Changes in Facility-Based Abortion Care Among Texas Resident Minors and Young Adults After a 2021 Abortion Ban: September 2020–May 2022

<b>Objectives.</b> To compare changes in the number of facility-based abortions among Texas residents in different age groups following the state's 2021 law prohibiting abortion after detection of embryonic cardiac activity. <b>Methods.</b> We obtained data from Texas and 6 surrounding states on Texas residents' age at abortion from state vital statistics and data provided directly by out-of-state abortion facilities. Using negative binomial regression, we estimated the percentage change in abortions before (September 2020-May 2021) and after (September 2021-May 2022) the law went into effect. <b>Results.</b> After the law's implementation, total (in-state and out-of-state) facility-based abortions decreased by 26.1% (95% confidence interval [CI] = -32.7%, -18.8%) among Texans younger than 18 years, by 19.6% (95% CI = -21.4%, -17.7%) among young adult Texans aged 18 to 24 years, and by 17.0% (95% CI = -19.1%, -14.8%) among Texans aged 25 to 29 years. <b>Conclusions.</b> Texas's law disproportionately affected access to facility-based abortion care among Texans aged 24 years and younger. <b>Public Health Implications.</b> State laws prohibiting abortions in early pregnancy disproportionately affect young people's reproductive autonomy, likely by compounding long-standing financial and logistical barriers to facility-based care. (<i>Am J Public Health</i>. 2026;116(3):337-340. https://doi.org/10.2105/AJPH.2025.308289).