In the ongoing war on women’s reproductive rights, the mounting pile of state-level abortion restrictions are pulling some parts of the country back to a time before Roe v. Wade, when a woman’s abortion access was largely dependent on her privilege. Even though Roe still stands, it doesn’t necessarily do much to protect the economically disadvantaged women who live in states that are hostile to abortion rights. That’s because anti-choice lawmakers are using several effective tactics to drive up the cost of abortion, essentially pricing poor women out of their reproductive rights.
Many Americans may not think of abortion rights as an economic justice issue. But the mounting economic barriers that stand between women and their reproductive care provide evidence that it is, in fact, an area that has an outsized impact on poorer Americans. Here’s how state lawmakers are working to make abortion too expensive for low-income women to access:
— Placing restrictions on the abortion pill. Non-invasive first-trimester abortions — in which women can safely terminate an early pregnancy by taking the RU-486 abortion pill — are the most common type of abortion care. The pill is an important reproductive resource particularly for low-income women who live in rural areas, and may not be able to travel to a clinic that offers surgical abortion procedures. Some states are attempting to improve those women’s access to abortion care even further by allowing them to use video technology to take the pill while supervised remotely by a doctor. But anti-choice lawmakers are waging a coordinated campaign against this practice, which they decry as “webcam abortion.” Just last week, Mississippi became the latest state to impose additional hurdles for women taking the pill, when Gov. Phil Bryant (R) signed a measure requiring the physician to by physically present to prescribe RU-486 and the women to make an in-person follow-up appointment.
— Driving up the cost of the abortion pill. When lawmakers place unnecessary restrictions on the abortion pill, they don’t just force disadvantaged women to figure out how to make a potentially expensive trip to a clinic. They also often drive up the cost of the pill itself. Several of the measures designed to make it harder for abortion clinics to prescribe RU-486 actually require clinics to adhere to an outdated FDA standard for the pill. The old standard requires a higher dosage, and that higher dosage necessitates a higher price. Medical experts, including the World Health Organization, agree that there is no real health benefit to increasing the medication’s dosage.
— Forcing abortion clinics out of business. Across the country, abortion opponents are advancing measures to force health clinics to close their doors. Just like tightening the requirements for the abortion pill, it’s easy for anti-choice lawmakers to make the case that strict standards for clinics are simply designed to keep women safe. But these laws aren’t about women’s safety at all. They represent an indirect method of attacking abortion access by going after the providers instead of banning the procedure itself, and they’re incredibly effective at forcing abortion clinics to shut down. And that means low-income women will incurr financial hardships — such as travel costs, the price of childcare, and missed wages at work — to travel farther distances to access the reduced number of clinics in their state. If some women are forced to delay their abortion services because they can’t travel to a clinic in time, they will end up paying even more money, since later abortion services become increasingly more expensive.
— Blocking insurance coverage for abortion services. Abortion opponents have successfully blocked public funding for abortion with the Hyde Amendment, which prevents the federal government from directly paying for abortion services. The majority of states across the country have adopted their own versions of this funding ban as well, so just 17 states will cover medically necessary abortions for poor women on Medicaid. It’s a popular talking point to make the case that the government shouldn’t pay for abortion — but in practice, that simply means that low-income women in the Medicaid program can’t get any insurance coverage for their reproductive care, and must pay for the entire procedure themselves. It’s not as much of a hardship for economically privileged women to pay out of pocket, but poorer women often can’t afford hundreds of dollars for an abortion. And now abortion opponents are attempting to use Obamacare to restrict abortion coverage for women who have private insurance plans as well.
There are class issues at play before and after abortion, too. Low-income women are less likely to have reliable access to contraceptives, and therefore have higher rates of unintended pregnancy and abortion. Understandably, considering all of the financial hardships that poorer women face as they attempt to obtain an abortion, not all of them are able to successfully terminate an unwanted pregnancy. But it’s a vicious economic cycle. If a woman cannot successfully obtain an abortion when she would have preferred to have one, she’s more likely to fall deeper into poverty.