No, it doesn't settle it once and for all. It settles it once for Mississippi. Other states are free to have different laws. That's the point of Dobbs.
ordinarily, i'd agree that by the constitution anything that's not a federal concern (principally international relations and interstate disputes) is a state concern, but the constitution also notes that neither the states nor the federal government can alienate residents from natural rights. bodily autonomy is a natural right, full stop, and it need not rest on a shaky privacy-based foundation, as roe had institutionalized it.
in time, this will be a case where the court will be found to be right in the small and wrong in the large.