Opinion: State’s abortion access ecosystem pushed to limit two years after demise of Roe v. Wade

Bold actions – and sometimes painful decisions – are being made to meet the demands of this crisis.

Interior of the U.S. Supreme Court

Interior of the U.S. Supreme Court CHBD

June 24, 2024, marked two years since the U.S. Supreme Court overturned Roe v. Wade, eliminating the federal right to abortion across the country. This devastating news not only had an immediate harmful impact on pregnant people but initiated a ripple effect of grave challenges for reproductive health care at large. Abortion bans threaten the sustainability of health care providers and abortion access funds, even in states considered safe for abortion care, like New York. Two years after the end of Roe, it's time to say the quiet part out loud: New York’s abortion access ecosystem is being pushed to the limit. 

According to the American College of Obstetricians and Gynecologists, medical practices will experience an 8% increase in operational costs over just two years due to inflation. On top of inflation, sexual and reproductive health care providers and patient support systems are grappling with compounding challenges: pandemic recovery, national staffing shortages, a dearth of abortion care providers in the state’s rural regions and a hostile political landscape that is driving up demand for abortion care. Unsurprisingly, insurers' attitudes toward reproductive health care haven’t changed, leaving many providers to absorb astronomical costs to care for their patients. Planned Parenthood is proud to deliver a wide range of sexual and reproductive health services, including abortion, regardless of anyone's ability to pay, while abortion funds like the New York Abortion Access Fund help close the gap in costs and practical support groups like The Brigid Alliance make sure people can travel to get to their appointments. However, despite the rising costs of rendering that care, funding – including public and private insurance reimbursement rates – remains largely stagnant. The ever-widening gap between reimbursement and expenses threatens the sustainability of our programs and puts abortion access at risk. 

In this past legislative session, both chambers of the Legislature indicated support for increasing Medicaid reimbursement rates for medication abortion, but ultimately, this vital increase was not included in the enacted budget. More than 50% of patients at Planned Parenthood health centers rely on Medicaid for their health care coverage. Medicaid is a critical program that ensures New Yorkers with low incomes have access to high-quality, comprehensive health care. New York elected leaders understand that comprehensive health care coverage must include sexual and reproductive services and abortion. We are fortunate to live in a state where abortion is covered by the state’s Medicaid program, which is not true across the country, but it’s not enough. Other abortion-access states like California, Illinois, and Oregon have taken steps to increase Medicaid reimbursement for medication abortion. New York providers also need equitable compensation by state and commercial payers for the cost of delivering essential, life-saving care to their local communities. The state’s failure to increase reimbursement rates for medication abortion was a missed opportunity to make a systematic, long-term investment in New York’s abortion access infrastructure. For New York to cement its position as a leader in the fight for reproductive rights it must increase Medicaid reimbursement rates and double down on its dedication to ensuring access to care at all gestations. 

Nonprofit health providers and abortion access funds deeply rely on the unwavering supporters of our elected champions, our advocates and our donors. In 2022, donors, outraged by the Supreme Court's wrongful decision to overturn Roe v. Wade, showed an outpouring of support for abortion patients, providers, and access funds. Two years later, the increase in giving motivated by the loss of Roe is leveling off while the demand for care and the cost of providing it continues to rise steeply. Since the Dobbs decision two years ago, people nationwide are getting fewer health benefits and services at higher costs, abortion seekers are experiencing that crunch tenfold. Thanks to our donors and local and national abortion access funds like the New York Abortion Access Fund and The Brigid Alliance, patients from out-of-state are relieved of the worry of having to pay for transportation, lodging, child care and coverage for their procedures. As we strive to compensate for systemic flaws in private and public funding, philanthropy remains critical to our ability to service our communities.

Our transparency is not meant to alarm but to inform our patients and supporters as we actively work to preserve and protect long-term access to our services for the most marginalized New Yorkers – BIPOC communities, LGBTQ+ people, people who have recently migrated to the U.S. and families with low incomes. As leaders, we are all being called to respond to this urgent moment with bold actions – and sometimes make painful decisions – to meet the demands of today, tomorrow, and the future.

This opinion was co-authored by the CEOs of New York’s Planned Parenthood affiliates