For months, thousands of people in surrounding states have traveled to Oklahoma to seek abortion care — that is, if they were able to get an appointment and could afford to travel. Now that local lawmakers have passed the harshest anti-abortion law in the country, they will likely have to travel even farther to receive care. Many won’t be able to afford the journey.
Before Oklahoma Governor Kevin Stitt signed the near-total abortion ban, funds to get out-of-state patients to Oklahoma clinics already weren’t enough to meet demand: One nonprofit operator said a fund specifically meant to support those in the state often ran out of money about halfway through the month. About 5,000 people got an abortion in Oklahoma in 2019, data from the US Centers for Disease Control and Prevention show.
While abortion funds have seen mounting support from states and individuals in the wake of the leaked Supreme Court decision draft that could overturn Roe v. Wade, the money may not be enough to cover the rising costs for people who have to travel farther to get the procedure they need as states like Oklahoma ban nearly all access to abortion care. Democratic-led states have pledged millions of dollar toward clinics and nonprofits in an effort to preserve abortion access, but the systems in place may still struggle to help everyone. According to the National Network of Abortion Funds, its 90 partner organizations could only support 26% of the requests they received in 2019.
“Most of the abortions that we are funding that normally used to cost $500, are costing $1,000,” Sylvia Ghazaria, the executive director of non-profit Women’s Reproductive Rights Assistance Project, said. The organization disbursed just under $540,000 in funds to help 2,560 patients last year, and Ghazarian expects payments top $1 million this year.
California lawmakers have pledged $125 million to expand existing abortion access frameworks within the state, and New York Governor Kathy Hochul has promised $35 million. Kari White, the lead researcher with the Texas Policy Evaluation Project, warned that such fixes help, but may not make ends meet for everyone.
“The funding that these other states are offering will not cover the cost of lost wages or child care that people will have if they have to travel even longer distances for care,” she said. “Relieving part of the financial burden in some ways will provide support, but we can still expect financial, logistical and emotional impacts” as a result of widening abortion deserts."
In September, Texas implemented a ban on abortions after the detection of fetal cardiac activity, or about six weeks' gestation. The move pushed people to travel elsewhere for the procedure, and 45% those who left the state for an abortion between September and December headed to Oklahoma, according to a report from the Texas Policy Evaluation Project. That migration came to a screeching halt after Oklahoma implemented a similar six-week ban earlier this month, clinic workers said.
Should Roe be overturned, Kansas, New Mexico, and Colorado would be the closest states for many people living in Texas and Oklahoma. But getting there will be just one part of the battle. There is a 24-hour waiting period in Kansas, as well as a law that mandates a provider be present when someone takes at least one of the abortion pills, which typically are administered in a two-step regimen. Residents are also expected to vote on an amendment that would decide if the state’s constitution protects the right to abortion in August. And 90% of New Mexico’s residents don’t live in a county with an abortion clinic, so a further influx of visitors may overrun the seven facilities currently offering care.The result is a system that may not be able to sustain the 36 million child-bearing people of reproductive age whose access to care would be threatened if Roe is overturned.
“I wish people had paid attention to Oklahoma for years, but they didn't,” said Susan Braselton, a board member at the state-specific Roe Fund and the clinic escort coordinator at Tulsa Women's Clinic, an abortion provider that is currently barred from providing services under the new law. “So here we are fighting this battle. It's not unwinnable. It is logical. We just have to keep doing this.”
A total of 15 anti-abortion bills have been introduced by Oklahoma lawmakers during the 2022 session, part of a broader effort by legislators at the state level to build on the record-setting number of restrictions passed in 2021. The bills also build on earlier restrictions, such as a mandate that someone wait 72 hours between an initial consult and their abortion service.
“Care was not necessarily accessible when you had to wait 72 hours and sit through mandatory information from the state, but it was much more doable,” than in Arkansas and Missouri, said Emily Wales, the president and chief executive officer of Planned Parenthood Great Plains, which operates two reproductive health-care centers in Oklahoma. The 72-hour rule in those states mandate that both appointments be in person, whereas Oklahoma's prior rule allowed for a virtual consult.
And as burdensome as abortion restrictions can be, they often don’t deter people from wanting one, according to the Guttmacher Institute, a research group that supports abortion rights. Instead, they potentially make the process more expensive, both from a procedural perspective as well as regarding related costs such as time off work, a hotel room or child care for a patient’s family. The average cost of any abortion procedure in 2020 was over $550, according to a study by researchers at the University of California San Francisco published in April.
Planned Parenthood’s Wales also cautions against looking to the recent wave of companies pledging reimbursements should employees need to move as a solution. “If you work a low wage job, if you're on shift work, there are very few companies in that sector that are going to do this,” she said, adding that while such efforts are “an amazing commitment,” they will primarily benefit full-time workers.Several big employers like Citigroup Inc., Yelp Inc., and Uber Technologies Inc. have pledged to pay the travel expenses if their employees can’t access abortion care in their home states.
“If you are in a position of privilege and you have access to resources and paid leave, you will likely be able to get out of a state that limits abortion care,” Wales said. “If you are not in those categories, you won't.”
