Patients Are Traveling From Texas for Abortion Care. This May Be the New Normal.

by Megan Burbank

At midnight on the first day of September, after the Supreme Court failed to respond to an appeal from abortion providers, a law banning abortions after six weeks of pregnancy went into effect in Texas. SB 8 has ended access to an estimated 85% of procedures, empowered ordinary people to sue fellow citizens for seeking out or facilitating abortion care, and pushed patients to seek care across state lines, some as far as the Pacific Northwest. Less than a month after SB 8's implementation, Planned Parenthood disclosed to the Emerald that its Central District Health Center had seen its first patient from Texas.

This disruption in care, and rise in anti-abortion vigilanteism, has already been challenged by the Justice Department and drawn widespread criticism. Reproductive health care providers question its use of the term "fetal heartbeat," a descriptor that's more emotional than clinical (the sound heard on ultrasounds is caused by electrical activity; heart valves aren't actually present). Supreme Court Justice Sonia Sotomayor offered a blistering, Ruth Bader Ginsburg-esque dissent calling the law "clearly unconstitutional." The law has even been condemned by private companies like Lyft, which established a defense fund to cover legal fees for drivers sued under the law. In the words of one Slate headline: "The Supreme Court Overturned Roe v. Wade in the Most Cowardly Manner Imaginable."

But none of these objections lessen the impact the law has already had. SB 8 has had "a chilling effect" on abortion providers in Texas, said Lisa Humes-Schulz, vice president of policy and regulatory affairs at Planned Parenthood Alliance Advocates. "No one wants to get sued," she added, and the fallout has been swift.

On Sept. 20, the Austin-based news site The 19th* reported that Texas abortion clinics had effectively turned into "trauma centers," where staff were providing counseling and emotional support instead of abortion care. In that report, providers said low-income people and patients of color had been disproportionately impacted by the legislation. According to Katie Rogers of Planned Parenthood, the first patient to come from Texas to a Planned Parenthood clinic in Seattle arrived that same week.

It wasn't an isolated incident. Patients from Texas are also seeking care at Planned Parenthood affiliates in California. And in states bordering Texas, said Humes-Schulz, abortion care is backlogged, with patients facing wait times of two to three weeks. "Patients who have money and time are able to travel longer distances to Washington or California to avoid three-week wait times in a closer state," she said.

Meanwhile, the Northwest Abortion Access Fund (NWAAF), a regional organization that helps people pay for abortions, has already started providing funding to clients from Texas, Humes-Schulz said. NWAAF's service area typically only includes Washington State, Idaho, Oregon, and Alaska, although a board member noted that the organization's hotline fields calls from all over the country.

Reproductive rights advocates are concerned that the barriers to care compounded by SB 8 will only be exacerbated if the law is replicated elsewhere, and it's already attracted the attention of Republican-controlled state legislatures. Dusty Ginner, a NWAAF board member, said she expected Idaho to be one of them. "I'm petrified," she said. "I think that Idaho is going to take their lead from Texas, and I'm really scared for what that's going to look like for our people here."

This isn't likely to happen in Washington, where abortion is covered by state Medicaid funds and private insurance, and Initiative 120 enshrined Roe v. Wade into state law in 1991. But Washington and states like it are already sanctuary states for abortion access, and if SB 8 is adapted in Idaho, it will only add to Washington's burden of care and could impact Washingtonians seeking abortion care.

Planned Parenthood's Humes-Schulz said states like Washington should anticipate increased need for abortion services in the new year. "Having already seen patients from Texas, we know Washington will become a haven for patients from the several dozen states where abortion access may be eliminated in 2022," she said. "The reality is that this influx of patients may increase wait times for Washington patients seeking care."

Some speculate that SB 8 could pave the way for a national rollback of Roe vs. Wade. But even if that were to happen, said Stephanie Marquis of the Office of the Insurance Commissioner, abortion would remain legal in Washington. "If there is no federal law on an issue, then the state law would kick in and Washington State law would fill the gap on the question of abortion if Roe v. Wade were ended," she said. (The opposite is true in Idaho, where a trigger law would make abortion illegal in the event that Roe falls.)

But many pregnant people across the country are already living the reality of what could happen if Roe were overturned. "The people who can access abortion care with SB 8 in place in Texas, those are the people who are going to have means, who can travel, who can take off work, who can pay for a flight, who can find another abortion clinic in another state," said Ying Zhang, a Seattle family medicine doctor. "And the people who need interpreters or do day labor and can't take off work for several days, [or] might not have documentation to travel to fly or anything — those are the people that are really going to struggle …"

On Sept. 15, Northwest Health Law Advocates (NoHLA) released a statement acknowledging these socioeconomic conditions, when combined with laws like SB 8, effectively nullify Roe for many people. NoHLA's statement cites existing barriers in Texas including "previously enacted laws [requiring] counseling designed to discourage the decision [to have an abortion], a 24 hour waiting period, medically unnecessary ultrasounds, and more."

"The average drive time to obtain an abortion is 248 miles — or 3.5 hours one way at 70 mph," noted NoHLA. "These obstacles are all much more burdensome for the working poor: Someone making minimum wage ($7.25 an hour in Texas) would have to work a full day just to cover the gas for one round trip."

Seattle and Washington, like many regions with broader access to abortion, will likely continue to see an influx of patients from Texas in response to SB 8. And as desperate as these patients may be, they still don't represent those without the means to make a trip of almost 2,000 miles.

"In these peak moments of crisis, people are always strategizing: 'How am I going to terminate my pregnancy if I can't get a clinic abortion?' and that is just the truth," said Ginner, who is afraid people will try to self-induce abortions. Some may seek to end their pregnancies "through acts of violence," she said.

Others may simply have to carry their pregnancies to term. "That is the toll of what this looks like … becoming a parent before you're thinking about becoming a parent, becoming a parent before you're equipped … and then we know the cyclical nature of that, and how that impacts communities for decades," she said.

Megan Burbank is a writer and editor based in Seattle. Before going full-time freelance, she worked as an editor and reporter at the Portland Mercury and The Seattle Times. She specializes in enterprise reporting on reproductive health policy, and stories at the nexus of gender, politics, and culture.

Featured image is attributed to Lorie Shaull (under a Creative Commons, CC BY 2.0 license).