Earlier this week, Arkansas Gov. Asa Hutchinson signed a new law barring abortions “except to save the life of a pregnant woman in a medical emergency.” This near-total ban on abortion clearly violates the rights spelled out in Roe v. Wade.

The ban is not scheduled to go into effect until late this summer, so people in Arkansas can still obtain an abortion. The ACLU and Planned Parenthood will challenge the new law in court, and depending on how those challenges play out, there’s a chance it may never go into effect.

But the Arkansas law is part of a much larger wave of states seeking to restrict or overturn abortion rights. The Guttmacher Institute reports that in the first two months of 2021 384 anti-abortion provisions were introduced in 43 states. The proposals include complete bans on abortion, gestational bans, bans on particular methods, and bans (like the Arkansas law) limiting abortions to special circumstances. Since the beginning of the year, eight abortion restrictions or bans have been enacted in Arkansas, Kansas, Kentucky, Ohio, South Carolina, and South Dakota.

This onslaught on reproductive rights is not unexpected or new. But it is accelerating now, spurred on by Donald Trump’s remaking of the federal judiciary. In addition to the three anti-abortion justices Trump appointed to the Supreme Court, shifting the court to a 6-3 conservative majority, he also appointed more than 200 judges to the lower federal courts. Those appointees are overwhelmingly young, white, male, and staunchly anti-abortion. Between the Supreme Court and the lower courts, Trump’s judicial appointees put Roe in real danger, either of being overturned outright, or suffering slow death by a thousand cuts.

In fact, it’s not only abortion rights that are under attack, but a full range of reproductive rights including family planning and evidence-based sexuality education. The Population Institute just released its annual 50 state report card on reproductive health and rights for 2020, which measured a broad range of programs and indicators: 23 states received a failing grade, and — for the second year in a row — the U.S. overall also failed.

Arkansas was one of the 23 states that failed. Among the many abortion restrictions it has in place is a 20-week abortion ban. It also imposes a 72-hour waiting period, requiring patients seeking an abortion to make two trips to the provider. This is a very burdensome restriction especially in a state, like Arkansas, where 77 percent of women live in a county without an abortion provider.

The Biden-Harris administration will work to expand access to family planning and reproductive services at the federal level — but it won’t be easy or quick to undo all the damage inflicted by the previous administration. Many states will continue to attack abortion rights, worsening the growing divide between states that promote reproductive health and rights and those — like Arkansas — that undermine them. Trump-appointed judges are likely to make that divide even wider.

Although Americans’ reproductive rights and health aren’t supposed to depend on who they are or where they live, increasingly they do. As more restrictions are placed on abortion, access gets pushed further out of reach for already underserved populations including low-income people, Black people and other people of color, young people, and the LGBTQ+ community.

Constitutionally, Roe is still the law of the land, but practically — for an ever-growing number of people — access to abortion services is already severely limited, and only getting worse.

Reproductive rights are meaningless if people are not able to exercise them.

Abortion and all reproductive health care is essential health care — and a basic right. Everyone has the right to access a full range of reproductive health care services, regardless of where they live, how much money they make, their age, race, or how they identify. State governments, as well as the federal government and federal courts, have an obligation to uphold that right.

This op-ed by Jennie Wetter, who is the Director of Public Policy with the Population Institute, originally ran on March 13, 2021 in The Hill.