Since the fall of Roe v. Wade, low-income people in some states with abortion bans are facing shrinking financial options
By Christopher Rowland
Published in the Washington Post, July 15, 2022
The threat of legal jeopardy in the wake of the Supreme Court’s reversal of Roe v. Wade is forcing a retreat by nonprofit groups that provide vital financial support to low-income women seeking abortions.
Sources of assistance are drying up just as economically disadvantaged women and other pregnant people in states that have moved to ban abortion need money more than ever — not just for medical fees but for plane tickets, gas and hotels as they seek to travel to abortion-friendly states far from home.
Health Insurance coverage for abortion is spotty or nonexistent in conservative states, and in many blue states as well. Local and regional abortion funds, which receive grants from large national advocacy groups as well as donations from grass roots supporters, have for years filled the gap.
But disruptions to that support system are rapidly unfolding — and threaten to exacerbate inequality between those who struggle to pay for abortion and those who can more readily book a ticket to a state where abortion is legal, advocates from multiple states said in interviews.
At least seven abortion funds in Texas have shut down and stopped paying for procedures and travel assistance since the June 24 Supreme Court decision, fearing their staff and volunteers would face criminal prosecution — even for abortions obtained out-of-state. Leaders of the funds said they fear that simply supplying advice to patients on how to obtain an out-of-state abortion could put them in legal jeopardy.
“If we want to keep our staff and our board out of jail, we have to cease operations,” said Rockie Gonzalez, founder of Frontera Fund, one of the shuttered Texas funds, which serves patients in the Rio Grande Valley. “We are seeing the criminalization of an entire network that has built a functional safety net for pregnant people.”
Some of the slack can be taken up by abortion funds operating in states where abortion remains legal, and such funds are seeing demand soar from people stuck in states with bans. But lawyers and advocates for abortion rights say the legal environment is uncertain and changing fast. And they warn that providing aid to residents of states with prohibitions — even when done from seemingly safe territory outside those states — may carry risks.
The National Abortion Federation and its NAF Hotline Fund — a large advocacy and abortion funding group in Washington, D.C., supported with tens of millions of dollars from billionaire Warren Buffett’s charitable foundation, public records show — said it has stopped funding abortion care in multiple states with bans, including Texas, Mississippi, Louisiana, Arkansas and Kentucky.
The federation said it continues helping patients travel to states where abortion is legal and maintains its hotline to offer guidance nationwide. But continuing to support abortions in hostile states could expose the national organization to legal danger, Veronica Jones, NAF’s chief operating officer, said in an interview.
“Failing to incorporate this new reality into our decision-making would put our entire operation at risk, ultimately leaving hundreds of thousands without access to care,” Jones said. Even with the cutbacks, she said the federation has helped more than 3,000 people across the country obtain abortions since the Supreme Court ruling.
A phone message left at Buffett’s foundation was not returned; the foundation says on its website it does not respond to most inquiries.
Newly enacted and proposed laws banning abortion are expected in 26 states, and even stricter laws are beginning to take shape for consideration in upcoming legislative sessions, which typically begin in January. Antiabortion lawmakers have made clear they plan to target not just abortion providers but also employers, funders and volunteers who “aid and abet” abortion, moves intended to make it harder for low-income patients to get around abortion bans by traveling elsewhere.
Under model state legislation proposed last month by the National Right to Life Committee, “conspiring to cause” or “aiding or abetting” abortion would be a felony and would encompass virtually any sort of support. Its list of potential offenses includes posting information on a website to help patients find services.
In a federal court filing last month, Texas antiabortion lawyer Jonathan F. Mitchell, a key architect of the Texas SB 8 civil liability law that allows private citizens to sue abortion providers or anyone who aids an abortion, defended the idea of targeting activists who help pay for abortions with donations.
“Contributing money to help others terminate the life of an unborn child is no more 'speech’ than hiring a hit man or contributing money to organizations that murder innocent civilians,” Mitchell wrote in the filing.
In an email to The Post, Mitchell said abortion funders in Texas and elsewhere who are curtailing operations are clearly responding to a legally dangerous environment in the wake of the Supreme Court’s decision.
“Anyone who knowingly pays for an abortion or abortion travel could be criminally charged if any part of the abortion or the travel occurs in a state where abortion has been outlawed,” Mitchell wrote. “It’s not clear whether the courts would ultimately allow an antiabortion state to prosecute abortion funders in these situations, but they can’t take the risk.”
Last week, the Texas Freedom Caucus, a group of conservative state lawmakers, said in a letter that it plans to introduce legislation that would specifically target employers and others who provide financial support for out-of-state abortions. The provisions would bolster existing prohibitions and apply “regardless of where the abortion occurs, and regardless of the law in the jurisdiction where the abortion occurs,” their letter said.
President Biden has said the federal government will protect the rights of people who cross state lines to get abortions, and ensure access to Food and Drug Administration-approved abortion pills for all Americans, regardless of where they live. But the administration has yet to release any specifics about how those protections would work, despite intense pressure from Democratic allies. On July 8, Biden issued an executive order directing the Department of Health and Human Services to develop a plan.
Meanwhile, the right to travel for an abortion may not be much use to low-income people in Texas if they are prohibited from receiving abortion funding and advice, said Emily Berman, a professor at the University of Houston Law Center.
“Is that right to travel really meaningful if you can’t get any help in doing it?” Berman said.
Even in states where abortion is protected, some activists said they have encountered evidence of the chilling effect.
Three days before the Supreme Court wiped out the constitutional right to abortion, Megan Jeyifo, executive director of the Chicago Abortion Fund, received a text message from the leader of a national foundation that had pledged ongoing support just one day earlier. She declined to identify the foundation.
“I am so sorry for the bad news — especially having reached out to you — but our lawyers have put the brakes on any donations to abortion services given several states will move to make helping women move across state lines against the law after Roe is overturned,” the funder said in the text message, which Jeyifo read aloud to a Post reporter.
Jeyifo said she is not as concerned about being targeted personally by prosecutors or litigants in another state, partly because Illinois leaders have vowed to enact protections that would stifle abortion-related investigations in Illinois by other states.
“Our job is to connect people to the care they need by any means necessary,” she said.
Planned Parenthood, the largest abortion provider in the country, says on its website that it helps patients pay for abortion using a sliding fee scale based on income at its national network of reproductive health clinics. The organization declined to respond to questions about the legal issues raised by helping people located in states where its services are prohibited.
For the independent abortion funds, which have a national network that helps them coordinate financial and legal strategies, the rapidly changing legal landscape has forced them to keep a close eye on state legislatures and courts, sometimes on a daily basis. Fund leaders said they are in frequent contact with their own lawyers to understand what’s legal and what’s not.
Some states had abortion bans on the books from the days before the 1973 Roe v. Wade decision. Critics call these “zombie” laws because they sprang back to life after the Supreme Court overturned Roe. Some states have more-recently-passed “trigger laws” designed to ban or severely restrict abortion in the event Roe fell. Some states have both.
The map of states where abortion is legal is shrinking fast, especially in the Midwest, where Illinois is emerging as an island in a sea of antiabortion states — and a key destination for desperate patients.
The Conant Family Foundation, a Chicago philanthropic organization, has been strategizing with other foundations about how to funnel money to other states. Conant also is supporting a move by a Memphis clinic to establish a new facility in Carbondale, Ill., the southernmost stop in Illinois on the City of New Orleans Amtrak line. The passenger line cuts through Jackson, Miss., and Memphis, on its way north toward Illinois.
“I thoroughly review each organization and trust them not to get us into legal difficulties without consulting us first,” said Leslie Ramyk, Conant’s executive director.
In Kentucky, where a trigger law was temporarily halted by a state court, abortions continue to be performed while the case plays out. Nonetheless, the National Abortion Federation has already pulled back funding there, advocates said. The Chicago Abortion Fund sent $5,000 to a Kentucky abortion clinic as a block grant to help patients left in the lurch by NAF’s withdrawal, Jeyifo said.
Jones, at the NAF, confirmed Kentucky was among the places where it cut funding but declined to discuss the decision.
Erin Smith, executive director of the Kentucky Health Justice Network, one of the state’s abortion funds, said the loss of the national financial support “has hurt us significantly.” Only medication abortions are being performed in Kentucky; patients who need a surgical abortion are being sent to Illinois and Indiana, which increases costs, Smith said.
In Alabama, after that state’s trigger law took effect, the Yellowhammer Fund said it was shutting down until July 15 to review the legal landscape. Oklahoma’s Roe Fund also has suspended operations.
In Oregon and Florida, where abortion remains legal, nonprofit funders said they are seeing big spikes in requests for financial assistance from states where abortion is being outlawed.
Though Florida law bans abortions after 15 weeks, that measure has been temporarily blocked by a state judge — opening the door to a flood of requests for aid from patients prepared to travel from Alabama, Mississippi and other states, said Julia Desangles, co-executive director of the Florida Access Network abortion fund. If Florida’s ban takes effect, patients needing later-term procedures will have to travel at least as far as North Carolina, she said.
Money from grass roots donors, meanwhile, has strengthened since the Supreme Court ruling, with $80,000 flooding in a single day, Desangles said. The network has been able to boost aid to individual patients from an average of $175 to up to $300, including people from neighboring states.
“It’s been really overwhelming emotionally to have that kind of fall on us,” Desangles said.
The Northwest Abortion Access Fund, which provides funding for abortions in Oregon, Washington, Idaho and Alaska, is retraining staff and volunteers who offer hotline assistance to people seeking abortions. Representatives can provide factual information about what services are legal in which states, but they cannot make recommendations, said Riley Keane, who leads the organization’s logistical support efforts.
Queries from Texas have quadrupled since passage of SB 8 last year — and many callers are afraid, she said: “Exposing yourself to a legal battle is terrifying.”