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Family policy implications of the expected ruling on Roe v. Wade

By David Rothwell

The draft opinion of Justice Alito to overrule Roe v. Wade and Planned Parenthood v. Casey has brought intense public attention to matters of family policy. The decision to transfer oversight from the federal courts to state legislatures will disrupt the reproductive rights and family life of millions of women. On Thursday May 12, I’ll be participating in a flash panel organized by the School of Public Policy on the implications of the ruling. In this blog post, I’ll explain why the ruling matters for family policy and identify 3 areas of concern for American families.  

Why does this matter?

While the creation of human life is a fundamental function of families, many pregnancies are unintended. In these difficult scenarios, the decision to terminate pregnancy and whether or not a woman has access to abortion raises questions of moral (what is the role of the state in protecting / ending life?) and political philosophy (should this matter be decided by the judicial branch or by states?). I will leave those topics for others and instead focus on how the consequences of the decision relate to family policy. I suggest that undoing Roe deviates from a historical pattern of family policy, increases inequality between states, and reduces economic security for low income mothers.

1. Restricting freedom represents a family policy paradox

Family policy concerns legislative actions that affect the core family functions of formation/reproduction, childrearing, economic support, partner relations, and caregiving. The ruling is expected to undo nationwide constitutional protection of abortion rights. In doing so, the court aims to give state governments control. “Roe and Casey arrogated that authority. We now overrule those decisions and return that authority to the people and their elected representatives” (Gerstein & Ward, 2022). As a result, 13 states are set to overturn the Roe decision following the supreme court ruling (McCann & Johnston, 2022). This transition counters historical liberal-conservative positions on family policy. Liberal and conservative views about family policy tend to be consistent with views about government (Strach, 2019). Traditional conservative family policies include the personal responsibility inherent in the work requirements, time limits, and sanctions that were included in 1996 welfare reform, choice in schooling and charter schools, and private/market solutions to childcare; liberal policies include expanding anti-poverty measures such as the child tax credit, broadening access to public health insurance, and providing family and medical leave for all regardless of employer. When conservatives advocate for the state to play a more active role in what has been private family decisions for nearly 50 years, it signals a paradox in traditional family policy.

2. Allowing states to regulate abortion will increase inequality between states

Health and wellbeing of families is shaped by structural factors and undoing Roe would increase inequality among states. States have always had considerable control over family policy, but there has been a trend toward more devolution since the 1970s (see Perlstein, 2020). And, just as individuals have become more polarized in their political views, states have also trended away from the centerline. For example, cash assistance for families with children and health insurance access is largely determined by the state one lives. Consider the 1996 welfare reform that ended Aid to Families with Dependent Children (AFDC) and created Temporary Aid for Needy Families (TANF) along with giving states wide discretion in how they spend “welfare” dollars. The share of TANF funding now spent on basic assistance now varies from 4 to 68 percent in 2020; Oregon spends roughly 34% (Azevedo-Mccaffrey & Safawi, 2022).

The 2004 Affordable Care Act is another example, where 12 states elected to not expand Medicaid: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, South Dakota, Tennessee, Texas, Wisconsin, and Wyoming. In other areas such as family leave, states have responded to the lack of federal policy by establishing state specific-policies. There is now paid family leave in over ten states, Oregon is one of the most recent to join. Together, this patchwork of policy availability in some states and not others has produced high levels of inequalities in outcomes. Consider the poverty rate ranges from 14.5 in Mississippi to 5.9 in Minnesota (Fox & Burns, 2021). The likelihood of maternal mortality is over four times larger in Arkansas compared to Illinois (Declercq & Zephyrin, 2020) and the average life expectancy in West Virginia is 7 years less than Hawaii (Montez et al., 2020).  

By enabling states to regulate abortion, the court ruling will increase social inequalities across the country. One’s ability to exercise choice over reproduction, like poverty and health access, will be largely determined by geographic residence. Cross the state border and the same American family will have access to far more or fewer resources and limitations on their free will.

3. The lack of family policy means more economic insecurity

The increasing number of mothers in the workforce has transformed family life over the past century. This shift has resulted in more economic security for women and a closing of the gender pay gap. Women’s increases in earnings over the past 40 years have outpaced men’s, especially at the bottom of the income distribution (Autor, 2014). It’s important to note these changes took place after Roe: my calculations show a 40% increase in female labor force participation since 1973.

Without access to abortion, unintended pregnancies will result in more births, and those births will be concentrated among teens and racial/ethnic minorities. Around the time of birth all working mothers take leave – paid or unpaid –from work or exit the workforce entirely to care for a new child. In this way motherhood disrupts economic security for many (Stanczyk, 2015), with especially large declines in resources for new mothers who lack access to paid leave or partners with sufficient resources to substitute lost wages. The draft ruling argues that increased demand for adoption makes abortion less necessary and that adoption may play a role in offsetting some of these losses (Gerstein & Ward, 2022). However, this assertion is entirely undocumented by social science unlike the strong causal relationships that have been established between abortion access and increased employment (Meyer et al., 2021). Further, this ignores the psychosocial strain that may accompany the pregnancy and birth itself.

Family policies – specifically economic supports – can play a strong role in offsetting some of these market vulnerabilities. But, the 13 states where abortion bans are expected to take place shortly after the ruling have some of the most stringent social safety net and insufficient work-family policies. For every 100 families in poverty in these states, just 9 receive TANF cash assistance (compared to 21 across the nation; 49 in Oregon) (Center on Budget and Policy Priorities, 2022). Recent evidence documents that states with larger percentages of black residents are less likely to provide cash assistance to the poor (Parolin, 2019) and a strong relationship between racist beliefs of blacks among whites and declining cash support for low income families (Fusaro, 2021). The poverty rates in these states are higher than the national average and none have paid family leave.  

Considering these birth impacts on economic livelihoods are large and concentrated among some of the most socially isolated and disadvantaged, overturning Roe is likely to reverse gains in gender equality and exacerbate socio-economic disadvantage.


Autor, D. (2014). Skills, education, and the rise of earnings inequality among the” other 99 percent”. Science, 344(6186), 843–851.

Azevedo-Mccaffrey, D., & Safawi, A. (2022). To Promote Equity, States Should Invest More TANF Dollars in Basic Assistance. Center on Budget and Policy Priorities.

Center on Budget and Policy Priorities. (2022). State Fact Sheets: Trends in State TANF-to-Poverty Ratios. Center on Budget and Policy Priorities.

Declercq, E., & Zephyrin, L. (2020). Maternal mortality in the United States: A primer. Commonwealth Fund.

Fox, L., & Burns, K. (2021). The Supplemental Poverty Measure: 2020.

Fusaro, V. A. (2021). State Politics, Race, and “Welfare” as a Funding Stream: Cash Assistance Spending Under Temporary Assistance for Needy Families. Policy Studies Journal, 49(3), 811–834.

Gerstein, J., & Ward, A. (2022, May 2). Exclusive: Supreme Court has voted to overturn abortion rights, draft opinion shows. POLITICO.

McCann, A., & Johnston, T. (2022, May 3). Where Abortion Could Be Banned Without Roe v. Wade. The New York Times.

Meyer, E., Srinivasan, A., & Sabharwal, N. (2021). Brief of amici curiae economists in support of respondents [Brief of Amici Curiae]. Supreme Court of the United States.

Montez, J. K., Beckfield, J., Cooney, J. K., Grumbach, J. M., Hayward, M. D., Koytak, H. Z., Woolf, S. H., & Zajacova, A. (2020). US State Policies, Politics, and Life Expectancy. The Milbank Quarterly, 98(3), 668–699.

Parolin, Z. (2019). Temporary Assistance for Needy Families and the Black–White child poverty gap in the United States. Socio-Economic Review.

Perlstein, R. (2020). Reaganland: America’s Right Turn 1976-1980. Simon and Schuster.

Stanczyk, A. (2015). The Dynamics of Household Economic Circumstances around a Birth.

Strach, P. (2019). A Policy Paradox: Response to Theodora Ooms. Journal of Family Theory & Review, 11(1), 52–56.

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