But she also recommends inviting AI developers and some representatives from the private sector to participate, given how quickly artificial intelligence is evolving. 

Without them, she said, “the conversation is very limited” because those involved “need some understanding of the technology.”

Julian Jonker, an assistant professor of legal studies and business ethics at the University of Pennsylvania’s Wharton School, has his own concerns about the way in which the proposed commission’s members would be chosen. 

Although the process laid out in the bill represents “an attempt for bipartisan nomination,” because one party currently controls all three branches of U.S. government, there is still a chance the commission could end up “fairly partisan,” Jonker said.

Opportunity to expand  

Along with detailing plans for composition, the Human Dignity and Emerging Technologies Act directs its ethics commission to hold public hearings, issue reports and advise Congress and other relevant stakeholders on “AI, robotics, biotechnology, neurotechnology, emerging clinical technologies and other science or tech developments.” 

The commission would inform lawmakers about possible threats to human dignity posed by federal science and tech policy, and other congressional committees could call on the body to evaluate related programs. 

Jonker said it’s “really laudable” that the bill is “tuned into the intersection of several technologies,” but he also pointed out that it seems to exclude some important social concerns surrounding AI by focusing mainly on bioethics.

He identified issues such as labor displacement, deepfakes and the widespread use of online bots as among those the average American thinks about when considering AI’s impact on human dignity. 

The proposal also does not cover anything having to do with the environmental and economic consequences of AI buildup or data centers, he added. 

“I’m not saying that the commission has to cover everything,” he said. “But if this is the main way in which deliberation around the social impact of AI appears in Sen. Cruz’s framework, then we must note that it leaves out those things that I think are very prominent in most people’s minds right now.” 

The Trump administration has rolled back teen pregnancy prevention grants and repurposed a program designed to reduce unintended pregnancies so that it promotes childbearing. But several states, including Republican-led ones, have protected or expanded access to contraception in recent months.

Georgia Republican state Rep. Beth Camp sponsored a bill to expand contraceptive access in her state after her daughter faced a two-month delay renewing her birth control prescription. The new law, passed in April and signed in May by Republican Gov. Brian Kemp, allows pharmacists to prescribe contraception methods such as birth control pills and shots directly to patients without a doctor’s signature.

Current Georgia law requires patients to receive a birth control prescription from a doctor, which they can then fill at a pharmacy. Camp has said the new policy could help increase access to contraception in areas with primary care provider shortages.

“In our state, we have such a challenge with access for medical professionals,” Camp told the House Health Committee earlier this year. “This is just really, to me, opening up a whole new stream of opportunities for women to be able to access contraception.”

In Maryland, Democratic Gov. Wes Moore in May signed a measure that requires public higher education institutions and community colleges to annually submit a report on contraception access to the Maryland Higher Education Commission. It also requires the commission  to submit a report on contraception access to the General Assembly and requires each community college to provide students with access to all methods of over-the-counter contraception.

Tennessee Republican Gov. Bill Lee in March signed into law a bipartisan bill that requires private health care plans to cover a yearlong supply of birth control. The state’s Medicaid program, TennCare, already provides a 12-month supply of birth control. The measure is set to take effect July 1, 2027.

And Democratic Virginia Gov. Abigail Spanberger in April signed a new law establishing the right to contraception and allowing people to sue if their rights are violated. Spanberger also signed another law requiring health insurance companies to cover both prescription and over-the-counter contraceptives without cost-sharing. Both laws went into effect this month.

Stateline reporter Sofia Resnick can be reached at sresnick@stateline.org.

Earlier this year, the Wisconsin Department of Corrections entered into a  contract to put a series of reform proposals into practice.

DOC Secretary Jared Hoy signed the contract with Falcon Correctional and Community Services, Inc, a consulting and management firm that produced a report and made recommendations in partnership with the DOC. 

The report gave Wisconsin’s adult prison system advice on how to provide incarcerated people with better healthcare, reduce prisons’ use of solitary confinement and address a persistent understaffing problem. It found a significant number of staff were hired during or after the COVID-19 pandemic, and that newer staff had limitations because they were trained while normal operations were suspended due to the pandemic. 

The report also found a “general lack of uniformity” across facilities, creating problems with monitoring, oversight and accountability. Facilities needed a standard approach to basic security practices, incident reporting, investigations and hiring practices, the report recommended. 

In the contract documents, the DOC and Falcon plan to implement recommendations from the report, though the report stated that the majority of recommendations will require funding from the state. Susan Franzen of the prison reform advocacy group Ladies of SCI expressed concern about whether overcrowding and staffing shortages will affect the agency’s ability to effectively carry out the recommendations, and called for action from the state Legislature. 

Contract documents obtained by the Examiner in May show that “Phase 1” of the partnership involves Falcon helping the department turn recommendations into plans for action, visiting facilities, providing mentorship and coaching and helping prepare prisons to maintain the new changes after the partnership is over. 

The Department of Corrections didn’t respond to the Examiner’s requests for comment about whether any changes have been made to the contract’s status or the documents since the Examiner received them from the department on May 13. 

According to the documents, “Phase 1” focuses on six prisons, including the often-scrutinized Green Bay and Waupun Correctional Institutions.

The other prisons included in this phase are Taycheedah Correctional Institution, which houses women, the maximum-security Columbia Correctional Institution and the medium-security Redgranite and Stanley Correctional Institutions. 

DOC will follow recommendations from various priorities in the Falcon report, which include sections on solitary confinement, medical and mental health practices and human resources and staffing, according to the contract documents. 

Franzen of the Ladies of SCI said in a May interview that she thinks the Department of Corrections leadership in Madison wants to improve the system. She expressed concern about whether the change in approach will be carried out at the level of individual correctional officers working in particular units in the prison system. 

Some efforts may happen at a system-wide level when appropriate, according to the contract documents. This includes Falcon working with the DOC to train staff throughout the department’s division of adult prisons in two areas: “security back-to-basics” and building a culture of dignity and respect. 

For Franzen, the partnership raises the question of what metrics will be used to determine whether the department is succeeding at creating this culture. 

“I want to hear things from family members [of incarcerated people] that are different,” Franzen said. 

The department also planned a review of its adult prison policies to begin in March 2026. The goal is to fix gaps and redundancies and to have the policies match the new reforms. 

Under the contract, the project cost can’t go above $500,000 without prior approval from the DOC, with Falcon receiving payment in four installments after completion of tasks.

Site visits

The contract lists plans for two Falcon site visits, along with a third that would happen later in the phase if the DOC decides it is necessary. 

The first visit and a DOC/Falcon leadership summit were scheduled for early March 2026. It’s unclear whether the second visit has happened yet; the documents say it will take place partway through the process of implementing reforms. 

The second visit aims to provide mentoring, identify problems and review how the reforms are being put into practice, the contract documents say. The visit will be “strategically targeted” based on information gathered through remote monitoring and Department of Corrections oversight. 

The third visit, if the department holds it, would focus on sustaining improvements, leadership readiness and reform in the long term.

“There’s only so much you can tell from a video call,” Franzen said. “…I would hope that they take advantage of that [potential third visit], because I think that’s going to be a really good way to help reinforce things, and making sure that things have changed.”

Advocates want more oversight

The Department of Corrections has held friends and family forums for loved ones of people who are incarcerated or on active community supervision, and Franzen said advocates participated in a virtual workshop for the Falcon report last year. But Franzen wishes the Falcon report had dug deeper, and she also wants to see Wisconsin create an independent ombudsman’s office with oversight over the DOC. 

“I appreciate that they’re doing this, but yes… this is money that also could’ve been put towards an ombuds for someone that’s in it for the long haul,” Franzen said. “And also not someone who’s depending on a paycheck from the DOC.” 

Mark Rice, criminal justice campaign coordinator for the advocacy organization WISDOM, wants to see people impacted by the prison system having a central role in the process. 

Rice took issue with one of the contract documents, which states Falcon cannot employ a person who is on active probation, parole or extended supervision for any position where their primary duties involve working with incarcerated people or involves access to the records or funds of incarcerated people. 

“I feel that’s a lost opportunity,” Rice said. “Some of the people who would be the best and most informed people to be a part of this as paid staff are people currently under supervision.”