States brace for possibility that most of country will lose access to abortion

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A policy analyst at the Guttmacher Institute said an upcoming Supreme Court case could 'basically create two Americas when it comes to abortion.'

There's a very real chance that only a handful of states will fully support abortion rights in the near future, and those states will have to bear the burden for the rest of the country.

Abortion restrictions are being proposed — and enacted — at a record-breaking pace all across the country, but particularly in red states.

Additionally, the U.S. Supreme Court recently agreed to hear a dispute over Mississippi's 15-week abortion ban, a pre-viability ban that, if upheld, would alter the standard set by Roe v. Wade.

As abortion rights advocacy group NARAL noted when the Supreme Court announced it was taking the case, "There is no path for the Supreme Court to uphold Mississippi's abortion ban without overturning Roe's core holding."

Mary Ziegler, author of "Abortion and the Law in America: Roe v. Wade to the Present," stated that If a 15-week pre-viability ban such as Mississippi's is upheld, "it is not clear whether the court will impose any limit on abortion bans."

Taken together, these events signal that abortion access is in real peril. 

That peril, though, isn't evenly distributed across the country. Many Southern states, long more hostile to abortion than many of their Northern counterparts, have passed new restrictions this year, while large swaths of the West and Midwest have done the same. 

As Robin Marty, author of the book "The End of Roe v. Wade," explained to the Cut last year after Justice Ruth Bader Ginsburg died, "I think it's fair to say we're going to see abortion is completely illegal except for the West Coast, which is on fire, the Northeast, and then basically Colorado, Minnesota, Illinois, and New Mexico."

Making abortion access difficult or even illegal doesn't stop people from needing abortions. It does make it more expensive and logistically challenging to obtain them, particularly when people need to travel out of state. 

Often, abortion funds, groups that provide assistance, both financial and practical, to people seeking abortions, can help. However, those groups are already overtaxed. In 2019, the National Network of Abortion Funds helped 62,933 people, but they had over 200,000 requests for help. That need spiked even higher during the pandemic, with call volumes doubling since May 2020. 

The president of the National Abortion Federation, the Rev. Katherine Ragsdale, told NBC News that any Supreme Court decision that doesn't fully uphold Roe "is going to result in more people having to travel farther and raise more resources, whether that's paying for procedures or travel costs or lost wages costs." If that happens, she said, people will become more dependent on the limited resources of abortion funds. 

It isn't just abortion funds that face a crunch, however. States that are supportive of abortion will need to absorb patients traveling from those states that don't, a fact that the early stages of the coronavirus crisis made apparent.

At the start of the pandemic, Texas entirely banned abortion, calling it a "nonessential procedure," despite outcry from doctors. Nearly 1,000 Texas residents had to seek abortion care outside the state in April 2020 alone. One clinic in New Mexico saw a three- to four-fold increase in patients from Texas in those early months of the pandemic. Similarly, a Wichita, Kansas, clinic that performs abortions up to 21.6 weeks saw its caseload nearly triple in March 2020 compared to March of the previous year.

In the end, a handful of states and a stitched-together network of private funds are unlikely to be able to meet the nation's need for abortion care if the Supreme Court overturns or severely limits Roe. Funds are stretched thin as it is, and, as Yamani Hernandez, president of the National Network of Abortion Funds, told the Nation in 2019, "it usually takes more than one abortion fund to cover one abortion."

But even if clinics in supportive states can expand care and funds can raise more money, people in states hostile to abortion would still need to travel long distances to obtain care.

This would be particularly arduous in the South, where a large number of adjacent states would all be likely to ban abortion outright should Roe be overturned. If the Mississippi decision leads only to pre-viability bans being legal, rather than a complete repudiation of Roe, it may only be a matter of time before abortion opponents succeed at seeing Texas's six-week ban upheld as well. Six weeks is often before many people know they are pregnant, which means a ban such as that in Texas can function as a complete bar to obtaining an abortion. 

That creates some obstacles that can't be solved. While abortion funds can help pay for abortions and travel costs, they can't make employers agree to multiple days off, for example.

If a person needs to travel all the way from the southernmost portion of Texas all the way to Illinois to obtain an abortion, that's a multiday trip. There will be many people for whom this simply isn't feasible, no matter how much assistance they might be able to receive. 

Elizabeth Nash, a policy analyst at the Guttmacher Institute, which studies and advocates for reproductive health rights, said that allowing a pre-viability ban overturning Roe's current standard "would basically create two Americas when it comes to abortion."

 The right to abortion may remain, but it could become a right that many will be unable to exercise.