Days after the fall of Roe v. Wade, the country has yet to feel the full impact of the Supreme Court’s decision to overturn nearly 50 years of precedent. This moment is full of confusion, anger and misinformation, but one thing is inevitable: The end of Roe will hurt the entire country, even states where abortion remains legal.
Trigger laws are taking effect across the U.S., and abortion is set to become illegal in at least 22 states. But Americans will still need that care, even as access is cut dramatically.
“It will not just be a ripple effect. It will be a tsunami effect,” said Andrea Miller, president of the National Institute for Reproductive Health.
The demand for abortion has increased in the past few years, according to a recent report from the Guttmacher Institute, a pro-abortion rights research organization. After decades of decline in abortion care, there was an 8% increase in abortions performed between 2017 and 2020. And at least 202 abortion clinics ― just over a quarter of all the facilities in the country ― are eventually expected to close due to the repeal of Roe, according to a report published by Advancing New Standards in Reproductive Health, a leading research group.
Some people in states where abortion is illegal will be able to overcome the necessary hurdles, including paying for transportation and lodging and taking time off from work, to travel to get an abortion. But this, in turn, will result in a massive surge in patients in blue states.
The country already witnessed this after Texas passed its six-week abortion ban in September. Surrounding states were inundated with abortion patients from Texas, creating longer wait times to see a physician. Most patients seeking care outside of Texas and in surrounding states had to wait three to four weeks to get an appointment for medication abortion, and sometimes longer for people who needed a procedural abortion. One Oklahoma abortion provider told HuffPost in November that 75% of his patients were from Texas.
“The reality is that this is going to mean that anyone who needs abortion care is probably going to be pushed further into their pregnancies, because the ability to get an appointment will be further out and further out as the states where [abortion] is accessible and available try to absorb the needs coming from other states,” Miller said.
And pushing people further into unwanted pregnancies ― whether they’re traveling out of state or they live in a state that offers abortion — will bring about a landslide of issues.
“It will not just be a ripple effect. It will be a tsunami effect.”
– Andrea Miller, president, National Institute for Reproductive Health
Prior to the repeal of Roe, medication abortion was the most common method, accounting for about 60% of all abortions in the U.S. The number of clinics that provide only medication abortion actually increased between 2017 and 2021, specifically in blue states, according to the ANSIRH report. But medication abortion is only used to terminate pregnancies until the 10- to 12-week point, meaning some people may be too far along for a medication abortion by the time they’re able to get an appointment.
“The trend that we’re seeing, even in the protected access states, is that more and more clinics are medication abortion only, so they only offer abortion up to about 12 weeks at the most,” Dr. Ushma Upadhyay, author of the ANSIRH report, told HuffPost earlier this month. “Once they get to those protected access states, they’re more likely to find clinics that offer medication abortion only, which they won’t be eligible for.”
While there will be many providers who offer procedural abortion in blue states, the surge in patients ― plus the fact that many blue-state clinics are already working with few resources ― means some patients will be turned away.
Many people also simply won’t be able to afford abortions when they’re pushed further into pregnancy. The later in a pregnancy, the more expensive an abortion is.
“People having longer wait times means they literally have to pay more money to have their abortions,” said Kamyon Conner, executive director of the Texas Equal Access Fund. “It could take you from a $500 abortion out of pocket to $700 or $800 out of pocket or more, because things keep getting pushed further along.”
People may also struggle to find appointments for other forms of health care. Most clinics in blue states also provide birth control services, Pap smears and STD testing.
“By having to up the amount of abortion services they’re providing, they’re having to cut back on other essential gynecological services,” said Allison Coffman, director of Amplify Georgia Collaborative, a pro-abortion rights organization. “You may not even be going to these clinics to access abortion care, but you’re not [going to] be able to get your family planning, you’re not able to get your Pap smears ― essential health care services.”
Again, this happened in Oklahoma after Texas severely restricted abortion access. Trust Women’s Oklahoma City abortion clinic stopped providing other health care services in order to accommodate the extra 600 abortion procedures their staff was doing each month.
Conservatives and abortion rights opponents aren’t slowing down, despite their victory over Roe. Republicans are calling for a nationwide abortion ban ― which would be politically difficult but not impossible ― and many are already waging a war on telehealth for abortion, including medication abortion sent by mail. Most anti-abortion rights lawmakers at the state level are also trying to put restrictions on people traveling out of state for abortion care.
“We know that states that are hostile to abortion care are contemplating passing laws that reach into states that protect abortion care, and try to criminalize the provision of that care for patients traveling from, say, a state like Texas,” said Rebecca Hart Holder, executive director of the Massachusetts-based group Reproductive Equity Now. “Those [laws] haven’t passed yet, but they are a very, very real threat to the provision of abortion care.”
Abortion restrictions and bans in red states will affect people’s ability to get abortion care and other health care services in blue states. Some people may think they’re safe because they live in a progressive city or state, but it’s not that simple. The health system as a whole is going to have to absorb the shock, and it will take months for the country to feel the full effects of the fall of Roe.
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