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SALT LAKE CITY — Organizations that provide or advocate for women's reproductive health care have been planning for years for the possibility that Roe v. Wade, the landmark Supreme Court decision that established a constitutional right to abortion, could be overturned.
After the leak of the draft majority opinion that indicates the Supreme Court privately voted to strike down Roe v. Wade, those efforts have kicked into overdrive as abortion providers, advocacy organizations, and some state legislatures and governors work to assist women from other states with trigger laws that would ban or severely restrict access to abortion.
But even with those supports, women seeking care in states with no or fewer restrictions on abortion have already experienced increased wait times as more women from other states travel to seek care.
For example Planned Parenthood's Colorado clinics saw 44 patients from Texas between September 2020 and March 2021. During the same period a year later, and after the passage of the Texas Heartbeat Act, they saw 506 Texas patients, according to a report by FiveThirtyEight.com, which specializes in opinion poll analysis, politics, economics and sports blogging.
Even before the leak of the Supreme Court's draft opinion, women "have had to have the wherewithal to work within the system to actualize an abortion," said Karrie Galloway, CEO and president of Planned Parenthood Association of Utah.
Under current law, patients in Utah must receive state-directed counseling that includes information designed to discourage them from having an abortion and then wait 72 hours before the procedure is provided, according to the Guttmacher Institute, a self-described "leading research and policy organization committed to advancing sexual and reproductive health and rights worldwide."
There are also limitations on health plan or insurance coverage or public funding for abortion. In Utah, the parent of a minor must consent and be notified before an abortion is provided.
In Utah, overturning Roe v. Wade would trigger SB174 , passed by the Utah Legislature in 2020. The legislation, sponsored by Sen. Dan McCay, R-Riverton, prohibits elective abortion but allows procedures in instances of rape or incest, risk to the mother's life and certain fetal defects.
Traveling for abortions
If Roe is overturned, women who seek elective abortions would have to travel out of state for care, but much depends on their personal resources and circumstances.
Even with financial assistance for travel expenses, lodging and meals, some women cannot leave their families, jobs or other responsibilities to seek care elsewhere. People with disabilities or those unauthorized to be in the United States face additional challenges.
"What we've learned in Texas is that so many people have never left the county that they were born in so the thought of leaving their state to get basic health care is just not a possibility. It's just, it's not within the realm of thinking. That's where the reality of being able to help people comes into play, and so it's just an extremely eye-opening state of affairs," Galloway said.
When asked if the prospect of women having to seek abortion services in other states gives him pause, McCay responded, "As a son of a single mother, it gives me pause that a single mother would feel trapped and that her only option is an abortion."
Pregnant women have far more government social services and health care services available to them and their children in 2022 than were available in the era of the Roe decision in 1973 or even the Casey decision in 1992, McCay said.
"I'm hopeful that with changes that we've seen in the country and then locally, with Medicaid, Medicaid expansion and CHIP (Children's Health Insurance Program), all programs that did not exist when Roe and Casey existed, and if we add to that community programs and community support that we see all over the place, I think there's a lot more support for women with unexpected pregnancies," he said.
As for the resulting patchwork of of abortion laws should the Supreme Court overturn Roe v. Wade, "I would just say the country already has a patchwork of laws ... and the country seems to function just fine. I don't think a patchwork of laws on this issue — so that it can more accurately reflect the local sentiments towards the policy — I don't think that's a bad thing at all," McCay said.
An 'island' in an 'abortion desert'
Even with an enhanced safety net of services, some women will seek elective abortions. For Utah women, the closest abortion clinic along a major thoroughfare, I-70, is in Glenwood Springs, Colorado, approximately 369 miles from Salt Lake City.
In recent years, relatively few women from Utah have sought care from Colorado abortion clinics. In 2021, 56 women from Utah received abortions in Colorado, according to the Colorado Department of Public Health and Environment. That was a slight increase from 49, the previous year, but the numbers of Utahns seeking abortions in neighboring Colorado were substantially lower than Wyoming and New Mexico, both smaller in population.
But should that change, Utah women would be among growing numbers of women who live outside Colorado and could come to the state for reproductive health care.
Of 11,580 abortions in Colorado in 2021, which was a 12-year high, 13.5% were among women from outside of the state. The number of nonresident cases rose from 1,283 in 2020 to 1,560 in 2021.
If Roe is overturned, the result will be a patchwork of laws. Overturning Roe v. Wade would not outlaw abortion but states could individually determine the procedure's legality.
In the Rocky Mountain states, Utah, Wyoming, North Dakota, South Dakota and Idaho all have trigger laws, while Colorado remains one of the few states that neither restricts when an abortion can occur nor requires a waiting period after required abortion counseling.
If Roe is overturned, Colorado would become "an island in the middle of an abortion desert," Kristina Tocce, the vice president and medical director of Planned Parenthood of the Rockies, told the Denver Gazette.
Planned Parenthood of the Rockies — which encompasses Colorado, New Mexico and southern Nevada — has been working to increase its capacity for three years, and the leaked draft will spur rapid action in the coming weeks and months, the Gazette reported.
Galloway emphasized that the leaked Supreme Court opinion is a draft and abortion is still legal in the United States.
"Planned Parenthood is not going away. Our basic premise is to help people plan their families, whether to achieve pregnancy or postpone it, to make their strongest family possible, and we will never abandon that mission."
She added: "We promise the people of Utah that we will do whatever is in our power, as we have for the past 50 years, to work within the letter and the spirit of the law, but not giving up on our mission. We will make sure that we work with anybody who gets to us to make sure that they can get the services they need."
McCay said the leak of the draft majority opinion has led to rumors, gossip and speculation.
"We really don't know if Roe is going to be overturned yet," he said.
"As a result, I'm not currently working on anything and don't see anybody else (is) until after we get a final opinion from the Supreme Court and we know what direction, you know, state law is permitted to take," said McCay, who is an attorney.
One possibility is that the court might rule on the constitutionality of the Mississippi law and leave "the rest of it alone," he said. Enacted in 2018, Mississippi's Gestational Age Act prohibits abortion after 15 weeks' gestation, with exceptions for medical emergency or severe fetal abnormality.
McCay said the leak of the draft opinion "actually may make it less likely that that's the final opinion, but that's total speculation."
Other states' response
While some states prepare to enact trigger laws should the Supreme Court overturn Roe v. Wade, other states' leaders are codifying protections in state statutes or proposing amendments to their state constitutions.
Three Republican governors in New England recently vowed to protect abortion rights in their states, according to the New York Times.
"It would be a massive setback for women in states without responsible laws protecting abortion access and reproductive health services," said Massachusetts Gov. Charlie Baker.
It is anticipated that California voters could be voting on a proposed amendment to the state's constitution that enshrines the right to abortion as soon as November, according to The New York Times.
Some states are considering using state funds to help both residents and nonresidents obtain abortion care regardless of the Supreme Court's final decision. Oregon lawmakers established a $15 million Reproductive Health Equity Fund this spring to provide grants to local organizations to help pay for the procedure, and California is considering similar legislation, Politico reported.
Meanwhile, Utah Gov. Spencer Cox and Lt. Gov. Deidre Henderson, both Republicans, said in a statement: "While we are encouraged and optimistic at the possibility that abortion law will be left to the duly elected representatives of the states, draft rulings are not actual rulings and leaked drafts are a dangerous violation of court protocol and deliberations. Utah has already passed a law, SB174, that will govern if the high court decides to overturn Roe. We anxiously await the court's actual ruling in this case."
Emphasis on family planning
Galloway, who has worked for Planned Parenthood in Utah since 1981 and has been its director since 1987, said the association plans to "double down" on family planning efforts.
After three years with no federal Title X funding, which supports clinics that provide family planning services to low-income people, Planned Parenthood Association of Utah is back in the federal grant program.
Utah's Planned Parenthood exited the program in 2019 because of a "gag rule" implemented during the Trump administration that prohibited recipients from referring patients for abortion except in cases of rape, incest or medical emergency.
"We have just gotten back the Title X money to be the stewards of that in Utah," Galloway said. "We've got almost three years without federal funding to subsidize birth control here in Utah, and we didn't go away."
Galloway said Utah's Planned Parenthood will "still open in all our health centers statewide, providing family planning services."
"We will be bigger and prouder with that going forward," she said. "So we're not going away. No, we're here to stay. We're here to help people. People can count on us."
