Date

7-21-2026

Department

Helms School of Government

Degree

Doctor of Philosophy in Public Policy (PhD)

Chair

H. Lee Cheek

Keywords

abortion, telemedicine, public choice theory, Dobbs, Roe, state autonomy

Disciplines

Public Affairs, Public Policy and Public Administration

Abstract

Telemedicine is a growing area of health care that has become one of the primary policy tools to enhance abortion access following the 2022 Dobbs decision, which gave states full autonomy over abortion policy as a result of overturning the landmark case Roe v. Wade (1973). The purpose of this dissertation is to study the effect of the Dobbs decision on state abortion policy regarding telemedicine and understand how these policies are used to either restrict or protect abortion at the state level. This dissertation was guided by Buchanan’s Public Choice Theory. The following research question guided the study: What effect does the Dobbs decision have on state abortion policy regarding telemedicine? This study used a multi-case study design to understand the nationwide effect of Dobbs on the implementation of four key telemedicine policies used to either protect or restrict abortion: telemedicine use for abortion pill dispersal, telemedicine use for abortion counseling, mail-order abortion pills, and shield laws for telemedicine abortion services. The findings reveal a clear effect of Dobbs on telemedicine abortion policies, as states used their new autonomy to either limit or ban telemedicine use in abortion services, leading to greater abortion restrictions, or expand telemedicine use in abortion services through policy, leading to fewer abortion restrictions and ultimately more abortion access. The shield law became the greatest outgrowth of the Dobbs decision related to telemedicine policy, leading to telemedicine expansion and new state autonomy, as well as a new legal and political landscape on the abortion issue that must be further explored. The study provided vital baseline policy analysis regarding the Dobbs effect on the new policy landscape of state abortion telemedicine law, which will inform continued state policy developments on abortion and provide an understanding of how abortion protections and restrictions in policy affect Americans.

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