America’s abortion policy is at a standstill. Republicans are poised to take control of Congress in January and block the protections, but their slim majority makes a nationwide ban unlikely. At the state level, pro-choice advocates have focused over the past two years on ballot measures to protect abortion rights. Most of these measures were passed. Currently, only two states remain in serious condition limitwhich allows constitutional amendments and has already failed to pass constitutional protections.
Since then Roe vs. Wade Despite being overturned in 2022, abortion rates in the U.S. are either flat or rising. That’s partly because tens of thousands of women in states with widespread restrictions ordered the two-pill abortion pill, mifepristone and misoprostol, by mail. Thousands more are seeking abortions in states with more permissive rules, and that number could soon begin to rise even more rapidly. Pills are not effective in all situations, and many women who use them to circumvent restrictions fear being prosecuted. lawsuit A bill sponsored by attorneys general from three conservative states seeks to both outlaw mifepristone to minors and ban its delivery by mail. Project 2025, a second-term blueprint created by people with close ties to President-elect Donald Trump’s administration, outlines a plan to force the FDA to remove mifepristone from the market. (Trump himself does this too. flip flop repetition As to whether he will try to restrict access to the pills. )
Further restrictions on abortion drugs could mean more women needing to cross state lines to obtain abortions. That trip can cost thousands of dollars. Since then Dobbs v. Jackson Women’s Health Organizationa network of so-called practice support groups, is playing an increasing role in booking and financing abortion-related travel. Their work is quieter than the fights in the courts and Congress, but perhaps just as important in determining the future of abortion in America. As options for major policy changes are sorted out, this approach is likely to play an even more important role in preserving access to abortion in the United States, and could draw even more opposition.
Like virtually all health care in America, abortion care has always been geographically fragmented, with people in poorer and rural areas traveling further to receive services. A study published last month found that people who travel out of state for abortions; highly likely They must face expenses that threaten their ability to pay for basic needs. The more restrictions are tightened and more states implement them, the longer the distance the average patient has to traverse, and the higher the average cost of doing so. Practical support organizations may also provide money for petrol, arrange transportation to and from the airport, and even fund the purchase of a winter coat if your trip involves cold weather. nancy davisIn 2022, the Louisiana resident turned to an organization called Brigid Alliance for help. At that time, at about 10 weeks, her fetus was found to have anencephaly by ultrasound. Acephalia is a rare and fatal disease in which the skull is not completely formed. The doctor advised her to terminate the pregnancy, but Louisiana had just banned abortions, so Davis made an appointment in New York. Brigid paid for Davis and his fiancée’s flights, hotel and food, as well as child care for their three children at home. Megan Kovacs, volunteer and director of the Northwest Abortion Access Fund, said this level of logistical support is increasingly needed.
Until recently, practice support organizations such as the Northwest Abortion Access Fund existed primarily to help people living in rural eastern Oregon, for example, commute several hours to a clinic in Boise, Idaho. But when Dobbs turned over egg In 2022, aid organizations’ work will become more demanding, expensive and complex, Marisa Falcon, executive director of a hub for practical aid organizations called Apiary, told me. For example, a patient from Arkansas scheduled for surgery in Chicago might rely on a group in Illinois to book flights and hotels, and another group in Arkansas to drive them to the airport. There is a gender. Because of new restrictions in Idaho, the Northwest Abortion Access Fund has to not only help patients in Idaho leave the state, but also send patients from eastern Oregon to far-flung urban areas like Portland. are spending more money on. According to data Kovacs shared with me, the organization spent an average of $585 per customer on things like hotels and gas over the previous two years. Dobbs;Since Dobbsthe average is almost $875. The number of clients seeking practical support has almost tripled.
Advocacy groups also said costs are rising as the number of clinics dwindles, waiting lists for appointments get longer and more people seek abortions later in their pregnancy. The longer the pregnancy ends, the more complicated and expensive the abortion will be. Patients also take longer to recover. “What used to be a one-day activity is now a four-day activity and people have to leave their kids behind,” Falcon said. “Not only is the logistics more complex, but the costs are also much higher.”
in Dobbs Justice Brett Kavanaugh said in the ruling that Americans have a “constitutional right to interstate travel,” including for abortions. But abortion opponents, seeing it as a threat to the unborn child, seek to prevent people from crossing state lines for treatment. In Alabama, for exampleAttorney General Steve Marshall said facilitating travel for abortion was akin to a “criminal conspiracy.” last year in idaho outlawed Helping minors travel out of state for abortions without parental permission. Tennessee passed a copycat law this year. So far, both of these efforts have faced legal challenges, and similar bills filed in other states have not moved forward. Texas took a different approach. Some local laws allow residents to sue those who help women travel through their city or county to get an abortion in another state. At least one Texas man has already taken legal action. against His ex-girlfriend has announced her intention to file a wrongful death lawsuit against those who supported her for allegedly promoting out-of-state abortions.
Even if none of these legal efforts are successful, abortion opponents may seek to limit the activities of advocacy groups by restricting funding. Representatives from organizations I spoke to said the pace of funding has not kept pace with demand for services. Some small groups simply I don’t have enough money To meet demand. If abortion becomes more restricted, such as if the FDA rescinds mifepristone’s approval or if abortion lawsuits are successful, demand for out-of-state travel will surge again.
Abortion services rely primarily on donations, although some receive funding from state and local governments. That government funding is already a target of anti-abortion groups seeking to reduce abortion tourism. For example, in 2023, ohio voters Approved a constitutional amendment that enshrines the right to abortion. In response, the state Legislature introduced a bill to withhold state funds from cities and counties that fund practice support organizations. Last month, seven states passed ballot measures protecting abortion rights, and lawmakers in some states may try to repeat Ohio’s strategy. Christy Hamrick, vice president of media and policy for the anti-abortion group Students for Life Action, said her organization opposes the use of tax dollars for abortion travel and has already asked Trump to do so. limit Military funding for travel for service members seeking abortions.
As travel plays a larger role in how Americans access abortion, it will inevitably become a bigger target for abortion opponents. Practical advocacy groups have told me that in recent years, abortion rights advocates have focused on fundraising As the movement to pass the bill intensifies, practical aid organizations lack the funding they need to serve the growing number of travel seekers. In large parts of the country, people still need to travel or obtain medicine to terminate a pregnancy, even in areas where abortion rights have seen recent victories. In Missouri, for example, a November vote legalized abortion, but many other laws could mean it will take a long time for abortion to become widely available. “Without abortion support groups, people would not have access to abortion,” Sera Sippel, executive director of Brigid Alliance, told me. If advocates could wave a magic wand and restore the system. egg Even if people can’t go to a doctor’s office tomorrow, many of them will no longer exist.Dobbs. For now, the most important conflicts may be practical ones, even over gas money, babysitters, and winter coats.
