In 2012, voters in Wyoming were asked to approve on three changes to the state constitution: to preserve the right to hunt, fish, and trap; to expand the power of certain judicial employees; and to establish citizens’ authority to determine their own health-care choices. Billed as the Health Care Freedom Amendment, the measure was designed as a rebuke to the Affordable Care Act, the federal health-care law that had been enacted two years earlier and largely upheld by the Supreme Court that summer. Critics of Obamacare had asserted that it would usher in “death panels” and that its mandate that individuals purchase health insurance infringed on personal freedom. The Wyoming amendment provided that “each competent adult shall have the right to make his or her own health care decisions.” The measure was largely a “message amendment” with little practical impact, according to Robert Keiter, the leading expert on the state’s constitution. Still, it passed overwhelmingly, with seventy-six per cent in favor.

Now enshrined as Article 1, Section 38, the provision has become an unlikely savior of abortion rights. Wyoming is the reddest state in the nation; a place where President Donald Trump won reëlection in 2024 with 71.6 per cent of the vote, and the Wyoming Supreme Court is composed entirely of justices appointed by a Republican governor. (The most recent Democratic governor left office in 2011.) Yet in a long-awaited ruling on Tuesday, the Court, splitting 4–1, struck down two laws, passed in 2023, that imposed a near-total ban on the procedure. One, the Life Is a Human Right Act, barred almost all abortions; the other, the first of its kind in the country, made it illegal to dispense or use abortion medication. Both laws, the justices concluded, violated the “very specific language” of Wyoming’s anti-Obamacare amendment. They unanimously rejected the state’s argument that abortion is not a form of health care, and that, as a result, the amendment did not apply. Pregnancy, the majority said, poses significant medical risks, and abortions “are medical procedures performed or administered by qualified medical professionals.” Therefore, “the phrase ‘health care’ includes abortion care and that the decision whether to terminate or continue a pregnancy is a ‘health care decision.’ ” The majority likewise dismissed the state’s claim that the intention of the voters—they thought they were taking a poke at Obamacare, not protecting abortion rights—should be taken into account. “The plain meaning of the provision controls, and we are not at liberty to read restrictions into that language,” the majority observed.

Another part of the amendment grants the legislature power to “determine reasonable and necessary restrictions” on health care “to protect the health and general welfare of the people.” But the majority said that that provision could not be interpreted in a way that would effectively undo the individual right to make health-care decisions. A fourth justice, concurring, said the state had failed to prove that the abortion restrictions were “reasonable and necessary.” The dissenting justice, Kari Jo Gray, focussed on that same provision, relying on it to find the laws were justified by the legislature’s interest in “preserving prenatal life at all stages of development.”

Wyoming’s explicit protection of the right to make health-care decisions appears to be unique, according to the opinion. But the ruling has implications beyond the state, reflecting the increased significance of state courts and state constitutional protections at a time when the U.S. Supreme Court is cutting back on federal constitutional rights. In neighboring Montana, for example, the state constitution explicitly guarantees the right to privacy, and the state Supreme Court has repeatedly cited that provision in striking down various abortion restrictions. (In 2024, Montana voters approved a constitutional amendment enshrining the right to abortion.)

The Wyoming ruling is hardly the end of the abortion battle, of course. The state’s legislature is split not so much between Republicans and Democrats—there are just two Democrats in the thirty-one-member Senate and six in the sixty-two-member House of Representatives—as it is between traditional Republicans and a more extreme contingent, members of the Freedom Caucus. The latter are increasingly gaining the upper hand; in 2025, the Freedom Caucus gained a majority in the Wyoming House, marking the first time the group had won control over a state legislative chamber. Following the Wyoming Supreme Court ruling, the state’s governor, Mark Gordon, a Republican of the more traditional camp, called on the legislature, which is to convene in February, to put a constitutional amendment restricting abortion rights on the November ballot; one proposal has already been filed. Yet it’s not at all certain that such an amendment would pass; Wyoming conservatism has a significant libertarian streak, and private polling in the state has shown that a majority of voters oppose eliminating the right to abortion. An anti-abortion amendment was last on the ballot in 1994, and it failed spectacularly, with only thirty-nine per cent of voters supporting it. (One of the justices who participated in Tuesday’s ruling, Kate Fox, represented the Wyoming National Abortion Rights Action League in an effort to keep that measure off the ballot.)

Freedom Caucus members could try other, more sweeping approaches to rein in what they consider to be an out-of-control court. They could push to reduce the size of the court, from five to three. (Fox, one of the justices in the majority, has retired—she was allowed to rule in the case because it was argued while she was still in office—and has been replaced by the state’s former attorney general, so a strategically shrunken court could restore an abortion ban.) Or they could move to change the method for Supreme Court appointments. Under the current merit-selection system, the governor chooses justices from among nominees recommended by a commission of lawyers and citizens; new justices stand for retention election after the first year and every eight years thereafter. There has already been talk among Freedom Caucus members of a switch to electing justices, which would eliminate the insulation from partisan politics. A Wyoming Freedom Caucus post on X after the ruling was unsparing about the court—and ominous about the future. “This is what happens when you let a weak Governor @GovernorGordon appoint weak judges unchecked: woke attorneys with an unpopular agenda that would never get them elected legislating from the bench,” the group said. “We will never give up the fight to protect innocent preborn life.” ♦