Over the past three years, we’ve watched as state legislatures across the country have passed increasingly draconian restrictions on women’s reproductive rights. A report released by People For the American Way details these growing threats to women’s health, including everything from deceptive TRAP laws closing clinics for the size of janitorial closets, to mandatory counseling laws that force doctors to provide women with medically inaccurate information.
But what’s less well-known is how difficult it is for women to access their reproductive rights anywhere — even in the blue states with strong public support for reproductive choice. Connecticut, Massachusetts, Maine, and Rhode Island have all imposed some form of TRAP laws threatening clinics. Massachusetts and Vermont both have unenforceable and unconstitutional criminal bans on abortion still on the books. Massachusetts passed a law requiring mandatory waiting periods and counseling for women seeking to end a pregnancy, including a mandated consent form detailing the stage of fetal development. Connecticut, Massachusetts, Rhode Island, and Maine allow health care professionals to refuse to provide abortion care. In a rare piece of proactive news, the California legislature has finally passed a bill expanding access to first-trimester abortions in the state – in nearly half of California’s counties, there are no abortion providers beyond urgent care services. The bill is currently waiting signature by the governor. But this is an anomaly in the broader landscape. Even in blue states, legislators are making few proactive efforts to ensure access to reproductive rights.
Across the country, abortion and reproductive health care is difficult to access and afford, and becoming more so. And blue states are no exception. A nationwide study conducted by the University of California, San Francisco found that nearly six in 10 women seeking to end a pregnancy weren’t able to get an early term abortion because of the costs of the procedure and travel. Nationwide, the cost for first-trimester abortions at clinics ranges from $300 to $1,700, and hospitals usually cost more. Costs increase in the second trimester. Additionally, there are the costs of travel – 87% of U.S. counties do not have a clinic that provides abortion services — and often the added costs of lost wages, child care, and so on. According to a Guttmacher Institute survey, in 2008, American women traveled an average of 30 miles to access abortion services. In many states, because of mandatory waiting periods, women are now forced to make that trip twice. As Jenni Dye, the executive director of NARAL Pro-Choice Wisconsin and a member of the Young Elected Officials Action Network, noted to me, “Women are forced to travel long distances in order to receive timely access to comprehensive reproductive health care, including safe and legal abortion care, sometimes even having to travel to another state due to the limited number of providers and medically unnecessary laws restricting access to abortion in a growing number of states.”
Meanwhile, federal restrictions prevent low-income women from using government funded insurance to cover abortion services in most cases. Amendments to appropriations bills restrict abortion coverage for many low-income and disabled women on Medicaid, Medicare, SCHIP, and Indian Health Services, as well as military and government employees. Studies show that even women with private insurance often don’t use the coverage for payment, because they don’t know their plan will cover it, or because of fear of stigma.
But the stigma that right-wing activists have worked hard to attach to women who have had abortions doesn’t only affect those women. Too often we fail to recognize that paternalistic legislation anywhere — to restrict women’s autonomy, to publicly shame women making these personal decisions, to dictate women’s medical and life outcomes — echoes and affirms the assumption that politicians are free to police and legislate women’s bodies. Attacks on choice aren’t just an “anti-abortion belt” issue. While reproductive rights are being chipped away in so many states, women face challenges accessing their rights everywhere.