Who Is Behind Illinois' Abortion Law?

In 2019, Illinois governor J.B. Pritzker signed the Reproductive Health Act into law, which sponsors warned would be necessary should Roe v. Wade be overturned. The law expands abortion rights across the state, rescinding prohibitions on some late-term abortions and 45-year-old criminal restraints, such as criminal penalties for doctors performing abortions. The legislation also repealed the Parental Notification Act in 2021, allowing pregnant minors to choose whether or not a legal guardian or family member is involved in their decision.

The Illinois Reproductive Health Act

The RHA protects all individuals in Illinois, regardless of age, gender identity, sexual orientation, class, immigration status, race, ethnicity, language ability, or disability status, and even applies to individuals in state custody or control. It also ensures that abortion is kept confidential, regardless of age. The Act further requires that private health insurance plans in Illinois cover abortion, and that abortion is treated like other types of health care, with regulations that reflect current medical standards.

The RHA was established in response to the wave of legislation and court action across the nation restricting a woman's right to choose. Illinois has seen an increase in out-of-state patients travelling to the state to receive reproductive care. According to the Illinois Department of Public Health, 7,534 non-residents received abortions in Illinois in 2019, compared to 2,970 in 2014 and 5,528 in 2017.

The Act also repeals the Illinois Abortion Law of 1975, which banned abortions after 12 weeks, and rescinds previous legislation that criminalized the performance of late-term abortions. It affirms that a "fertilized egg, embryo, or fetus does not have independent rights" under Illinois law.

In addition to the RHA, Illinois has taken other steps to protect reproductive rights. In 2021, the state repealed the Parental Notification Act, which required doctors to notify a pregnant minor's parent within 48 hours before an abortion procedure. This repeal ensures that vulnerable youth, such as victims of rape, incest, and domestic abuse, are not compelled to involve their families in their decision to have an abortion.

The Partial-birth Abortion Ban Act

> "deliberately and intentionally vaginally delivers a living fetus until, in the case of a head-first presentation, the entire fetal head is outside the body of the mother, or, in the case of a breech presentation, any part of the fetal trunk past the navel is outside the body of the mother."

The Act was passed after an eight-year-long congressional fight, with the final legislation supported by 218 Republicans and 63 Democrats in the House, and 47 Republicans and 17 Democrats in the Senate.

The phrase "partial-birth abortion" was coined by Douglas Johnson of the National Right to Life Committee in 1995 to describe a medical procedure to remove fetuses from the womb, known as "dilation and extraction" or "intact dilation and extraction". The procedure is used in the second trimester, from 15 to 26 weeks, and the Act prohibits any physician from performing it unless necessary to save the life of a mother whose life is endangered by a physical disorder, illness, or injury.

The Act's constitutionality was challenged immediately after it was signed, with three U.S. district courts declaring it unconstitutional due to its omission of an exception for the health of the woman. However, the Supreme Court upheld the Act's constitutionality in 2007 in the case of Gonzales v. Carhart, with a 5-4 decision that the Act defined the banned procedure more clearly than previous bans.

The Parental Notice of Abortion Act

If individuals could not notify one of these adult family members, or if they did not fit a narrow set of exceptions, they had to go to court and answer questions in front of a judge to show that they were mature and well-informed enough to make the decision on their own. Alternatively, they could demonstrate that involving an adult family member was not in their best interest.

The law impacted young people in precarious or dangerous situations, such as those fearing physical or emotional abuse, getting kicked out of their homes, or being forced to continue a pregnancy against their wishes. It also perpetuated the idea that abortion is not a legitimate form of healthcare. Notably, once a young person is pregnant in Illinois, they have the right to consent to all healthcare procedures without parental involvement, except for abortion when the PNA was in effect.

The American Civil Liberties Union (ACLU) of Illinois opposed the PNA and took the matter to court, successfully preventing the law from being implemented until 2013. When the law came into effect, the ACLU established the Judicial Bypass Coordination Project, which operated a hotline and provided free legal representation for young people seeking abortions in the state.

In October 2021, the Illinois General Assembly approved the Youth Safe and Healthy Act (HB 370), which repealed the PNA and established an advisory working group to identify resources for youth. As of 1 June 2022, young people in Illinois regained the right to make confidential decisions about abortions and are no longer required to go to court to access abortion services.

The Illinois Abortion Law of 1975

The law also included a "trigger provision" that stated that if Roe v. Wade was ever overturned, abortion would become illegal again in Illinois. Similar statutes were enacted in Kentucky, Louisiana, and South Dakota. This provision was later repealed in 2017 by the 100th General Assembly, along with many of the law's other provisions. However, the bill that was signed into law by Governor Bruce Rauner also provided for abortion to be covered under Medicaid and state employee health insurance.

The Abortion Performance Refusal Act

Illinois has a long history of abortion laws, dating back to the early 1800s. The state has seen a constant back and forth between the legalization and criminalization of abortion. In 2019, Illinois updated its existing abortion laws, and in 2024, abortion was legal in the state.

The Act provides legal protection for health care providers and their patients, as many patients have travelled to Illinois to access reproductive health care that is banned in their home states. It also expands access to reproductive health care by broadening the scope of care certain health care professionals can provide. For example, Advanced Practice Registered Nurses and Physicians Assistants can now provide abortions within their scope of practice and training.

The Act also ensures insurance coverage for necessary care. It mandates that local government employers offer insurance plans that cover abortion medications, PEP/PrEP, and gender-affirming care at no extra cost to consumers. Additionally, it requires insurers to cover abortifacients, gender-affirming health care medications, and PEP/PrEP medication without charging consumers.

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