After Roe: What About Abortion in California? (2023)

The constitutional right to abortion in the United States no longer exists. Today, the United States Supreme Court delivered its landmark case, Roe v. Wade was eliminated in a 5-4 decision, ending nearly 50 years of guaranteed access to abortion for American women.

The historic trialexpected from the beginning of May, when aLeaked Draft Report, and it was widely anticipated long before, when conservative justices struck down the court. The fight for abortion rights is now returning to the states where it took place five decades ago, with the process immediately made almost or completely illegal.almost halfand several more bans are likely to follow.

California is moving in the opposite direction, increasing legal protections for abortion providers and investing resources to expand access, as clinics prepare for a possible surge in patients arriving from other states to terminate pregnancies.

to see howSupreme Court Decisionin Dobbs v. The Jackson Women's Health Organization will play in California:

Abortion will be the focus of the November elections

Expect to hear a lot about abortion rights in the coming months, with candidates touting their support for Planned Parenthood and flooding the airwaves with ads warning of the bleak future for access if their opponents win.

Since the draft decision was leaked last month, Democrats in California and across the country have followed suit.the protection of the right to abortion as a central issuefor the 2022 midterm elections.Decades of opinion pollsThat shows that most Americans believe abortion should be legal in all or most cases, and has put the party back on the offensive as it grapples with growing voter dissatisfaction with President Joe Biden and the Republicans' scathing attacks on inflation and the crime they face. .

“I hope people are angry,” said Acting Senate President Toni Atkins, a San Diego Democrat who ran a women's health clinic before entering politics.

“While we feel like we have better protections here and California is different, I hope they are angry and understand what is at stake,” he told CalMatters.

A questionnaireheld last monthof Monmouth University found that abortion was almost tied to economic policy as the top concern of voters across the country, a sharp increase from four years ago that can be attributed to its growing importance among Democrats. Othercurrent researchfrom UC San Diego asked Californians if they planned to vote before and after the reading in NovemberArticleon the possibility of a national ban on abortion if the Roe decision is overturned; The researchers found that it had a significant mobilizing effect on independent voters.

The potential for Republicans to win a nationwide abortion ban if they regain control of Congress is likely to figure prominently in a series of battleground contests across the state.Governor Gavin NewsommiAttorney General Rob Bontahave already put abortion rights at the center of their re-election campaigns, and even some candidates with less direct ties to ensuring abortion access, includingController of the Democratic State Malia Cohen, tried to sound the alarm about the beliefs of his Republican opponents.

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CalMatters

The right to abortion will also literally be up for a vote in California in November. Democratic lawmakers in Sacramento are racing to qualify a measure that, if approved by voters, would.Anchoring of “reproductive freedom” in the state constitution.

While California already protects abortion access with a constitutional right to privacy, Atkins, who is leading the change in the legislature, said a more explicit guarantee is important as litigation continues over the future of reproductive rights.

“That is my biggest fear. You find a judge somewhere in California to decide, and our entire right to privacy, as it currently exists in California, is being questioned," Atkins said, though he acknowledged there are additional political benefits: "I really hope this increases participation. electoral".

More legal support for abortion providers

While dozens of conservative states laid the groundwork for Roe's demise by passing abortion bans sparked by the Supreme Court decision, California attackedbuild a bulwark for reproductive rightsand accommodate a possible influx of patients from abroad.

Last fall, Newsom named theFuture of the Abortion Board, a coalition of reproductive rights, health and justice groups to explore how to make the state an abortion "sanctuary." His recommendations, published in December, formed the basis of a comprehensive package of more than a dozen bills now working through the legislature.

These include the AtkinsSenate Act 1375, which would increase the number of providers by allowing some nurses to perform first-trimester abortions independently without medical supervision, andAssembly Act of 1918by Congresswoman Cottie Petrie-Norris, a Costa Mesa Democrat who would create a "reproductive health service corps" for underserved parts of the state.

Several measures would protect doctors from legal and financial penalties when traveling to other states to perform abortions or treat out-of-state patients:AB 1666Rebecca Bauer-Kahan, D-Orinda, won final passage of the bill Thursday and would overturn civil judgments in other states.AB 2091Rep. Mia Bonta, D-Alameda, would prohibit doctors and insurance companies from sharing information in cases seeking to punish abortion.AB2626by Rep. Lisa Calderón, D-Whittier, would prevent the state medical board from suspending or revoking the license of a doctor who is sanctioned in another state for performing an abortion under California law.

Anti-abortion activists appeared in front of the state Capitol to protestAB2223by Assemblywoman Buffy Wicks, D-Oakland. I'm looking forProtecting Californians from overzealous law enforcement agenciesand prosecutors who may be hostile to abortion rights, remove the requirement that medical examiners investigate the cause of fetal deaths from suspected self-induced abortions, clarify that women cannot be criminally or civilly liable for pregnancy loss or miscarriage abortion, and build the capacity to prosecute prosecutors and others who violate these protections.

"We're covering a lot of ground," Atkins said. "As daunting as this reality is, we must prepare for it... given all we are doing to strengthen our protections and access to services, we will be ready."

Newsom voiced his support for many of the proposals, and he did.signed lawsearlier this year to eliminate abortion costs in health plans. While some would take effect immediately if passed, including the three bills expanding legal protections for doctors, others wouldn't take effect until January.

Newsom, joined by the governors of Oregon and Washington, announced today thata "commitment to reproductive freedom" on the west coast.“We will not stand by and allow criminal prosecution to intimidate patients seeking reproductive care in our states or the physicians who provide that care. We refuse to go back and we will fight like crazy to protect our rights and our values,” she said.in a video message.

fiscal GeneralRob Bonta swore fast today"Use the full force of the law to protect reproductive health care for all who seek it in our state."

Jodi Hicks, executive director of Planned Parenthood Affiliates in California, reiterated that promise. “I want to be very clear: abortion is still legal here in California and we are working to ensure that people, no matter where they are from, can access abortion services with the most support and the fewest barriers possible,” she said. she. she said in a statement. "For people across the country who live in an anti-abortion state, California is here for you. We will not push people away and we will find a way to support them in getting the care they need."

Influx from abroad, but how big?

With the fall of Roe, California became the closest state with access to abortion.about 1.3 million foreign women of reproductive age, according to the Guttmacher Institute, a think tank on abortion rights. That's an increase of almost 3,000% driven byArizona's Historic Abortion Banwhich typifies the procedure and entered into force when the Federal Supreme Court announced its decision.

Using women of reproductive age as proxies for abortion demand is inaccurate at best, and Guttmacher's prediction is based solely on distance traveled. But without nationwide abortion data, it's nearly impossible to estimate how many people can now trust California clinics.

Even before today's Supreme Court ruling, California attorneys and service providers said they serve women from states beyond Arizona.

“One of the things we saw is a domino effect. Wait times for appointment availability are increasing in border states and people are traveling to other states for care,” said Lisa Matsubara, general counsel for Planned Parenthood Affiliates of California.

In the first four months after Texas' controversial six-week ban last year, Planned Parenthood clinics in California performed abortions on about 6,000 out-of-state patients, Matsubara said. Patients from other states were three times as likely as patients from California to seek an abortion over other medical care during the same time period.

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Pennsylvania

In 2021, ACCESS Reproductive Justice, which provides grants to women to help offset the costs of the procedure and remove barriers like travel and lodging, helped people in 18 states, said Jessica Pinckney, the group's executive director.

Pinckney, who is part of the coalition of abortion advocates backing the 13-bill package in the legislature, said proponents made it clear to lawmakers that planning for the unknown was difficult, but providers did their best. to collectively assess what access gaps remain. in California and what they hope to see in the near future.

"There are so many things you can't predict," Pinckney said. "In a world where half the states have completely or nearly completely banned abortion, the barriers are only increasing."

Increase the number of suppliers?

Despite California's reputation as a safe haven for reproductive health, 40% of California counties do not have abortion clinics. Lawmakers are pushing to increase the number of abortion providers, offering financial incentives and tougher regulations governing who can perform abortions.

Newsom's proposed budget includes $20 million in grant and loan repayment options for physicians committed to providing reproductive health services. EITHERThe Legislature's spending plan investsAn additional $21 million in existing reproductive health workforce programs and a one-time investment of $20 million to recruit and train physicians who work in reproductive health facilities.

other measurethat aims to allow nurses to perform first-trimester abortions without medical supervision has been heralded as a way to increase the number of abortion providers, but even advocates say the impact may be limited.

In 2013, California passed a measure allowing certified nurses, physician assistants, and midwives to perform first-trimester abortions after receiving special training. However, since then, training opportunities have been limited.

"Very few nurses have been trained since the law went into effect," said Debbie Bamberger.

Bamberger was the first nurse in the state trained to perform abortions, has been a nurse for 28 years and works for Planned Parenthood in Oakland. Her training took place within the framework of alook forThis assessed the ability of non-medical professionals to safely perform aspiration abortions, a procedure that uses suction during the first 10 weeks of pregnancy. Forty doctors were trained over the course of that study, and Bamberger said few have been trained since.

Part of the problem is that nursing schools and health care programs do not have an abortion curriculum or training opportunities for students who want to learn the procedure. Most of the training is limited to residency programs for doctors who don't want to give up their limited slots to other types of doctors.

Bamberger said her clinic has trained five nurses to perform abortions in the past two years, and Planned Parenthood of Northern California does not provide widespread training.

"It's mostly about removing barriers, but it's not necessarily going to improve access much if the training isn't out there yet," he said.

The State invests in access to abortion

Both the Democratic leadership of the Legislature and the Newsom administration have made it clear that they are willing to spend a significant portion of the state's record surplus on abortion rights.

In his latest budget proposal, Newsompledged $125 millionfor reproductive health care, including $60 million to directly subsidize the cost of abortions for low-income or uninsured patients. About a third of that money is reserved for low- and middle-income Californians enrolled in Covered California state insurance, but $40 million could be used to compensate abortion providers for procedures performed on people who cannot pay for it, even for those who are not in the country.

His proposal, backed by the Legislature, also allocates $20 million to improve physical and digital security at abortion clinics and $15 million to community organizations to provide sexual and reproductive health education.

The legislature's spending plan goes even further,another $156 million plannedin reproductive health spending to educate more providers, increase funding for clinics serving Medi-Cal patients and open a "Safe Harbor" abortion pilot program in Los Angeles.

Asexcellent investmentLawmakers and the governor have yet to reach an agreement on the creation of the California Abortion Support Fund. The fund would provide grants to organizations that help pay for travel, lodging, childcare and other costs that advocates say prevent women from attending an abortion clinic. While the money would go to California-based nonprofits, women seeking abortions in any state can apply for grants.

"Part of the concern I've heard from legislators and the government is that it's not common for us to provide direct support," said Pinckney of ACCESS Reproductive Justice. “But there is no other health system that is prohibited and urgent. You can't wait six months to save the money."