A new bill in the North Carolina legislature, House Bill 465, would make it impossible for East Carolina University or University of North Carolina's medical schools to train ob-gyn residents to perform abortions.
The law would immediately reduce the number of abortion providers in North Carolina. (UNC estimates it performed 400 abortion procedures in 2014 — a small number, but not zero.) And it would prevent the schools from training future abortion providers — theoretically restricting access in the state. The law itself also jeopardizes accreditation of the medical schools themselves.
There's also a larger issue at stake: Successful abortion restrictions often do not stay in one state — they spread. Politically, this makes sense: if legislators in North Carolina can successfully ban abortions at in-state medical schools, why shouldn't legislators in Kansas or Arizona who oppose abortion try to do the same?
If UNC stopped training doctors in abortion procedures, it likely wouldn't be a massive blow to access in the country. Doctors could train elsewhere in the country, and come to the state to practice at a private clinic.
But historically, these laws don't apply narrowly. This trend has been especially clear with 20-week abortion bans. Nebraska passed the first such law in 2010. It seemed like a local issue at the time: the state was trying to push LeRoy Carhart, one of the few doctors to provide late-term, third-trimester abortions, out of the state (it worked). But it also kicked off a national movement to ban abortion after 20 weeks. Now, five years later, nine more states have passed similar laws.
Similar trends have happened with telemedicine abortions (banned in 15 states since 2010) and, to a lesser extent, with laws that require abortion providers to have admitting privileges at a local hospital.
What happens in North Carolina, in other words, doesn't stay in North Carolina: if the state passes a law that bars state-funded medical schools from terminating pregnancies, it's nearly certain that other states will follow that example.