Massachusetts Abortion Laws: How the State Protects Your Rights

Abortion is legal in Massachusetts. Through 24 weeks of pregnancy, a physician, physician assistant, nurse practitioner or nurse midwife can provide it for any reason. After 24 weeks, Chapter 188 of the Acts of 2026, signed August 10, 2026, leaves the decision to the physician’s professional judgment and replaces the four medical grounds that applied before.

Chapter 188 is set to take effect November 8, 2026, and a referendum petition filed to suspend it could change which rule applies. The sections below explain what the law says in each case, plus the rules for minors, insurance, out-of-state patients and emergency care.

What Chapter 188 Changed About Abortion After 24 Weeks

Chapter 188 of the Acts of 2026, “An Act prioritizing patient access to care,” has three sections. Each one amends the later-pregnancy provisions of G.L. c. 112.

The four-ground rule it replaced

Since the 2020 ROE Act, G.L. c. 112, § 12N allowed an abortion at 24 weeks or later only if a physician judged it necessary for one of four reasons. Those were to save the patient’s life, to protect the patient’s physical or mental health, because of a lethal fetal anomaly, or because of a grave fetal diagnosis meaning the fetus could not survive outside the uterus even with extraordinary medical intervention.

The ROE Act became law on December 29, 2020, when the Senate voted 32 to 8 to override Governor Charlie Baker’s veto, a day after the House voted 107 to 46.

What Chapter 188 puts in its place

Section 1 strikes the list of grounds from § 12N and substitutes one sentence: an abortion may be performed by a physician based upon the professional judgment of the physician. Only physicians, not the other clinicians who can provide care before 24 weeks, can perform an abortion under this section.

Section 2 replaces § 12N½ with a new provision stating that no medical review process shall override the professional judgment of a treating physician. In plain terms, a hospital committee cannot overrule the physician and patient.

Section 3 strikes the second paragraph of G.L. c. 112, § 12P. That paragraph required abortions under § 12N to take place in a hospital authorized to provide obstetrical services, unless an emergency required immediate action. With it gone, the hospital-only requirement no longer appears in the statute.

How the bill passed, and the debate over it

The House passed H.5595 on July 22, 2026, by 119 to 33. On July 31, the Senate approved it by voice vote and the House enacted it 121 to 35. Governor Maura Healey signed it August 10.

Supporters, including House Speaker Ronald Mariano, said patients with serious late-pregnancy diagnoses were being forced to leave the state because the statutory grounds did not fit every medical situation. Opponents, including the state’s Catholic bishops and Massachusetts Citizens for Life, argued the law removes legal protection for viable fetuses.

Comparison graphic of the four grounds for abortion after 24 weeks before Chapter 188 and the single physician-judgment standard under Chapter 188

When Chapter 188 Takes Effect and What the 2028 Referendum Could Do

Massachusetts laws without an emergency preamble take effect 90 days after the governor signs them, which makes Chapter 188’s date November 8, 2026. A veto referendum under Article 48 of the state constitution can interrupt that.

Two signature thresholds apply, based on the vote for governor. Roughly 37,289 certified signatures put a repeal question on the November 2028 ballot, and 49,716 certified signatures suspend the law until voters decide, according to the Secretary of the Commonwealth’s office as reported by WBUR.

A coalition called Repeal 188 filed its signatures with the Secretary of the Commonwealth on October 29, 2026, and reported about 97,000 certified signatures. The Secretary’s certification decides whether the law is suspended.

The governor can override a suspension. Under Article 48, she may attach an emergency preamble declaring that the law’s immediate effect is needed for public health, safety or convenience, and the law then takes effect even if a petition would otherwise have suspended it. Healey did exactly that with the 2024 firearms law, and her office said after the filing that it was evaluating its options for Chapter 188.

What happens	Chapter 188	Rule after 24 weeks
Fewer than 49,716 signatures certified, or no petition	Takes effect November 8, 2026	Physician’s professional judgment
49,716 or more certified and no emergency preamble	Suspended until the November 2028 vote	The four grounds in the 2020 version of § 12N
Governor files an emergency preamble	Takes effect despite the petition	Physician’s professional judgment

Everything in this article about care before 24 weeks, minors, insurance and the Shield Law is unaffected by Chapter 188 or the referendum. If you need care after 24 weeks, ask your provider which version of § 12N applies on your appointment date.

Timeline of Chapter 188 from signing in August 2026 to the possible 2028 referendum vote

Abortion Through 24 Weeks: Who Provides Care and What You Sign

Under G.L. c. 112, § 12M, a physician, physician assistant, nurse practitioner or nurse midwife may perform an abortion within their license and scope of practice when, in their best medical judgment, the pregnancy is less than 24 weeks along. No reason has to be given.

The only paperwork requirement is written informed consent on a form prescribed by the Department of Public Health under § 12R. You can sign it before the appointment, and there is no waiting period.

Medication abortion

Medication abortion uses mifepristone, which stops the pregnancy from developing, followed 24 to 48 hours later by misoprostol, which causes cramping and bleeding. It is generally used through about the first 10 weeks of pregnancy.

Insurers must cover it. Division of Insurance Bulletin 2024-07 tells carriers that insured plans must cover mifepristone with misoprostol, or misoprostol alone, without cost sharing, subject to the exceptions covered below. Executive Order 609 confirms that medication abortion is protected under the state Shield Law.

In-clinic abortion

An in-clinic, or procedural, abortion takes place at a clinic, health center or hospital. The gestational limit for in-clinic care varies by provider, so ask the provider for its cutoff when you book.

Rules for Minors: Age 16 and Up, and Under 16

Patients 16 and older can consent to an abortion on their own, with no parent involved. The ROE Act lowered that age from 18, and G.L. c. 112, § 12R now sets the rules.

A patient under 16 needs the consent of one parent or guardian. If she cannot get it, chooses not to ask, or the pregnancy resulted from incest, a Superior Court judge can authorize the abortion after a hearing.

How judicial bypass works

The judge must find either that the minor is mature enough to give informed consent, or, if not, that the abortion is in her best interests. Both findings lead to the same result: permission.

The minor chooses between an in-person hearing and a teleconference.
These cases take precedence over other court business so a decision comes quickly.
She can appear on her own behalf, the court tells her she can have a lawyer, and it appoints one if she asks.
Proceedings and records are confidential, and the judge must issue written findings.
If the judge denies the petition, the Supreme Judicial Court hears the appeal.

Flow diagram showing consent paths for patients 16 and older and patients under 16 in Massachusetts

Insurance Coverage and Paying Without It

Chapter 127 of the Acts of 2022 requires fully insured health plans issued, delivered or renewed in Massachusetts on or after January 1, 2023 to cover abortion and abortion-related care without cost sharing. The Division of Insurance FAQ says this reaches plans bought through the Massachusetts Health Connector, including ConnectorCare, and also applies to MassHealth and the Group Insurance Commission.

The catch is the type of plan you have. Many large employers self-fund their plans, and self-funded plans are not bound by state benefit mandates.

Your plan	Abortion coverage	Cost sharing
Fully insured plan issued in Massachusetts	Required	None for in-network care
MassHealth or Group Insurance Commission	Required	None
Fully insured high-deductible plan with an HSA	Required	Federal HSA rules can allow a deductible to apply
Self-funded employer plan	Not required by the state mandate	Depends on the plan; ask HR

HMO members who go out of network may find the service is not covered, so ask your plan before you book.

If you have no coverage

Abortion funds pay for part or all of the procedure and sometimes travel. The Abortion Rights Fund of Western Massachusetts takes calls or texts at 413-582-3532 and serves people across New England. The Eastern Massachusetts Abortion Fund and Tides for Reproductive Freedom also operate in the state.

The Shield Laws: Protection for Patients, Providers and Out-of-State Travelers

Massachusetts has two layers of shield legislation. Chapter 127 of the Acts of 2022, signed July 29, 2022, protects providers of reproductive and gender-affirming care from out-of-state legal action and discipline. Its provider list covers nurses, physicians, pharmacists, physician assistants, genetic counselors, psychologists and social workers, according to state guidance.

Chapter 16 of the Acts of 2025, signed August 7, 2025 and known as Shield Law 2.0, added several protections:

State and local authorities may not cooperate with federal or out-of-state investigations into care that is legal in Massachusetts.
Sensitive information, such as a physician’s name, is protected, and prescriptions can carry a practice name instead of an individual’s.
Acute-care hospitals must provide stabilizing emergency treatment, which includes abortion when it is necessary to resolve a patient’s emergency medical condition.
The Department of Public Health must form a technical advisory group on privacy protections for electronic medical records.

Out-of-state patients get the same access as residents. The Abortion Legal Hotline accepts calls from patients traveling here for care, and the shield protections apply to the Massachusetts clinicians who treat them.

Illustration of a shield over Massachusetts blocking lines from other states, representing the state Shield Law

Finding a Provider and Avoiding Crisis Pregnancy Centers

The state’s Sexual and Reproductive Health service locator and the Reproductive Equity Now provider finder list clinics, health centers and hospitals that offer abortion care. Hospitals and private OB-GYN practices also provide it.

Crisis pregnancy centers can look like medical clinics but do not provide comprehensive reproductive health care. The state’s guidance says their aim is to keep people from accessing abortion. If one misled you, file a complaint with the Attorney General’s Civil Rights Division online or at 617-963-2917.

The Abortion Legal Hotline

The free, confidential Abortion Legal Hotline, 833-309-6301, connects patients, providers and helpers with volunteer attorneys. You leave a message with a callback number and say whether you are a patient, provider or helper. Staff aim to respond within two to three business days, and the people who answer do not give legal advice themselves. Anyone under 18 can use it, and it will not notify parents or officials.

Frequently Asked Questions

Is abortion legal in Massachusetts after 24 weeks?

Yes. Under Chapter 188, a physician can perform one based on professional judgment once the law is in effect. If the law is suspended, the older four grounds in § 12N apply: life, physical or mental health, lethal fetal anomaly, or a diagnosis incompatible with survival outside the uterus.

When does Chapter 188 take effect?

November 8, 2026, which is 90 days after the August 10 signing. A certified referendum petition would suspend it until the November 2028 vote, unless the governor attaches an emergency preamble.

Do I need a parent’s permission if I am 16 or 17?

No. Patients 16 and older consent for themselves under G.L. c. 112, § 12R. Patients under 16 need one parent or guardian, or a Superior Court judge’s approval through judicial bypass.

Will my insurance cover an abortion?

Fully insured plans issued in Massachusetts, MassHealth and the Group Insurance Commission must cover it without cost sharing. Self-funded employer plans are not covered by the state mandate, so ask your HR department.

Can I get care in Massachusetts if I live in a state with a ban?

Yes. Residents of other states can receive the same care, and Chapter 127 of 2022 and Chapter 16 of 2025 protect Massachusetts providers and bar state cooperation with out-of-state investigations.

Who can I call with legal questions about abortion in Massachusetts?

Call the Abortion Legal Hotline at 833-309-6301. It is free and confidential, and you can leave a message without giving your name.