Liberal States and Cities Have Options to Protect Abortion Access
By Arielle Swernoff
Earlier this month, the state of Texas enacted its six week abortion ban, SB8, effectively banning some 85 percent of abortions taking place in the state. SB8 is an escalation of the right’s decade-long, state-level war on abortion; from requiring mandatory ultrasounds and waiting periods, to regulating the width of clinic hallways, to demanding unreasonable hospital admitting privileges, policies passed by Republican state legislatures have already made abortion near impossible to access in many areas of the country.
This month’s Supreme Court decision upholding SB8 was a particularly impactful blow in this campaign. And this spring, the Court is expected to hear another case, Dobbs v. Jackson Women's Health Organization, that could end up overturning Roe.
The results could be grim: twenty two states are likely to heavily restrict abortion or make it illegal outright. This includes states with unenforced pre-Roe abortion bans, states with “trigger laws,” which would ban most or all abortion if Roe is overturned, and states with laws currently blocked by the courts, but which could be revisited in a post-Roe world. Some states, like Arkansas and Mississippi, have all three.
Abortion access could be seriously curtailed for millions of Americans, particularly in the South and Midwest — states are already researching copycat bills similar to Texas’s SB8. Research published by the NY Times estimates that 41 percent of women[1] of childbearing age would see their nearest clinic close, and the average distance they would have to drive to access a procedure would go up from 35 miles to 279.
The impact of this will not be felt equally. For wealthy people, particularly in coastal states, abortion will remain easily accessible. For poor people, people of color, undocumented people, trans and gender non-conforming people, minors, and people in rural areas, abortion could become even harder to access than it is today. In fact, for many people, in many parts of the country, it’s as though Roe already doesn’t exist. According to the Guttmacher Institute, 40 million women of reproductive age live in states considered “hostile” to abortion based on criteria including mandated waiting periods, restrictions on Medicaid coverage of abortion procedures, restrictions on minors having abortions without parental knowledge or consent, and other laws that put up barriers to access. These restrictions have disproportionate impacts on abortion seekers who are already poor or otherwise marginalized.
It’s natural for people in “blue” states to feel helpless. But what if policymakers in liberal states and cities could take action to protect, and even expand, abortion access — including for out-of-state visitors? Abortion seekers from hostile states already travel to neighboring states or even far away metro areas to access abortion care, a practice that will likely increase.
For example, states with Democratic trifectas can work to counteract the Hyde Amendment, which bans the use of federal funds to pay for abortion, except in cases of rape, incest, or to save the life of the pregnant person. In practice, this means that federal insurance programs do not cover abortion, most notably Medicaid but also programs covering people enrolled in Indian Health Services, members of the military, people employed by the federal government, and people in immigration facilities and prisons.
Sixteen states make up the gap, providing abortion coverage for Medicaid patients through state funds. Unsurprisingly, these are the states that tend to have more liberal attitudes towards abortion, and conmesurate policies. However, several states with Democratic trifectas, including Colorado, Delaware, Nevada, Rhode Island, and Virginia, have not used state funds to include abortion coverage under Medicaid.
In fact, liberal cities can directly act to support abortion funds. Austin, Texas and New York City have created municipal funding streams for abortion and other related health care: the New York City budget includes a direct grant to the New York Abortion Access Fund to help cover costs for people traveling from out of state. In Austin, the municipality supports grants that help cover practical support costs for abortion seekers, such as travel and lodging. Other cities can follow their lead.
The pandemic prompted an increase in abortion care via telemedicine, which made it easier for a person seeking an abortion to have an initial consultation with a doctor via secure video conference, pick up medicine from a clinic, and have an abortion safely at home. As states rush to “return to normal,” maintaining telemedicine abortion services could go a long way to increase access.
There is always more to be done. As long as people have gotten pregnant, people have had abortions. Policymakers at every level of government can do their part to push back against rollbacks in access.
[1] People of all genders have abortions; I only use the term women when citing research or surveys which only included women.
Arielle Swernoff (@ArielleSchw) is an organizer and strategist living in New York City. She currently works for a climate justice coalition, and has previously worked to elect progressive candidates to state and local office, for the New York City Council, and in adolescent health communications.