With more than two dozen states poised to ban abortion if the U.S. Supreme Court gives them the OK next year, California clinics and their allies in the state Legislature on Wednesday revealed a plan to make the state a "sanctuary" for those seeking reproductive care, including possibly paying for travel, lodging and procedures for people from other states.
The California Future of Abortion Council, made up of more than 40 abortion providers and advocacy groups, released a list of 45 recommendations for the state to consider if the high court overturns Roe v. Wade — the 48-year-old decision that forbids states from outlawing abortion.
The recommendations are not just a liberal fantasy. Some of the state's most important policymakers helped write them, including Toni Atkins, the San Diego Democrat who leads the state Senate and attended multiple meetings.
Democratic Gov. Gavin Newsom started the group himself and in an interview last week with The Associated Press said some of the report's details will be included in his budget proposal in January.
"We'll be a sanctuary," Gov. Newsom said, adding he's aware patients will likely travel to California from other states to seek abortions. "We are looking at ways to support that inevitability and looking at ways to expand our protections."
Abortion, perhaps more than any other issue, has divided the country for decades along mostly traditional partisan lines. A new decision overturning Roe v. Wade, which could come next summer, would be the culmination of more than 40 years of conservative activism. But Wednesday's report offers a first glimpse of how Democratic-dominated states could respond and how the debate over abortion access would change.
California already pays for abortions for many low-income residents through the state's Medicaid program. And California is one of six states that require private insurance companies to cover abortions, although many patients still end up paying deductibles and co-payments.
But money won't be a problem for state-funded abortion services for patients from other states. California's coffers have soared throughout the pandemic, fueling a record budget surplus this year. Next year, the state's independent Legislative Analyst's Office predicts California will have a surplus of about $31 billion.
California's affiliates of Planned Parenthood, the nation's largest abortion provider, got a sneak preview of how people might seek abortions outside their home states this year when a Texas law that outlawed abortion after six weeks of pregnancy was allowed to take effect. California clinics reported a slight increase in patients from Texas.
Now, California abortion providers are asking California to make it easier for those people to get to the state.
The report recommends funding — including public spending — to support patients seeking abortion for travel expenses such as gas, lodging, transportation and child care. It asks lawmakers to reimburse abortion providers for services to those who can't afford to pay — including those who travel to California from other states whose income is low enough that they would qualify for state-funded abortions under Medicaid if they lived there.
It's unclear about how many people would come to California for abortions if Roe v. Wade is overturned. California does not collect or report abortion statistics. The Guttmacher Institute, a research group that supports abortion rights, said 132,680 abortions were performed in California in 2017, or about 15% of all abortions nationally. That number includes people from out of state as well as teenagers, who are not required to have their parents' permission for an abortion in California.
Planned Parenthood, which accounts for about half of California's abortion clinics, said it served 7,000 people from other states last year.
A huge influx of people from other states "will definitely destabilize the abortion provider network," said Fabiola Carrion, interim director for reproductive and sexual health at the national Health Law Program. She said out-of-state abortions would also likely be later term procedures, which are more complicated and expensive.
The report asks lawmakers to help clinics increase their workforce to prepare for more patients by giving scholarships to medical students who pledge to offer abortion services in rural areas, help them pay off their student loans and assist with their monthly liability insurance premiums.
"We're looking at how to build capacity and build workforce," said Jodi Hicks, CEO of Planned Parenthood Affiliates of California. "It will take a partnership and investment with the state."
Abortion opponents in California, meanwhile, are also preparing for a potential surge of patients from other states seeking the procedure — only they hope to convince them not to do it.
Jonathan Keller, president and CEO of the California Family Council, said California has about 160 pregnancy resource centers whose aim is to convince women not to get abortions. He said about half of those centers are medical clinics, while the rest are faith-based counseling centers.
Many of the centers are located near abortion clinics in an attempt to entice people to seek their counseling before opting to end pregnancies. Keller said many are already planning on increasing their staffing if California gets an increase of patients.
"Even if we are not facing any immediate legislative opportunities or legislative victories, it's a reminder that the work of changing hearts and minds and also providing real support and resources to women facing unplanned pregnancies — that work will always continue," Keller said.
He added: "In many ways, that work is going to be even more important, both in light of the Supreme Court's decision and in light of whatever Sacramento decides they are going to do in response."
Additional reporting by The Associated Press.