Idaho has become the first state to pass a law explicitly restricting some out-of-state travel for abortions.

The new legislation makes helping a pregnant minor get an abortion, whether through medication or a procedure, in another state punishable by two to five years in prison. Gov. Brad Little signed the bill on Wednesday night, and it goes into effect after 30 days.

Abortion has been banned at all stages of pregnancy in Idaho since August — a result of the Supreme Court’s decision to overturn Roe v. Wade. Terminating a pregnancy is illegal in the state unless it saves the life of the mother or in cases of rape and incest in which the survivor has reported the incident to law enforcement.

Although Oklahoma and Texas allow lawsuits against people who help facilitate an abortion within the states’ borders, Idaho’s law is the first that expressly criminalizes assisting with an out-of-state abortion.

“Giving [minors] money, giving them a ride, helping them organize the visit to a doctor out of state — all of the activity that’s required to help a young person leave the state — any of that would be punishable,” said Elisabeth Smith, the director of U.S. state policy and advocacy at the Center for Reproductive Rights.

With the bill’s passage, Idaho has the most extreme abortion restrictions in the U.S., according to Mistie DelliCarpini-Tolman, Idaho state director of Planned Parenthood Alliance Advocates.

“House Bill 242 might be the most extreme bill that I’ve ever seen in my career,” she said. 

Since the Supreme Court’s Dobbs decision last year, legal experts have anticipated attempts from conservative lawmakers to further restrict abortion access. Now, Smith said, Idaho has outlined a playbook for other states to copy.

“For a long time, there has been this sort of jockeying of which state could have the most oppressive laws on abortion,” she said. “For that reason, I think Idaho could be an example to anti-abortion lawmakers.”

Fierce debate over the new law

Idaho’s new law offers those who facilitate a minor’s access to abortion a reasonable defense against prosecution if the parents consented.

David Ripley, executive director of Idaho Chooses Life, a political action committee that lobbies for anti-abortion legislation, said one reason for the law is that minors are unable to make their own informed decisions about any kind of medical care.

“When you’re talking about a minor being transported across state lines, especially for a medical procedure without parental consent, I think that is clearly within the authority of the state of Idaho to criminalize and discourage,” Ripley said.

But abortion rights advocates think the bill could pave the way for future laws that target people who help adults seek out-of-state abortions.

“That is the way, historically, all abortion restrictions have begun: by first limiting young people’s access, and then moving to adult access,” Smith said.

DelliCarpini-Tolman said Planned Parenthood will be “examining every angle that we can to fight this legislation.”

“The mere suggestion that the state would consider prosecuting someone for assisting a young person accessing safe, legal medical care in another state flies in the face of our democratic system and sets a dangerous statutory precedent,” she added.

A legal battle among bordering states

Idaho isn’t the first state to attempt to limit people’s ability to assist those seeking out-of-state abortions.

In 2021, Missouri lawmakers included a provision in a larger abortion bill that would have made it illegal for a person to help a Missouri resident get an abortion outside the state. But the state’s House of Representatives blocked the provision.

In February, a federal judge in Texas also temporarily blocked prosecutors from pursuing charges against people who help facilitate out-of-state abortions while a lawsuit challenging the state’s abortion ban is argued in court.

States where abortion is legal, on the other hand, have pushed for legislation to protect out-of-state travelers who seek abortions within their borders.

Washington’s state Senate is currently considering a bill that would restrict courts and law enforcement agencies from responding to warrants, subpoenas or other court orders from states seeking information about abortions performed in Washington for nonresidents. Oregon is weighing similar legislation.

These so-called shield laws could make it tougher for Idaho prosecutors to build cases related to out-of-state abortions, Smith said.

Paul Dillon, the outgoing vice president of public affairs at Planned Parenthood of Greater Washington and North Idaho, said Washington legislators are expected to vote on the state’s shield law any day.

“It does feel like a race, I think, to make sure that those protections are in place before this Idaho law goes into effect,” Dillon said.

In the meantime, he added, patients who travel to Planned Parenthood clinics in Washington aren’t required to disclose where they came from or whom they traveled with. Residence data from those who’ve offered it suggests the Washington state clinics saw a 75% increase in Idaho patients from January 2022 to early 2023.

Idaho’s anti-abortion laws could affect access to maternal health care

Idaho health workers who refer patients out of state for an abortion are in fraught legal territory, according to a recent letter from the state’s attorney general, which suggests its abortion ban prohibits these referrals. On Thursday, a group of providers, including Planned Parenthood, filed a legal challenge to that interpretation.

Critics of Idaho’s anti-abortion policies say the laws are already having downstream effects, including reduced access to reproductive health services.

Two Idaho hospitals announced last month that they were closing their labor and delivery units. One of them, Bonner General Health, said in a news release that the closure was due to a pediatrician shortage and Idaho’s political climate.

“The Idaho Legislature continues to introduce and pass bills that criminalize physicians for medical care nationally recognized as the standard of care,” the statement said.

Medical providers said the closures force patients to travel farther for reproductive care, which could jeopardize their health in emergencies. From Bonner General Health, the next closest Idaho hospital with a labor and delivery unit is 45 miles away.