Abortion clinics are closing, even in states where abortion is legal
The abortion funding system across the U.S. is battered three years after the Supreme Court overturned Roe v. Wade and allowed states to enforce bans.
An initial surge of donations has subsided, scores of clinics have closed and advocates fear that federal policy changes will result in more shutting down.
'We're all collectively struggling,' said Ramsie Monk, director of development at the Women's Health Centers of West Virginia and Maryland, which opened a clinic in 2023 in western Maryland after abortion was banned in West Virginia.
ARTICLE CONTINUES BELOW
'I honestly don't know if it's a sustainable model,' said Mercedes Sanchez, executive director at the Cedar River Clinics in Washington. 'Clinics, providers, funds are all very committed to making sure people can access care, but it is definitely going to be more of a challenge.'
Bans in some states mean travel has become a bigger part of obtaining an abortion, bring a host of costs.
A mitigating factor is that most abortions are now done with medications. They can be prescribed by telehealth, including to women in states where abortion is banned. But they can't be used in every case, some women prefer procedures, and there are challenges to the legality of pills and how they're prescribed.
Abortion isn't funded like other health care
Not all private insurance plans cover abortions. Federal taxpayer funds cannot be used for abortions, but state Medicaid funds cover them in some places. And a network of private funding helps cover procedures or travel and other costs.
The increase in contributions that followed the 2022 Supreme Court ruling has declined for most funds and clinics. 'The resources have not kept pace with demand continuing to surge,' Lynn McCann-Yeh, co-executive director of the Baltimore Abortion Fund.
With bans on abortion at all stages of pregnancy now being enforced in 12 states and bans at about six weeks' gestation being enforced in four others, travel for abortion has become more frequent. Costs for each trip can include plane tickets or gas for long drives, meals, hotels and child care — all on top of clinic fees.
ARTICLE CONTINUES BELOW
ARTICLE CONTINUES BELOW
Last year, the National Abortion Federation's hotline fund reduced the portion of clinic costs it covers for people with financial needs to 30% from 50% so it could help more people as demand increased. The group's says travel costs now average over $1,000 per person.
Travel needs have made the job for abortion funds not only more expensive but more intricate.
Before the Texas ban started in 2021, Fund Texas Choice got about 40 calls a month, executive director Anna Rupani said. Now, it's over 200. And assisting each caller can take more time because they involve arranging flights and hotels, not just lining up rides to clinics in the state.
Some people cobble together money from a hodgepodge of groups to pay for an abortion. Grace McGarry, who manages the phone line for Whole Woman's Health, which operates five clinics across the U.S., said he talked to a patient who was getting aid from nine different groups.
Clinics have closed, even in states without new bans
Since the Supreme Court's ruling in Dobbs v. Jackson Women's Health Organization, I Need An A, which operates a website dedicated to providing information about abortion options, has tallied 105 clinics closing.
Twenty-nine closures were in states where abortion is now banned at all stages of pregnancy. Eleven were in states where it's banned at about six weeks' gestation, before many women realize they're pregnant. But 65 of the closures were in other states.
ARTICLE CONTINUES BELOW
ARTICLE CONTINUES BELOW
At the same time, 34 clinics have opened anew or moved to states where abortion is legal.
'Each and every one of those has been a blow to that community that hasn't been refilled,' said Rebecca Nall, the founder of I Need An A.
Planned Parenthood North Central States announced in May that it would close eight locations in Iowa and Minnesota while expanding services at some other clinics.
Ruth Richardson, the CEO of that Planned Parenthood affiliate, said the reorganization recognizes that the number of abortions in Iowa plummeted after the state started enforcing its strict abortion law. It also reflects that the regional group's overall budget is down.
'We've got the compounded challenges of the fact that sexual and reproductive health care has been politicized in this environment,' she said.
Marjorie Dannenfelser, president of SBA Pro-Life America, said in a statement that the closures are warranted: 'Planned Parenthood's focus is squarely on abortions, gender transitions and political spending.'
ARTICLE CONTINUES BELOW
ARTICLE CONTINUES BELOW
The federal government has moved to cut funding for clinics
In March, the Department of Health and Human Services withheld $27.5 million that groups were expecting to provide family planning, contraception, cancer screening and sexually transmitted infection tests and treatment. Some of the groups also provide abortions and include at least 11 regional Planned Parenthood affiliates.
'We're absolutely in a public health crisis of epic proportions,' said Brittany Fonteno, president and CEO of the National Abortion Federation. 'We're in a situation where there are reproductive health care deserts, not just abortion care deserts.'
President Donald Trump's tax and budget bill that is up for consideration in the Senate after getting House approval would deliver more blows to abortion funding.
It would bar federally subsidized health insurance plans from covering abortion, except if it's necessary to save the life of the woman, or in cases of rape or incest.
The bill also would bar Medicaid funds from flowing to Planned Parenthood, the nation's biggest abortion provider.
Planned Parenthood said those provisions could lead to the closures of about half its clinics that provide abortion —- and about one-fourth of abortion clinics nationwide. The biggest impact on affiliate clinics would be in states where abortion is legal.
Alexis McGill-Johnson, president and CEO of Planned Parenthood Federation of America, said it's almost been a challenge to fund abortion — and all health care — for low-income people.
'If the market could have figured it out,' she said, 'then we wouldn't exist.'
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Global News
a day ago
- Global News
The U.S. OKs twice-a-year HIV prevention shot. Could it end transmission?
The U.S. has approved the world's only twice-a-year shot to prevent HIV, the first step in an anticipated global rollout that could protect millions – although it's unclear how many in the U.S. and abroad will get access to the powerful new option. While a vaccine to prevent HIV still is needed, some experts say the shot made by Gilead Sciences — a drug called lenacapavir — could be the next best thing. It nearly eliminated new infections in two groundbreaking studies of people at high risk, better than daily preventive pills they can forget to take. 'This really has the possibility of ending HIV transmission,' said Greg Millett, public policy director at amfAR, The Foundation for AIDS Research. Condoms help guard against HIV infection if used properly but what's called PrEP — regularly using preventive medicines such as the daily pills or a different shot given every two months — is increasingly important. Lenacapavir's six-month protection makes it the longest-lasting type, an option that could attract people wary of more frequent doctor visits or stigma from daily pills. Story continues below advertisement But upheaval in U.S. healthcare — including cuts to public health agencies and Medicaid — and slashing of American foreign aid to fight HIV are clouding the prospects. Millett said 'gaping holes in the system' in the U.S. and globally 'are going to make it difficult for us to make sure we not only get lenacapavir into people's bodies but make sure they come back' twice a year to keep up their protection. How does the shot work? Gilead's drug already is sold to treat HIV under the brand name Sunlenca. The prevention dose will be sold under a different name, Yeztugo. It's given as two injections under the skin of the abdomen, leaving a small 'depot' of medication to slowly absorb into the body. People must test negative for HIV before getting their twice-a-year dose, Gilead warned. It only prevents HIV transmission — it doesn't block other sexually transmitted diseases. Some researchers who helped test the shot advise cold packs to counter injection-site pain. Story continues below advertisement Global efforts at ending the HIV pandemic by 2030 have stalled. There still are more than 30,000 new infections in the U.S. each year and about 1.3 million worldwide. Get weekly health news Receive the latest medical news and health information delivered to you every Sunday. Sign up for weekly health newsletter Sign Up By providing your email address, you have read and agree to Global News' Terms and Conditions and Privacy Policy Only about 400,000 Americans already use some form of PrEP, a fraction of those estimated to benefit. A recent study found states with high use of PrEP saw a decrease in HIV infections, while rates continued rising elsewhere. 2:02 Doctors, health experts call on Nova Scotia to cover birth control and HIV-prevention drug About half of new infections are in women, who often need protection they can use without a partner's knowledge or consent. One rigorous study in South Africa and Uganda compared more than 5,300 sexually active young women and teen girls given twice-yearly lenacapavir or the daily pills. There were no HIV infections in those receiving the shot while about 2% in the comparison group caught HIV from infected sex partners. A second study found the twice-yearly shot nearly as effective in gay men and gender-nonconforming people in the U.S. and in several other countries hard-hit by HIV. Story continues below advertisement Ian Haddock of Houston had tried PrEP off and on since 2015 but he jumped at the chance to participate in the lenacapavir study and continues with the twice-yearly shots as part of the research follow-up. 'Now I forget that I'm on PrEP because I don't have to carry around a pill bottle,' said Haddock, who leads the Normal Anomaly Initiative, a nonprofit serving Black LGBTQ+ communities. 'Men, women, gay, straight – it really just kinds of expands the opportunity for prevention,' he added. Just remembering a clinic visit every six months 'is a powerful tool versus constantly having to talk about, like, condoms, constantly making sure you're taking your pill every day.' Shot could 'change nothing' if unaffordable Gilead said the U.S. list price, meaning before insurance, is US$28,218 a year, which it called similar to some other PrEP options. The company said it anticipated insurance coverage but also has some financial assistance programs. Story continues below advertisement Most private insurers are supposed to cover PrEP options without a co-pay although the Supreme Court is considering a case that could overturn that requirement. Congress also is considering huge cuts to Medicaid. And while community health centers still are an option, the Trump administration has largely dismantled HIV prevention work at the Centers for Disease Control and Prevention that would normally get the message to vulnerable populations who'd qualify for the shot, said Carl Schmid of the nonprofit HIV+Hepatitis Policy Institute. Schmid worries the shot won't meet its potential because 'we're basically pulling the rug out of HIV prevention and testing and outreach programs.' Gilead also has applications pending for the twice-yearly shot in other countries. Last fall, the company signed agreements with six generic drug makers to produce low-cost versions of the shot for 120 poor countries mostly in Africa, Southeast Asia and the Caribbean. Gilead plans to make enough shots to supply 2 million people in those countries, at no profit, until the generics are available, said company senior vice president Dr. Jared Baeten. Winnie Byanyima, executive director of UNAIDS, said in a statement the price is still too high. If it's unaffordable, she said, 'it will change nothing.' And HIV experts worry the arrangements Gilead has made to reduce costs in some countries leave out middle-income countries like some in Latin America. 'Everyone in every country who's at risk of HIV needs access to PrEP,' said Dr. Gordon Crofoot of Houston, who helped lead the study in men. 'We need to get easier access to PrEP that's highly effective like this is.'
Winnipeg Free Press
2 days ago
- Winnipeg Free Press
FDA approves the world's only twice-a-year shot to prevent HIV
WASHINGTON (AP) — The U.S. has approved the world's only twice-a-year shot to prevent HIV, maker Gilead Sciences announced Wednesday. It's the first step in an anticipated global rollout that could protect millions – although it's unclear how many in the U.S. and abroad will get access to the powerful new option. While a vaccine to prevent HIV still is needed, some experts say the shot — a drug called lenacapvir — could be the next best thing. It nearly eliminated new infections in two groundbreaking studies of people at high risk, better than daily preventive pills they can forget to take. 'This really has the possibility of ending HIV transmission,' said Greg Millett, public policy director at amfAR, The Foundation for AIDS Research. Condoms help guard against HIV infection if used properly but what's called PrEP — regularly using preventive medicines such as the daily pills or a different shot given every two months — is increasingly important. Lenacapavir's six-month protection makes it the longest-lasting type, an option that could attract people wary of more frequent doctor visits or stigma from daily pills. But upheaval in U.S. healthcare — including cuts to public health agencies and Medicaid — and slashing of American foreign aid to fight HIV are clouding the prospects. Millett said 'gaping holes in the system' in the U.S. and globally 'are going to make it difficult for us to make sure we not only get lenacapavir into people's bodies but make sure they come back' even as little as twice a year. Gilead's drug already is sold to treat HIV under the brand name Sunlenca. The prevention dose will be sold under a different name, Yeztugo. It's given as two injections under the skin of the abdomen, leaving a small 'depot' of medication to slowly absorb into the body. Gilead didn't immediately announce its price. The drug only prevents HIV transmission – it doesn't block other sexually transmitted diseases. Global efforts at ending the HIV pandemic by 2030 have stalled. There still are more than 30,000 new infections in the U.S. each year and about 1.3 million worldwide. Only about 400,000 Americans already use some form of PrEP, a fraction of those estimated to benefit. A recent study found states with high use of PrEP saw a decrease in HIV infections, while rates continued rising elsewhere. About half of new infections are in women, who often need protection they can use without a partner's knowledge or consent. One rigorous study in South Africa and Uganda compared more than 5,300 sexually active young women and teen girls given twice-yearly lenacapavir or the daily pills. There were no HIV infections in those receiving the shot while about 2% in the comparison group caught HIV from infected sex partners. A second study found the twice-yearly shot nearly as effective in gay men and gender-nonconforming people in the U.S. and in several other countries hard-hit by HIV. Ian Haddock of Houston had tried PrEP off and on since 2015 but he jumped at the chance to participate in the lenacapavir study and continues with the twice-yearly shots as part of the research follow-up. 'Now I forget that I'm on PrEP because I don't have to carry around a pill bottle,' said Haddock, who leads the Normal Anomaly Initiative, a nonprofit serving Black LGBTQ+ communities. 'Men, women, gay, straight – it really just kinds of expands the opportunity for prevention,' he added. Just remembering a clinic visit every six months 'is a powerful tool versus constantly having to talk about, like, condoms, constantly making sure you're taking your pill every day.' 'Everyone in every country who's at risk of HIV needs access to PrEP,' added Dr. Gordon Crofoot of Houston, who helped lead the study in men. 'We need to get easier access to PrEP that's highly effective like this is.' ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
Toronto Star
2 days ago
- Toronto Star
California senators demand Trump immigration officials stop using Medicaid data
WASHINGTON (AP) — California's two U.S. senators demanded on Wednesday that the Trump administration stop using personal data of millions of Medicaid enrollees — including their immigration status — as part of its sweeping deportation campaign. In a letter to top administration officials, Democratic Sens. Adam Schiff and Alex Padilla expressed alarm over an Associated Press report last week that detailed how deportation officials had obtained the sensitive data over the objections of career health officials. They wrote that health officials needed to stop sharing the information and that the Department of Homeland Security should 'destroy any and all such data' it had obtained.
