DENVER — When the U.S. Supreme Court overturned Roe v. Wade, Colorado abortion providers began to scramble — they had some plans in place, but they knew the demand for their services would go up significantly for people from other states. Advocacy groups also increased efforts to expand access through state legislation.
Now a year after the Dobbs v. Jackson Women’s Health Organization ruling that put the question of abortion rights in the hands of individual states, Colorado providers say their fears have been actualized. Abortion funds to help patients have tripled the amount of money spent to help out-of-state patients, wait times for services have gone up, and the number of people seeking abortion care from other states has increased significantly. The “impact on Colorado has been devastating,” according to reproductive rights group Cobalt.
“Abortion is health care,” Cobalt’s statement on the one-year anniversary read. “That’s not a slogan. That’s a statement of fact, and we are seeing the effects in Colorado of dozens of states all around us banning a health care procedure.”
The Cobalt Abortion Fund, which provides monetary and travel assistance to people seeking abortions, helped 1,154 clients in 2021, spending $206,511. In 2022, that support went up threefold — $737,174 ($200,000 of that after the Dobbs decision) for 1,717 clients getting the procedure and 640 clients with practical support. Only 49 of those 640 were from Colorado, with 435 from Texas, and the rest from states like Oklahoma, Nebraska and even Puerto Rico. In the first half of 2023, the fund has already spent half of what it did in 2022 in the first five months of the year: $356,769 in procedure support and $77,532 in practical support.
“As a high-risk obstetrician, I am acutely aware of the risks of pregnancy and the grief of families who are told their pregnancy will not result in the child they so want for one reason or another. As an abortion care provider, I know that every abortion I provide is life-saving,” said Dr. Leilah Zahedi-Spung. “A year after Dobbs, these are still truths but unfortunately for so many across the country they are not a reality.”
Zahedi-Spung moved from Tennessee to Colorado after her former state banned abortions and she could have faced prison time for providing them. She wanted to live in a state where she could continue to help patients with abortions. She added that the full extent of the harm from these bans has yet to be seen, “but I will continue to fight to care for every patient who fights their way to me.”
The Dobbs decision has made Colorado and other states safe havens for abortion, particularly as surrounding states’ trigger laws went into effect outlawing abortions after the overturning of Roe. Colorado is among at least 16 states that have abortion protections at the state level, with some states such as Oregon allocating funding to help out-of-state patients traveling for abortions. California and Maryland, like Colorado, have passed laws to require insurance providers to cover abortions.
Jack Teter, Planned Parenthood of the Rocky Mountains’ policy director, keeps coming back to the same story, representing the “horror of the moment,” about a woman who drove for 17 hours one way from Texas to Colorado for an abortion, leaving her phone at home, worried she’d be tracked or reported to bounty hunters. He thinks about the people who have to get on planes for the first time, many times to get a medically-necessary procedure, with their kids in tow.
“We knew that any decision from a court that allowed states to start banning abortion was going to strip tens of millions of people from their right to access abortion in their home state. And that has happened — states all around us have, in some cases made all abortion care, a felony, completely illegal. Some of them have bounty laws, some of them have six-week bans, which is effectively a total ban,” he said. “And I think we anticipated patient travel certainly. We’re seeing that. I don’t know if the broader statewide health care and government agency infrastructure was prepared for the ripple effects.”
Planned Parenthood clinics, for example, were seeing thousands of additional patients for abortion care from other states, and as the largest provider of family planning services in the state, that made it harder for people trying to get appointments for birth control, annual exams, cancer screenings and STI testing. That’s something the health system as a whole has had to contend with.
In Colorado, Planned Parenthood health centers have seen a 33% increase in abortion care in the year after Dobbs, and a 41% increase across the region (Colorado, Nevada and New Mexico). Financial assistance for patients totaled about $7 million compared to $1.5 million the year prior.
About 2 in 5 patients at Colorado health centers are from out of state, compared with about 22% before Dobbs and 12% before Texas’ six-week abortion ban. Wait times for abortion appointments are now 10 days, which has gone down from the 28 days immediately after Dobbs.
That’s a testament to changes the nonprofit has made to meet the increased need, according to spokesperson Fawn Bolak, who said the centers expanded hours, increased staff training for medication abortion, increased the number of health clinics and expanded telehealth services and patient navigation support.
Planned Parenthood and other reproductive-rights organizations worked with state lawmakers to pass legislation in April 2022, before Dobbs, to guarantee the right to abortions in Colorado, and this year, passed laws to protect patients and providers.
Teter said he wasn’t anticipating the speed by which states that banned abortion would also ban gender-affirming care, but that’s partly why Colorado’s legislation protects both.
The coalition of nonprofits also plans to pursue a ballot measure in 2024 that would ensure abortion access is enshrined in the state constitution, with bans against using public funding removed.
“Since the Dobbs decision, we are taking care of more complex patients from all over the country and the world,” wrote OB-GYN Dr. Michael Belmonte in a statement. “We, as a community of those committed to reproductive justice, have made great strides to furthering the protections for providers and patients who come to Colorado, and I remain optimistic that we can create a more equitable future as we continue the fight.”
----------
