A letterpress poster collection made by 4000 Years for Choice.

Forty-two years ago this month, we celebrated a victory for equality and personal autonomy.

The prohibition on legal abortion technically ended with the Roe v. Wade ruling in 1973, which stated that Americans have the right to terminate a pregnancy before the point of viability no matter where they live or what their life circumstances.

It turns out, though, that a legal right doesn’t guarantee access to that right in real life. One Supreme Court win did not automatically secure the availability of reproductive healthcare.

To mark the Roe anniversary on January 22nd, the All* Above All campaign—an advocacy coalition seeking to lift bans prohibiting the use of public funds for abortion care—is reflecting on the practical affects of Roe on actual, live people.

“Our theme is: ‘Is Roe a reality for all?’” said Kate Stewart, Executive Vice President of Advocates for Youth and All* Above All steering committee member. “We’re raising awareness that the answer is a very simple: No.”

Data firmly backs up Stewart’s assertion. The Guttmacher Institute, a domestic research nonprofit focusing on sexual and reproductive health, and the Population Institute, an international nonprofit promoting universal access to family planning education, both released their 2014 reports detailing the abysmal state of safe, legal abortion availability in the United States.

According to Guttmacher, the 231 abortion restrictions enacted over the past four years have created an environment where the residents of more than half our country’s states are losers in the zip code lottery. Twenty-seven states are now “hostile” to abortion access with eighteen being designated “extremely hostile.” The Population Institute gives the U.S. a barely passing C grade overall in reproductive rights.

The closure of clinics, Targeted Regulation of Abortion Provider (TRAP) laws, waiting periods, the prohibition of public funding for abortion care, and continued cultural stigma have made it nearly impossible for many to terminate pregnancies they don’t want to carry to term. Stewart sighed as she described the demographics of those most marginalized and left behind by these harmful regulations.

“It’s the low-income women, young women, women of color who are without access,” said Stewart. “And it’s becoming women across the board. The restrictions are deceptive and limit access to a whole range of health services including abortion which has been put out of reach for so many women.”

The All Above All campaign ran these ads on bus stops in Washington DC last year.

The new GOP-lead Congress has seen fit to make reducing access even more of a priority this legislative session—hardly taking time to breathe between the oath of office and the introduction of five new anti-abortion laws. Republican leadership has declared their main goal to be bringing the U.S. down to a failing grade on reproductive rights. On the first day of the 2015 session, the very first bill introduced in the Senate was a federal 20-week abortion ban, which mirrors the one that passed the House last year. The following day, four more restrictions were proposed. It seems the ladies still have too much access to their rights for this uber male, uber white, uber rich, uber conservative Christian Congress.

In the recent Population Institute report card, only four states—New Mexico, California, Oregon, and Washington — received “A” grades despite legislatures in seventeen states having introduced access-expanding measures. That’s how far behind we are in much of the country. According to Guttmacher, 87 percent of Americans live in counties without an abortion provider.

Those are some daunting statistics. The scope of the work is vast and there’s a culture shift needed to make the access-expanding work permanent. So, why aren’t reproductive justice advocates throwing up their hands and walking away exhausted and defeated?

“There’s no doubt we’re facing a tough political climate,” said Stewart, referencing the five new anti-choice bills. “In our minds, this is exactly the time we need to be standing up and being proactive.”

Over the summer, people from coast to coast answered All* Above All’s call to be proactive on a cross-country, abortion-story telling bus tour which culminated in an education day on the Hill. The group had 175 people from around the country to push for more equitable abortion access, convincing eight members of Congress to sign onto the “Be Bold!” declaration to end abortion bans.

Abortion access does have champions in the legislature—and they’re getting louder. In response to Sen. Mitch McConnell (R-KY) promising a federal 20-week abortion ban should he become Majority Leader last year, Sen. Patty Murray (D-Wash.) announced legislation of her own. Murray is pushing back on abstinence-only sex education; seeking to ensure that all hospitals let rape victims know they have a right to emergency contraception and abortion care; and a continued push for the “Not My Boss’ Business Act” to overturn the Hobby Lobby case and compel for-profit corporations to adhere to the birth control provisions of the Affordable Care Act.

Patty Murray, speaking in favor of the “Not My Boss’ Business Act.”

“It’s time to turn the tide; we have people energized,” said Stewart. “Now is the time for us to push back. And we need to remember that those who too often have been left behind because of political expediency—low income women, women of color—these are the people who get traded away when it gets politically tough.”

All* Above All and their coalition members aren’t waiting for a “friendly” Congress to advocate for those who’s needs have been too inconvenient to address in our legislature because the need won’t wait. The biggest barrier to universal accessibility is cost: the cost of traveling to get an abortion, the cost of time off work, the cost of childcare, the cost of the actual procedure. All* Above All has focused on the Hyde Amendment because it directly addresses the primary cost barrier and — as an amendment to the Medicaid funding bill — it is perpetually up for renewal.

While the news from Congress is dispiriting, 2015 is the perfect time to join with the campaign to repeal Hyde and end coverage bans—especially if you started the year feeling frustrated and powerless.

“Hyde is a rider that gets put in the budget every year,” explained Stewart. “The reason all of us need to be out there talking about it is that we need to put pressure on the president. Tell him: ‘Don’t put Hyde in your budget.’ We need to tell members of Congress on the appropriations committee: ‘We don’t want to see this come up every year; we want to see this gone.’ That’s going to take all of us.”

Stewart added a motivating reminder to those who feel this issue doesn’t affect them: “You can’t just say, ‘I’m safe here’ if people next door don’t have access. We can’t just stay isolated in our own community. We need to make sure if we say something is a right, that it is accessible. Otherwise, what does that say about all of our rights?”

On this 42nd anniversary of Roe, the All* Above All campaign and their coalition members are reaffirming their commitment to making abortion a real right in this country. While they and other pro-choice groups push for legislative action, Stewart emphasizes the most important thing an individual can do: contribute to the sea change happening slowly, but surely through people speaking up.

Related Reading: Nicki Minaj Shows the Importance of Fighting Abortion Stigma.

Katie Klabusich is a writer, reproductive justice activist and media contributor. You can follow her work at KatieSpeak.com and on Twitter at @Katie_Speak.