Just one day after Supreme Court Justice Brett Kavanaugh began hearing cases, Planned Parenthood announced an initiative to protect and expand abortion access in the United States. The plan includes heavily investing in a network of clinics in abortion-friendly states so they can can take on a higher volume of patients traveling from other states.
Kavanaugh’s confirmation marks the the start of a 5-4 conservative majority court, and federal protections for abortion are thought to be in jeopardy. Planned Parenthood is focusing its efforts at the state level with a new plan dubbed Care for All. The multimillion-dollar effort has three components: increasing access to abortion in states with laws supportive of reproductive rights, supporting state legislation to strengthen those rights, and, finally, addressing cultural stigma around abortion.
If Roe v. Wade were overturned outright, abortion would be immediately banned in four states (Louisiana, Mississippi, North Dakota, and South Dakota), thanks to what are known as “trigger laws.” But the Supreme Court wouldn’t need to actually overturn Roe in order to chip away at abortion access, it could instead uphold severe restrictions at the state level.
There are currently 13 cases at the federal appeals court level involving abortion where both Roe and Planned Parenthood v Casey—a case that upheld Roe but established that states could restrict abortion as long as the regulation wasn’t an “undue burden” on abortion access—could be “so significantly undermined as to be meaningless,” Dawn Laguens, executive vice president of the Planned Parenthood Action Fund, said in a call with reporters on Wednesday.
These cases are one step away from the Supreme Court, and they involve everything from mandatory waiting periods to a ban on a type of abortion procedure to requiring providers have admitting privileges at local hospitals. (Admitting-privileges requirements can and do lead to clinic closures; the Supreme Court ruled 5-3 in a 2016 case that such restrictions were unconstitutional. Still, people fear that a conservative court might rule the other way on a similar case.) Restricted access to abortion, alongside moves to limit birth control access, has the potential to create an environment where there are more unintended pregnancies and fewer places for women to have a safe, legal abortion, experts say.
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Which brings us back to the new plan. Its main plank is to expand access to help serve women in abortion deserts, which are likely to grow larger now that Trump’s second conservative justice was confirmed, Laguens says. (Currently, there are seven states with only one abortion clinic, and 20 percent of women travel at least 40 miles to their nearest clinic.)
Planned Parenthood will be investing in and expanding what it’s calling a “regional access network.” That’s a group of clinics—their own facilities as well as independent centers—in states with laws supportive of reproductive rights. The clinics will get additional resources to compensate for a possible influx of patients traveling from areas where abortion access will be limited, particularly in the Midwest and the South, Laguens says.
This network will expand access and services by hiring more providers, expanding hours, expanding telemedicine abortion, and opening more clinics, says Rachel Sussman, national director of state policy and advocacy for the Planned Parenthood Action Fund. Sussman declined to share the number of new hires on the press call, citing a desire to “avoid creating an environment where we’re laying out our plans for everyone.” (Read: for anti-choice activists.) But, she added, “We are going to be looking at all of the ways we provide care…to ensure that we are resourcing our health centers on the ground to see as many patients as we need to see.”
Sussman says a state like Illinois will be an important component of the regional access network, helping ensure adequate care for people in the Midwest. The Guttmacher Institute considers four of the five states that border Illinois to be “extremely hostile” to abortion (red in the chart below); the fifth, Iowa, is considered merely “hostile” (orange).
According to a release outlining the Care for All initiative, Planned Parenthood of Illinois is “aggressively” expanding services, and all 17 of its health centers will offer medication abortion by next summer; Planned Parenthood will also open a new Illinois health center by next year. During the past two years, the group expanded procedural abortion services from two to five locations, NPR reports.
Planned Parenthood is also working to make telemedicine consults for medication abortion available in more states; the service is currently offered in health centers in 14 states, Sussman says. Finally, Planned Parenthood also plans to open new health centers across the country; two have already been announced: one in Richmond, Virginia, and one in El Paso, Texas. Another West Texas clinic is slated to open in 2019.
On the policy front, Laguens says that Planned Parenthood will work with states "to ensure there’s an ironclad network of states across the country where abortion will be legal, no matter what happens at the Supreme Court." Sussman adds that they expect at least 25 states to aggressively push policies that expand and protect access in the 2019 legislative session. "In addition, Planned Parenthood advocacy organizations will be launching multi-year, 360-degree legislative campaigns in 10 of these states that are key to creating a regional access network for abortion," she says.
Laguens and Sussman say the organization it’s been preparing for this moment ever since Donald Trump and Mike Pence won the election. In fact, it held an abortion policy summit with staff from 19 states and Washington DC on the same day that swing-vote Anthony Kennedy announced his retirement from the court.
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