How California Plans to Serve the Nation and Safeguard Abortion

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Analysis Abortion

How California Plans to Serve the Nation and Safeguard Abortion

Xenia Ellenbogen

From working to enshrine abortion rights into the state constitution and become a "sanctuary" for access, California is becoming a blueprint for other states.

Update, June 28: On Monday, the California legislature passed a measure to enshrine abortion rights into the state constitution. The measure will now be on the November ballot for voters to decide.

It’s inevitable that Roe v. Wade will be overturned, throwing abortion access and rights into further chaos in this country. Thanks to Justice Samuel Alito’s leaked draft opinion, whether the Supreme Court overturns Roe in its ruling in Dobbs v. Jackson Women’s Health Organization seems to be a matter of when, not if.

When Roe falls, the number of people of reproductive age whose nearest provider would be California would be up to 1.4 million—or a staggering increase of nearly 3,000 percent, the Guttmacher Institute estimates. Since the leak, California lawmakers have been moving to protect abortion access.

On Wednesday, the California Senate introduced a bill to enshrine abortion rights—and explicitly mention the word abortion—in the state constitution. Similarly to Vermont, if the bill passes the California legislature, the amendment would go before voters in the November election; however Vermont’s Prop 5 does not say abortion, as Politico reported.

Roe is gone. The chaos is just beginning.

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But even before the leaked draft opinion was published earlier in early May, the state was digging heels into the silt, preparing to safeguard abortion access in anticipation of the Court’s ruling in Dobbs v. Jackson Women’s Health.

Last December, the California Future of Abortion Council, which includes providers, researchers and advocacy groups, released 45 policy recommendations to strengthen and expand abortion care in the Golden State. A package of 13 legislative bills, which were created from the recommendations, advanced out of its “house of origin” in late May. The package covers a swath of issues about abortion access like protecting patients and providers from criminalization and boosting infrastructure to cover an influx of out-of-state patients who’ll travel to California for care.

Democratic Gov. Gavin Newsom, who started the council last fall, seems undoubtedly focused on securing abortion rights in California: Last month, he announced a $125 million budget increase for reproductive health and in December said the state would be a “sanctuary” for abortion access.

California is setting a precedent for other states to follow.

“We can’t trust SCOTUS to protect the right to abortion, so we’ll do it ourselves,” Newsom tweeted.

A shield for access

Around 40 percent of California counties have no clinics that provide abortions, as of 2017.

Despite this, California is poised to be a refuge for abortion and serve not only its residents but patients from all over the country whose states have enacted extreme abortion laws or “trigger” bans that will immediately outlaw abortion once the Supreme Court overturns Roe.

However, as Brandon Richards, director of communications for Planned Parenthood Affiliates of California, notes that even in counties that do have a provider, a host of issues—traveling time, lack of accessible public transportation, language barriers, and the inability to take time off work—can leave care out of reach.

Since Texas SB 8 went into effect nine months ago, California’s Planned Parenthood clinics have seen an increase of 500 out-of-state patients a month, Richards said.

“Out-of-state patients are at least three times more likely to be seeking abortion services than Californians when visiting a California Planned Parenthood with the majority of the patients coming from Arizona and Texas,” Richards said.

Planned Parenthood is not the only abortion provider in the state, which means “these numbers are only a fraction of the real picture on the ground,” Richards added.

Gearing up for a rush of patients

Is California equipped for the influx of patients? That’s a question that Shannon Olivieri Hovis, director of NARAL Pro-Choice California, receives frequently, to which she responds that the state already provides more abortions than its proportion of the national population.

The state provides 1 in 6, or around 17 percent, of abortions in the country, and California accounts for about 12 percent of the U.S. population.

SB 1375, introduced by Senate President Pro Tempore Toni Atkins, who formerly operated women’s health clinics, seeks to expand providers by allowing nurses, nurse practitioners, and midwives to provide first-trimester abortions without a doctor’s oversight after undergoing training.

Increasing staffing, appointment slots, and expanding or building new facilities are some of the ways that Planned Parenthood is gearing up for the anticipated volume of patients, Richards explained.

To cover cost burdens, Newsom signed into law this year a bill that prohibits health insurance plans from charging co-pays and deductibles for abortion services. For those without insurance, AB 2134 will provide grants to providers who offer uncompensated abortion care to uninsured or low-income patients.

But what if you can’t afford to travel here?

“Nothing will ever replace being able to access health care, including abortion care, where a person resides,” Richards said. Those who face abortion restrictions impact individuals who encounter persistent barriers most.

“We really must ensure that we keep in mind the folks who will not easily (if at all) be able to leave their state to access an abortion: Undocumented individuals, young people who may require parental consent, and of course, those who just can’t get the time off, the childcare, or the necessary resources to fly to another state and be away from work and family responsibilities for two to five days to access their abortion,” Jessica Pinckney, executive director of Access Reproductive Justice, the only statewide abortion fund, said in an email.

“There will be some who cannot travel to California for the care they need or desire, but we’re working here in CA to reduce as many barriers to accessing care here as humanly possible.”

In the legislative package, some of the bills seek to address these potential disparities and ensure that people “can access their abortions without financial burden or barrier,” Pinckney said.

“If SB 1142 passes, the state will provide funds to practical support organizations that do defray costs for travel, as well as lodging, childcare, food, doula support and more,” Pinckney said.

Protection from criminalization

“Abortions can and will continue to take place in a variety of environments and we need to do everything possible to ensure people are not criminalized for self-managing abortion or making the decisions that are best for themselves, their families and their communities,” Pinckney said.

AB 1666 will protect abortion providers and patients from civil liability when the laws are based on claims from hostile states. Connecticut recently signed a similar bill into law.

“The mechanism to do that is to ensure that provider assets cannot be seized, essentially, based on laws from hostile states and against California’s public policies,” Hovis of NARAL said.

Another bill, AB 2626, will prevent abortion providers from having their licenses revoked or suspended.

“It is unconscionable to me,” Hovis said about the idea that a California telehealth provider offering medication abortion in another state could be extradited to that state and face criminalization.

“We need to make sure that we can protect against all of these different scenarios,” Hovis said, adding that this is “an ongoing conversation about how we do everything that we can to protect folks.”

The quickly shifting landscape of abortion access and legislation throughout the country will likely continue to inform how California shapes its policies. In response to the Supreme Court’s leaked draft opinion, California proposed an amendment to enshrine abortion rights in the state’s constitution.

Other states seem to be taking note, which advocates say is encouraging.

Sixteen states and the District of Columbia have laws that protect the right to abortion, according to Guttmacher, and other states currently have bills under consideration to safeguard and increase abortion access.

“I’m proud and relieved at the same time that we are not going at this alone,” Hovis said. “There are so many states that are really trying to do the same kinds of things that we are doing, and I’m proud that we were able to provide a model for them—a blueprint for folks to refer to.”