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California to Become an 'Abortion Sanctuary' if Supreme Court Guts Roe v. Wade

Access to abortion in the United States is under the greatest threat since the Roe v. Wade decision. In September, Texas enacted Senate Bill 8, banning abortions past six weeks, and permitting anyone in the country to sue abortion providers or anyone who “aids and abets” abortion care. On Dec. 1, the Supreme Court’s conservative majority indicated they may uphold tighter abortion bans — or overturn Roe altogether.

In response, the state of California announced measures it would take to become an “abortion sanctuary” to support patients who travel from other states to seek care. The California Future of Abortion Council (CA FAB), led by Gov. Gavin Newsom and 40 reproductive health organizations, released recommendations to expand and strengthen access to abortion.

If Roe v. Wade is overturned or gutted, 26 states are likely to ban abortion outright, the council noted, citing an October report from the Guttmacher Institute. “[This would increase] the number of out-of-state patients who would find their nearest clinic in California from 46,000 to 1.4 million – a nearly 3,000% increase,” CA FAB wrote. “These recommendations reflect the actions identified by the CA FAB Council and are crucial to ensuring that California is a state where the rights of patients seeking abortion care, and those who support them, are protected.”

CA FAB’s recommendations include:

  • Creating an uncompensated care fund to reimburse providers for rendering care to out-of-state patients who cannot afford to pay;
  • Funding for abortion providers and organizations to assist patients with gas, food, lodging, and other services;
  • Update and increase procedure reimbursement rates from Medi-Cal (California’s Medicaid program);
  • Expand and diversify the state’s network of abortion care providers;
  • Reduce administrative and institutional barriers to care, including access to medication abortion;
  • Strengthen legal protections for patients, providers, and other who assist patients in obtaining an abortion;
  • Reduce the spread of misinformation about abortions and abortion care.

“It is imperative that California policymakers begin acting upon these recommendations and preparing the state to serve potentially millions more people seeking abortion care as other states prepare extreme bans to an essential health service,” the council concluded. “For California to truly be a reproductive freedom state, we must take meaningful action to implement these recommendations and ensure abortion is available and equitably accessible to all.”

While no one knows exactly how the Supreme Court will rule next summer, states and reproductive health providers must prepare themselves and their patients for the possibility of little to no access to abortion care. Rigorous education on contraceptive options will be important, as will access to long-acting methods. “Women’s [contraceptive] decisions will be influenced most dramatically in states where abortions become very, very difficult to obtain,” says Robert A. Hatcher, MD, MPH, chairman of the Contraceptive Technology Update editorial board. “Contraceptive effectiveness has always been important but will become even more important if abortion is virtually unavailable for a woman.”

Further coverage of this topic, including ways reproductive care providers can prepare themselves, will be included in the February 2022 issue of Contraceptive Technology Update.