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Abortion bans and sanctuary plans: States are preparing for a possible future without Roe v Wade

People rally in support of abortion rights at the state capitol in Sacramento, in May 2019. (Rich Pedroncelli/AP)

America’s political divides over abortion access were stark this week as states looked toward a possible future without Roe v. Wade.

In California, liberal leaders backed a proposal to fund abortions for low-income women from out of state, laying out a sanctuary for “reproductive freedom” that might offer the nearest clinic for a million women in Arizona.

In Arkansas, Republican state lawmakers supported a bill to ban virtually all abortions at any stage of pregnancy. Ohio legislators passed a measure that would likely close clinics. And Texas entered its second week with new restrictions on abortion-inducing medication — the most common way for women in the state to end their pregnancies.

A Supreme Court ruling on a Mississippi abortion law that could gut decades of precedent is probably months away, and Texas’s unprecedented ban on most abortions after six weeks hangs in limbo after justices on Friday said providers could sue. But other states are already taking action — either emboldened or alarmed by signals that justices in the conservative majority are open to overturning a constitutional right to abortion. The latest flurry of activity caps a record year for antiabortion measures in the United States, with more than 100 restrictions enacted, according to the Guttmacher Institute, a research group that supports abortion access.

The latest measures promise to widen already-significant geographical differences in Americans’ ability to get abortions, experts said, ramping up a years-long trend.

“It’s a death by a thousand cuts,” said Emilia Strong Sykes (D), minority leader of Ohio’s House of Representatives.

In addition to approving new clinic requirements, her colleagues have introduced a proposal to completely outlaw abortion by extending all protections under Ohio law to fertilized eggs. It’s modeled after the ban in Texas, which was designed to evade court challenges by relying on private citizens to sue over violations. The Supreme Court left the law intact even as it opened the door for legal action.

A 2019 Ohio law barring almost all abortions after detection of a fetal heartbeat — once largely symbolic and quickly blocked — remains on the books. And a “trigger law” meant to take effect if Roe is reversed was introduced this year, without exceptions for rape or incest.

What abortion laws would look like if Roe v. Wade were overturned

“It seems they’re doing everything that they can” Sykes said.

Oral arguments last week before the Supreme Court gave abortion opponents more reason to think tight restrictions are newly viable. Conservative justices appeared likely to uphold a Mississippi law prohibiting most abortions after 15 weeks, well before the current standard of “fetal viability.”

Some projected interest in going further, and lawyers argued that even a narrower ruling affirming Mississippi’s restrictions would pave the way for earlier cutoffs. With courts still mulling Texas’s new cutoff for abortions — a state judge just ruled its enforcement mechanism unconstitutional but also did not halt it — abortion rights advocates are preparing to help many more patients make costly trips out of state for procedures.

“All of the groups of people that are already marginalized by our health-care systems really bear the brunt of attacks and restrictions on abortion access,” said Kristin Ford, the vice president of communications and research at NARAL Pro-Choice America. That means people of color, people in rural areas and those with low incomes. “And we’re going to see that at a dramatic scale if Roe falls.”

The number of people seeking financial help from groups within the National Network of Abortion Funds has been increasing for years as states pass restrictions, said Debasri Ghosh, the network’s managing director. Their funds got more than 80,000 calls last year, she said, nearly double the total from a couple years prior, and could not serve them all.

Ghosh said demand appears to have only grown, overwhelming resources. “Tons of funds are having to pause their lines,” she said.

Researchers estimated in 2019 that abortions would fall by about 13 percent in the immediate aftermath of a Roe reversal, basing their calculations on the effects of clinic closures in Texas. In states expected to have bans, abortions would drop by nearly a third, they found.

“My hope and prayer is that this would be a time that people of goodwill would be able to come together across the political spectrum and find ways to actually provide resources and support for families that are facing unplanned pregnancies,” said Jonathan Keller, president of the California Family Council, which opposes abortion. He gave child tax credits as an example and said that pregnancy “resource centers” are already gearing up for a potential influx of patients.

But the possibility of Roe’s unraveling has mostly sharpened divides.

Future of abortion rights is with the Supreme Court

The California Future of Abortion Council — an alliance of abortion rights advocates — formed in September with the backing of state political leaders, seeking ways to preserve access. Reeling over the restrictions in Texas, members were thinking about Californians but also asking “how we can be there for others across the country,” said Toni Atkins (D), president pro tempore of the state Senate.

On Wednesday the Council released a report with 45 recommendations, shortly after California Gov. Gavin Newsom (D) told the Associated Press, “We’ll be a sanctuary.”

Among the ideas: Reimburse abortion providers for services to some patients from other states and help groups that cover associated costs like travel, lodging and child care.

“We take seriously the recommendations made in this report,” Newsom said in a statement. His office helped shape the proposals.

Atkins said she believes the recommendations will find significant support in the state legislature. California already covers abortions for low-income residents through its Medicaid health care program. The council did not put a price tag on its ideas, but Atkins said the initiative could draw on both public and private funds.

California clinics are already starting to analyze what extra resources they might need, including abortion “navigators” to help guide people who need to travel for services, said Planned Parenthood Affiliates of California president and CEO Jodi Hicks.

Her organization is part of the Council. The guiding question, she said, was, “if we are going to be a ‘reproductive freedom state,’ how we can take that from just a value-based statement to action.”

Elsewhere, lawmakers are racing to curb abortions — even in places where public opinion is sharply split.

A 2019 Quinnipiac poll found a 55 percent majority of Ohio voters said abortion should be legal in “all” or “most” cases, and a slim 52 percent majority opposed banning abortion after a fetal heartbeat was detected.

“But you have almost a two-thirds anti-choice majority in the legislature,” said Kellie Copeland, executive director of NARAL Pro-Choice Ohio. She blames gerrymandering for the disconnect.

Dr. Erika Boothman, an OB/GYN in Ohio, told the story of her patient whose water broke when the baby was “pre-viable” in her testimony on Senate Bill 157. (Video: ProChoiceOh)

On Wednesday, state lawmakers passed a bill that experts and activists say could effectively close the two abortion clinics left in southwest Ohio — which would make Cincinnati the largest metropolitan area in the country without an abortion provider, according to Jessie Hill, a professor specializing in reproductive rights at Case Western Reserve University School of Law. The bill would bar clinics from working with doctors who teach at state-funded hospitals and medical schools.

“The bill ensures taxpayer dollars do not directly or indirectly fund abortions by prohibiting a physician from being employed at a state-funded higher education or medical institution if they serve as a consulting physician for an abortion clinic,” said state Sen. Terry Johnson (R), who sponsored the legislation, in a statement.

The governor appears likely to sign. Dan Tierney, a press secretary for Gov. Mike DeWine (R), said the bill is under review.

“Governor DeWine is strongly pro-life and believes in protecting the most vulnerable in our society, which includes the unborn,” Tierney said in an email.

The newest bill joins more than 30 others on abortion the Ohio legislature has enacted since 2011, ranging from limits on funding to bans on abortion based on prenatal diagnosis of Down syndrome, according to Planned Parenthood. Sykes, the Democratic lawmaker, said they have created confusion even when courts intervene.

“Republicans pass these laws, and then you may not hear that it’s being challenged and it’s not in effect,” she said. “That in and of itself creates a scenario where people don’t have access to a constitutionally protected right because they don’t know.”

Read more:

Supreme Court says Texas abortion providers may proceed with challenge of six-week ban, leaves law in effect for now

How Mississippi ended up with one abortion clinic

Supreme Court seems inclined to uphold Mississippi abortion law that would undermine Roe v. Wade

What the Supreme Court justices have said about abortion and Roe v. Wade

Roe v. Wade and abortion access in America

In June 2022 the Supreme Court struck down Roe v. Wade, which for nearly 50 years has protected the right to abortion. Read the full decision here.

What happens now? The legality of abortion is left to individual states. The Post is tracking states where abortion is banned or under threat, as well as Democratic-dominated states that moved to protect abortion rights enshrined in Roe v. Wade.

Abortion pills: Abortion advocates are concerned a Texas judge’s upcoming abortion pill ruling could halt over half the legal abortions carried out nationwide. Here’s how the ruling could impact access to the abortion pill mifepristone.

Post-Roe America: With Roe overturned, women who had secret abortions before Roe v. Wade felt compelled to speak out. Other women, who were and seeking abortions while living in states with strict abortion bans shared also shared their experience with The Post through calls, text messages and other documentation that supported their accounts. Here are photos and stories from across America since the reversal of Roe v. Wade.