A landmark U.S. Supreme Court decision ending the constitutional right to abortion in this country will have deep implications for people with disabilities, advocates say, potentially extending far beyond reproductive care.

The ruling from the high court late last week in a case known as Dobbs v. Jackson Women’s Health Organization overturned Roe v. Wade, the nearly 50-year-old case protecting the right to abortion across the U.S. The move is expected to lead to abortion bans in roughly half of states.

Writing for the majority, Justice Samuel Alito called the Roe decision “egregiously wrong” and said it “must be overruled.”

“Today’s Supreme Court decision is a disaster for people with disabilities,” said Julia Bascom, executive director of the Autistic Self Advocacy Network.

Bascom and other disability advocates pointed out that people with developmental disabilities are more likely to be victims of sexual assault and some people cannot safely carry a pregnancy to term due to their disabilities or treatments for them. In addition, they said that this ruling limiting access to abortion care in large swaths of the country will disproportionately impact people with disabilities who are more likely to live in poverty and have difficulty traveling to obtain such services.

“This decision will cause grave, and in many cases, lethal, bodily harm to far too many disabled people, especially those who already face the most significant barriers to accessing reproductive health care — low-income disabled people, disabled people of color and disabled LGBTQIA+ people,” said Maria Town, president and CEO of American Association of People with Disabilities, or AAPD.

But the consequences for people with disabilities could be much broader, advocates say.

In the majority opinion, Alito wrote that “nothing in this opinion should be understood to cast doubt on precedents that do not concern abortion.” But in his concurrent opinion, Justice Clarence Thomas wrote that the court “should reconsider” three other decisions that relied on similar legal reasoning, one related to the right to contraception, another doing away with sodomy laws and a case legalizing gay marriage.

And that has disability advocates concerned that a whole host of other civil rights protections could be impacted too.

“Today’s decision attacks the fundamental right to privacy and substantive due process, disregards precedent and drastically narrows the scope of rights protected by the Fourteenth Amendment,” said Bascom with the Autistic Self Advocacy Network. “In doing so, it threatens disabled people’s personal rights surrounding marriage, intimacy, sterilization, medical care, housing, speech and more.”

Earlier this month, after a draft of the Supreme Court’s decision in the Dobbs case had leaked in May, the Autistic Self Advocacy Network as well as the Disability Rights Education & Defense Fund, AAPD, the Autistic Women & Nonbinary Network, Little Lobbyists and Be A Hero issued a 10-page memorandum outlining a myriad of ways that the ruling could affect disability rights. The document also highlighted the instability that would be introduced into the legal system if the Supreme Court moves away from its long-held practice of following the rules set by previous cases as much as possible.

The memo warned of “devastating consequences” if the draft was not “significantly altered” before it was finalized. But, last week’s ruling largely mirrored the draft.

“Today it was the right to an abortion, tomorrow it could be other important rights like choice of who one can marry or access to other types of reproductive health,” warned Eric Buehlmann, deputy executive director for public policy at the National Disability Rights Network. “For people with disabilities, it might also mean whether or not they have a say in being sterilized, or whom they have intimate relations with or the choice to live in the community guaranteed by the Olmstead decision. This uncertainty that the Supreme Court can take away rights that people have had for decades is bad for all American society, including people with disabilities in so many different ways.”