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Opinion | Pro-Choice States Must Prepare for the Fall of Roe v. Wade

Removing unnecessary abortion barriers, a suggestion pushed by abortion rights advocates for years, takes on added importance now. In a post-Roe country, abortion-supportive states will see a dramatic increase in patients from places where abortion is banned. Already, the number of Texans traveling for abortions after S.B. 8, Texas’ ban on abortion after about six weeks of pregnancy, has strained capacity and delayed care from Kansas to Minnesota. Increasing the number of providers, reducing administrative burdens and streamlining care will help clinics serve this influx of patients.

Pooling the services of abortion providers across state lines is another way to help with what will surely become an overburdened abortion ecosystem — especially in abortion-supportive states that neighbor anti-abortion states. During the pandemic, many states enacted temporary measures that allowed out-of-state medical care professionals in good standing to treat patients in their states via telehealth. States could make the same allowance specifically for medication abortion.

States seeking to protect abortion rights need to think seriously about financing abortion care. The legality of abortion is irrelevant to people who cannot afford it. More state Medicaid plans can cover abortion, and states can improve their reimbursement rate so that abortion clinics are fairly paid for the services they provide, a necessary precondition for remaining open to serve patients from all over the country.

Abortion access is already marked by race and class disparities, which will grow significantly when out-of-state abortion patients must travel hundreds, if not thousands, of miles to find care. State and local governments could help by directly subsidizing abortion clinics or supporting abortion funds that assist with patient costs. After all, for decades, anti-abortion states have financed anti-abortion crisis pregnancies centers.

Finally, states should enact versions of so-called Safe at Home laws, like those in New Jersey and California, which protect abortion providers’ home addresses from public discovery. In a post-Roe future, anti-abortion extremism is likely to rise, putting abortion providers operating in safe states at risk of being personally targeted.

State legislators who support reproductive rights and justice need to take steps to ensure that abortion access is not dependent on ZIP code and financial status and that abortion providers are protected. Without these concerted actions from supportive legislators, the post-Roe reality will be much worse than it has to be.

David S. Cohen is a professor of law at Drexel University’s Kline School of Law and a co-author of “Obstacle Course: The Everyday Struggle to Get an Abortion in America.” Greer Donley is an assistant professor of law at the University of Pittsburgh Law School, where her scholarship focuses on reproductive justice, bioethics and F.D.A. law. Rachel Rebouché is a professor of law and the interim dean of Temple University’s Beasley School of Law, where her scholarship focuses on reproductive health, family law and public health.

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