California could become ?sanctuary? for care amid threat to abortion access

California could become a "sanctuary" for people seeking reproductive care if the supreme court overturns Roe v Wade and dramatically curtails abortion access in the US.

The California Future of Abortion Council, made up of more than 40 abortion providers and advocacy groups, and lawmakers on Wednesday released a list of 45 recommendations for California to consider if the high court overturns the 48-year-old decision that forbids states from outlawing abortion.

The recommendations, crafted with help from some of the state's most important policymakers, include possibly paying for travel, lodging and procedures for people from other states. With an estimated $31bn surplus next year, the state has money in its coffers to fund abortion services for patients from other states.

"We'll be a sanctuary," said Gavin Newsom, California's governor, adding he's aware patients will likely travel to the state from elsewhere to seek abortions. "We are looking at ways to support that inevitability and looking at ways to expand our protections."

Abortion access in the US is under threat as the supreme court weighs a law from Mississippi that bans abortion after 15 weeks gestation and ultimately seeks to overturn Roe v Wade. More than two dozen states are poised to ban abortion if the supreme court gives them the OK next year.

The state has already seen the effect of abortion bans in other states. In 2020, Planned Parenthood, which comprises about half of California's abortion clinics, said it served 7,000 people from other states. California affiliates of Planned Parenthood, the nation's largest abortion provider, also reported a slight increase in patients from Texas when a law in that state outlawing the procedure after six weeks of pregnancy went into effect.

A huge influx of people from other states "will definitely destabilize the abortion provider network", said Fabiola Carrion, the interim director for reproductive and sexual health at the national Health Law Program. Out-of-state abortions would also likely be later term procedures, Carrion said, which are more complicated and expensive.

California abortion providers want lawmakers to make it easier for people to get to the state for reproductive care. They recommend funding - including public spending - to support patients seeking abortion for travel expenses such as gas, lodging, transportation and childcare. The plan released Wednesday also asks lawmakers to reimburse abortion providers for services to those who can't afford to pay - including those who travel to California from other states whose income is low enough that they would qualify for state-funded abortions under Medicaid if they lived there.

But the number of people who would come to California for abortions if the supreme court overturns Roe v Wade is not clear. The state does not collect or report abortion statistics. The Guttmacher Institute, a research group that supports abortion rights, said 132,680 abortions were performed in California in 2017, or about 15% of all abortions nationally. That figure includes people from out of state as well as teenagers, who are not required to have their parents' permission for an abortion in California.

The plan also asks lawmakers to help clinics increase their workforce to prepare for more patients by giving scholarships to medical students who pledge to offer abortion services in rural areas, help them pay off student loans and assist with their monthly liability insurance premiums.

"We're looking at how to build capacity and build workforce," said Jodi Hicks, the CEO of Planned Parenthood Affiliates of California. "It will take a partnership and investment with the state."

Abortion opponents in California are also preparing for a potential surge of patients from other states seeking the procedure. But they hope to convince them not to do it.

Jonathan Keller, the president and CEO of the California Family Council, said California has about 160 pregnancy resource centers whose aim is to convince women not to get abortions. About half of those centers are medical clinics, while the rest are faith-based counseling centers, Keller said.

Many of the centers are located near abortion clinics in an attempt to entice people to seek their counseling before opting to end pregnancies. Keller said many are already planning on increasing their staffing if California gets an increase of patients.

"Even if we are not facing any immediate legislative opportunities or legislative victories, it's a reminder that the work of changing hearts and minds and also providing real support and resources to women facing unplanned pregnancies - that work will always continue," Keller said.