On October 22, 2025, two pivotal developments in the ongoing battle over abortion rights unfolded in the United States, drawing new lines in the sand over reproductive healthcare, state power, and the limits of medical exceptions. In Wyoming, Republican lawmakers, guided by the influential Alliance Defending Freedom (ADF), advanced the CARE Act—a sweeping bill that would make anti-abortion crisis pregnancy centers virtually untouchable by state regulation. Meanwhile, in Tennessee, a three-judge panel delivered a blow to the state government’s efforts to shut down a lawsuit challenging the vagueness and inadequacy of exceptions to the state’s near-total abortion ban, highlighting persistent concerns about women’s safety and constitutional rights.
Wyoming’s CARE Act, crafted by ADF—the same group widely credited with ending Roe v. Wade—marks a bold new front in the anti-abortion movement’s strategy. According to reporting by The New Republic, the bill would not only outlaw most forms of oversight for crisis pregnancy centers (CPCs), but would also empower these organizations to sue state officials who attempt to regulate them. Damages for such lawsuits would start at $5,000, but could rise to as much as three times the actual damages sustained. As ADF attorney Denise Burke put it, “The bill was designed to protect Wyoming’s pregnancy centers from censorship or discrimination.”
But critics argue that the legislation’s reach goes far beyond protecting free speech or religious liberty. CPCs, sometimes referred to as “fake clinics” by reproductive rights advocates, have long operated with minimal oversight in anti-abortion states, receiving hundreds of millions in taxpayer dollars while providing limited care. According to The New Republic, much of this funding is spent on staff salaries, travel, and even exercise equipment, with only a fraction reaching women in need. These centers often require women to participate in Bible study classes to obtain basic supplies like diapers, and research has shown that they routinely mislead women about their health and pregnancies. Furthermore, they frequently claim to protect patients’ medical privacy under HIPAA, despite not being real medical clinics and thus not subject to federal privacy laws.
The CARE Act would make it illegal—and expensive—for state or local authorities to impose any regulations on these centers. This, critics say, would allow CPCs to spread misinformation unchecked and further the anti-abortion movement’s agenda. The bill is also part of a broader effort to restrict access to contraception. While Republicans have not moved to ban birth control outright, they have worked to make it increasingly difficult to obtain. The CARE Act would prohibit requiring CPCs to offer, refer for, or even mention contraception, effectively eliminating birth control access in communities where CPCs are the only available providers. As The New Republic notes, “Republicans claim they’re simply meeting the post-Dobbs moment to support women, and showing that their ‘pro-life’ bonafides go beyond banning abortion.” Yet, the reality is that most CPCs do not have medical staff or provide genuine reproductive care—and certainly do not offer contraception.
The legislation’s language also appears to open the door for CPCs to access Title X federal family planning funds, a move long sought by conservative strategists. By framing any regulation as “discrimination,” the bill could allow religiously affiliated CPCs to compete for millions in grants, further shifting resources away from comprehensive reproductive health providers.
Perhaps most controversially, the CARE Act introduces the term “pre-viability separation procedure,” defined as “a medical procedure performed by a licensed physician to remove an unborn child from the mother’s uterine cavity” before fetal viability. This term, according to The New Republic, is a recent invention by anti-abortion groups designed to argue that abortion is never medically necessary. Rather than allowing standard abortion care in life-threatening situations, the bill encourages alternatives like c-sections or induced labor, even when the fetus cannot survive. This approach, critics warn, could lead to traumatic and unnecessary medical interventions, putting women’s lives at risk and erasing exceptions for medical emergencies.
“She was screaming—not from pain, but from the emotional trauma she was experiencing,” one physician recounted in an affidavit about a patient forced to deliver a nonviable fetus after being denied a standard abortion procedure. The patient hemorrhaged and lost nearly a liter of blood. Such stories, advocates argue, underscore the dangers of codifying “separation procedures” in law and normalizing the denial of life-saving abortion care.
Wyoming’s CARE Act is not an isolated effort. Similar legislation has already passed in Montana, been introduced in South Carolina, and is being pushed at the federal level. The goal, according to reproductive rights advocates, is to replace real reproductive health clinics with ideologically driven CPCs, restrict access to both abortion and contraception, and gradually eliminate exceptions for women’s lives.
While Wyoming’s lawmakers advanced the CARE Act, Tennessee’s courts were wrestling with the fallout of their own abortion restrictions. On the same day, a three-judge panel in Tennessee ruled against the state’s attempt to end a lawsuit challenging the adequacy of medical exceptions to the state’s near-total abortion ban. The lawsuit, originally filed in 2023 by Tennessee ob-gyns and women who had suffered serious medical complications during pregnancy—and later joined by the American Medical Association—argued that the law’s exceptions were too vague to protect women’s lives and health.
The state had contended that a 2025 amendment, adding “medical necessity exceptions” to the 2022 abortion ban, rendered the lawsuit moot. But the panel disagreed, writing, “The changes made by the 2025 Amendment do not significantly alter the status of this case.” The judges found that “the defects in the Medical Necessity Exception place their lives at risk in violation of their constitutional right to life.”
Tennessee’s abortion ban, which went into effect after the Supreme Court overturned Roe v. Wade in 2022, has been amended twice to provide limited exceptions for medical emergencies. However, it still contains no exceptions for rape, incest, or pregnancies with fatal fetal abnormalities. The 2023 amendment allowed doctors to perform abortions using “reasonable medical judgement” if necessary to prevent a woman’s death or serious risk of substantial and irreversible impairment of a major bodily function, and included molar and ectopic pregnancies as exceptions. The court later outlined four specific pregnancy-related conditions as qualifying for exceptions, but confusion and lack of consensus persisted among medical professionals.
The 2025 amendment codified these four conditions, but explicitly excluded mental health diagnoses as grounds for an exception—a point now being challenged by plaintiffs. The panel’s decision allows the lawsuit to proceed and opens the door to further scrutiny of the law’s adequacy and impact on women’s health. The court also permitted subpoenas for internal documents from the Tennessee General Assembly, governor, and Department of Health regarding the abortion ban and medical exceptions. In response, the state filed an emergency motion to appeal, citing separation-of-powers concerns.
As the legal and legislative battles rage on, the future of reproductive rights in America remains uncertain. With states like Wyoming and Tennessee pushing the boundaries of abortion and contraception restrictions, and courts grappling with the real-world consequences, the stakes for women’s health and autonomy have never been higher.
