Los Angeles, California, USA – Advocates in California seek to transform the US state into an abortion haven as millions of people in the United States may soon need travel thousands of miles in search of care.
The conservative-leaning US Supreme Court is expected to issue a decision in June on a direct challenge to Roe v Wadethe precedent-setting ruling that has guaranteed abortion rights in the US for nearly 50 years.
If it is overturned, more than two dozen states are expected to quickly outlaw abortion, prompting a surge of people to cross state lines to access the procedure. But many of them will face challenges that include paying out-of-pocket costs for health care, travel and child care.
“The thing that keeps me up at night, really, is that people are not going to be able to get here,” Lisa Matsubara, vice president for policy and general counsel for Planned Parenthood Affiliates of California, told Al Jazeera.
Planned Parenthood is one of more than 40 groups that recently came together to issue a report (PDF) that describes steps California should take to increase access to abortion. The coalition, known as the California Abortion Future Council, says that without these changes, the system will likely be overwhelmed by those traveling from out of state.
“We really want to make sure there is equitable access to abortion care,” Matsubara said. “Abortion bans really disproportionately impact people who are already marginalized or have low incomes, or are from communities of color.”
The report, which also serves as a model for other states, has resulted in 13 bills currently pending in the California state legislature.
If passed, it would fund abortions, travel and lodging for people who can’t afford the high costs; Train and fund more health care workers to perform procedures, and add legal protections so that people are not responsible for the results of their pregnancy.
California lawmakers and Gov. Gavin Newsom are working with the group to pass bills as quickly as possible before the legislative session ends in August. Their goal is to make California a haven for people in need of care. In December, Newsom said The Associated Press news agency, “We will be a sanctuary.”
The demand for abortions is already increasing in California. In the first four months after Texas Bill Senate Bill 8 – a law that allows private citizens to sue anyone who “aides or abets” abortion – went into effect on September 1, 2021, Planned Parenthood Affiliates of California told Al Jazeera they saw an anecdotal increase in Texan patients who travel to your state for an abortion. .
Arizonans also continue to cross into California for abortions, and Planned Parenthood expects those numbers to rise now that a 15-week ban takes effect there.
California ‘stepping up’
Whether the Supreme Court overturns Roe v Wade is a question of when, not if, experts say.
When it capsizes, 26 state are certain or likely to rapidly ban abortion, affecting 36 million women of reproductive age who may need to cross state lines to access abortion services, according to the Guttmacher Institute, a sexual health rights advocacy organization and reproductive. That number increases even more when transgender and non-binary people are included, but exact figures are not available.
Citing Guttmacher’s data in its report, the California Future of Abortion Council says the number of out-of-state patients whose nearest clinic would be in California, if they traveled by car, would rise from 46,000 to 1.4 million, an increase of nearly 3,000 percent.
“This is going to be massive,” said Elizabeth Nash, a state policy expert at the Guttmacher Institute.
She described a near future where people in need of care will be forced to drive and fly from conservative states in the Midwest, Great Plains, and South to liberal states along the coasts. They will flood an already overburdened system that anti-abortion activists have successfully eroded in recent decades. Waiting lists are already weeks long in some places, and will only grow, Nash said.
“What is happening in California is incredibly important. It is escalating in a major way,” she added. California Assembly Bill 2223, which aims to protect people from civil and criminal liability if they have a miscarriage or abortion, is a recent example of legislative efforts in the state. Two women have recently faced prosecution in the state for miscarriages.
“We need other states to do what California is doing: make it clear that pregnancy outcomes are a health issue and not a police issue,” Nash said.
Distance the ‘number one barrier’
Currently, there are no mandatory waiting periods or parental consent required for abortions in California. The state also guarantees privacy and the right to obtain an abortion. California’s low-income health insurance plan, Medi-Cal, covers abortion, unlike other states, and just passed a law called SB-245 to eliminate out-of-pocket abortion costs that can run up to more than $1,000.
“That means that not only abortions will be covered, but co-payments and deductibles will also be absorbed by the insurance plan, which is fantastic,” explained Fabiola Carrión, director of reproductive and sexual health at the National Law Program. of Health, who is on the steering committee of the California Abortion Future Council.
But California is also a sprawling state with abortion providers concentrated in urban areas, meaning even residents must travel hundreds of miles to get care. Carrión believes that the biggest challenge California faces in becoming a sanctuary state is that people with few resources will have to travel a long way.
“Our number one barrier in California is distance,” he said. “At the center of this are the most marginalized people: black, indigenous and other people of color, people who work to make ends meet, undocumented immigrants, young people,” he added.
If someone is low-income, uninsured and can’t afford an abortion, “they’re usually forced to carry a pregnancy to term or have to make some sacrifices like not paying rent, utilities or child care.” Carrion said. She added that in other cases, people in the US, including California, are sometimes forced to perform or manage their own abortions, even getting cheaper pills like mifepristone.
The council proposed Assembly Bill 2134, which would establish a program to award grants to safety net providers who offer reproductive health care to patients who are low-income, uninsured, or have plans that do not cover abortion. It is currently before the legislature. “What this plan will also do is offer some help for those who come [from] out of state,” Carrión said.
As Carrion prepares for the Supreme Court to overturn Roe v Wade, she said the California Abortion Future Council gives her hope. “We have the support of our governor, we have the support of our legislature, and we’ve come up with things that are really bold,” he said.
“The fact that California says that we are not only going to welcome people from out of state, but there is a high probability that we will pay for their abortion, it is incredible.”