Jan. 22, 2017, marks the 44th anniversary of the Supreme Court’s ruling in Roe v. Wade, which legalized abortion care in the United States. And as the post 44 years have shown, abortion access is an issue that affects individuals from many backgrounds — racial, ethnic, financial, geographic.
But one group that is perhaps disproportionately affected by the ways in which abortion has been regulated — and restricted — over the past 44 years is low-income Americans in need of abortion care who are too often effectively barred from it because of cost.
Why? The Hyde Amendment, the 40-year-old budget rider that bans federal funds from going toward abortion care, a measure that keeps abortion from being the only — the only — medical procedure banned from Medicaid coverage. As a result, the poorest people in America are kept from having insurance coverage for a procedure that, without coverage, can cost $400 to $1,500 on average, depending at the point in gestation when the abortion is performed. And this procedure, which 70 percent of those seeking abortion care in the U.S. pay for out of pocket, is one that can radically alter the course of a person’s life should she be forced to carry an unplanned pregnancy to term.
After all, according to the National Network of Abortion Funds (NNAF) 75 percent of those who seek abortion care say that they have the procedure because they are unable to afford a child. Almost 70 percent of people obtaining abortions have an income that is under 200 percent of the federal poverty level: $10,830. And low wages combined with lack of insurance coverage can be truly insurmountable, especially when combined with the travel and childcare costs many women must incur in order to access abortion care in the U.S.
Which is where abortion funds can come in.
The National Network of Abortion Funds
The NNAF is comprised of a network of about 70 independent abortion funds across the country, groups that do everything from helping women pay for abortion procedures to helping cover costs for travel or assisting with lodging and childcare associated with an abortion procedure.
The NNAF and its member organizations received 116,000 calls in 2016 from women in need of financial assistance for their abortion procedures. Abortion funds are nonprofit organizations that raise funds that can then be distributed to individuals who, without this aid, would not be able to afford an abortion. Strikingly, of all the calls the NNAF and its member organizations received this year, they were only able to support 30,000 people with $3.5 million in abortion funding and another $90,000 in travel assistance and childcare.
An upcoming paper being published in the Journal Social Work in Health Care notes that the average cost of the abortion that patients who contact the NNAF’s Tiller Memorial Fund for assistance was $2,248, and abortion costs were highest for adolescents 11-13, whose procedures cost an average of $4,016, and adolescents 14-17, whose procedures cost on average $2,696. The average amount of funds patients had to contribute toward their procedures, the researchers found, was $535, though. And on average, patients received a pledge of $258 from NNAF, with a range of funding from $30 to $8,000.
And the need for abortion funds stands to only grow under the Trump administration with its talk of repeal of the Affordable Care Act, repeal of Medicaid expansion, cuts to Title X (the federal family planning program), and defunding of Planned Parenthood. These are all measures that would only make the financial situations and burdens more pronounced for those who need help. Financial circumstances often contribute to the decision to have an abortion, so these measures would effectively bar those who need abortion care.
But the election of Donald Trump to the presidency is also having a perhaps unintentional effect on abortion fundraising efforts — NNAF executive director Yamani Hernandez tells Yahoo Beauty that the NNAF raised four times more money in November 2016 than it raised in all of 2015, with an 80 percent increase in total money raised between November and December 2016 compared with 2015. Furthermore, six times more people became new donors to the NNAF than in the previous year.
Women’s Medical Fund
Marah Lange is the Program Coordinator of the Women’s Medical Fund in Philadelphia. She explains to Yahoo Beauty that the political climate of a state and the social culture of its communities can often predicate the need for funding for abortion care — and for advocacy to helps raise donations for abortions funds.
The helpline run by the Women’s Medical Fund is staffed five days a week with students and volunteers, and, Lange notes, the women calling seeking financial assistance from the fund have usually already made the decision to have an abortion and made their appointment for the procedure — but are just trying to make the procedure financially viable.
“We work with each person to try to apply funds in an equitable manner, to try to stretch the fund. There’s never enough,” Lange says.
And yet, Lange says, the relationship between funds and providers and patients is a dynamic, and deeply compassionate one.
“Here’s the thing that quickly become evident with each of our callers. More so than any other medical procedure, the providers these women go to are advocating for their patients. I would tell women seeking abortion care, but worried about the financial component, to talk to folks at the clinic — often, they’ll be the ones to refer you to an abortion fund or find a way to help you. They will strategize on how to make a plan so you can get the care you need,” Lange says.
She adds, “I think that one of the things that a lot of people don’t recognize is that for a lot of the women we talk to, making a decision to terminate a pregnancy is making a decision to take care of their families. Most of the women we speak with already have one child — they’re making a decision so they can best care for the children they have. They are usually trying to find a job, get on a better path, and an unplanned pregnancy is just another barrier to overcome all that poverty sets up for folks. Being able to access and afford an abortion might just feel like a moment in time for some people, but for a lot of women, that moment might be what they need to stay on track — to stay in school, to keep a job and then advance in that job. It’s a decision that can help with a lifelong track. It’s not incidental.”
“We try to be a soft landing place for folks struggling to overcome a lot of other obstacles,” Lange says of the work of the Women’s Medical Fund. “Maybe we can only help with $100 for the cost of their abortion, but maybe we can also connect them with a shelter so they can be safe or have a place to live if they are homeless. Our counselors can make what might seem like a simple few-minute conversation into something where women can get access to as many resources as we have to possibly connect them with.”
The Lilith Fund
Amanda Williams is the executive director of the Lilith Fund, based in Austin, Texas, and describes the group’s work to Yahoo Beauty as “providing small grants to people who need abortion and can’t afford it.” But the group is also a grassroots organization that works to “advocate for change in the movement for reproductive justice.”
“I think that in general, there’s a lack of awareness around the cost of abortion and how the restrictions can equate to additional expenses. In Texas, because so many clinics have closed down, more of our clients are traveling out of state, more of our clients are traveling longer distances within the state to get to the nearest clinic — and since two-thirds of our clients are already mothers, then they are incurring the cost of childcare. There’s the cost of gas or a bus ticket or a plane ticket. Taking time off of work. Hotel and lodging. The costs just add up. When it comes to abortion, the procedure itself can be out of reach — and then the logistical hoops that people have to jump through can be incredibly difficult for people to navigate and pay for,” Williams says.
She continues, “A lot of people don’t realize how these expenses can add up and push abortion even further out of reach for those in poverty, those without secure housing, without secure transportation, without support. This is a process that can take a lot of support not only from the people close to you, but from the systems from which the people we serve have often been disenfranchised.”
Which is why abortion funds like the Lilith Fund do so much more than just help cover the costs of an abortion procedure itself.
“The Lilith Fund feels that we can’t holistically advocate for our clients by providing direct financial support alone — we must make systemic changes at every level,” says Williams. “For us, that means fighting for policies that protect our clients’ full lives. We try to embody the framework of reproductive justice and approach our work in an intersectional way by plugging into other movements that look to build better lives for the people we serve. Housing, fair pay, immigration, LGBTQ equality — we work to do our best to work across movements and show up for other causes because we know that abortion isn’t the only thing facing our clients when they call our hotline. A lot of our clients would want to be a parent if they had the resources to create the lives they wanted and the families they wanted. But housing plays a part in their experience, racism plays a part in their experience, discrimination plays a part in their experience.”
Which is why, Williams says, “we have to normalize the connection between abortion, reproductive justice, human rights, social justice, immigrant rights, racial justice because they are all intrinsically linked. And when we show up and leverage our position in our movement to advocate for other movements, we can build power together.”
Access Reproductive Care – Southeast
Oriaku Njoku is the co-founder and executive director of the Access Reproductive Care (ARC) – Southeast, an abortion fund based in Atlanta. She describes the work of her organization as “a reproductive justice organization that helps folks in the Southeast access safe, affordable, and compassionate reproductive health care.” ARC-Southeast also runs a helpline to assist those in need of funding for abortion care and also provides what they refer to as “technical support” — that is “rides to a provider, lodging, help paying for childcare for when someone goes for their abortion.” Furthermore, “We also do a lot of work on building power in communities of color.”
“There is no one type of abortion. And there is no one type of person who needs these services. We have folks we serve who are students, who are parents, who have served our country in the military. There are people who come from a variety of religious background. We live in the Bible Belt — we’re in the South — and most of the people we serve are religious in some way, shape, or form,” Njoku says.
And yet, the diversity of lived experience of those seeking abortion care often finds common ground in the financial burdens faced by those most in need of this care.
“There are people who have insurance and work full-time, but their deductible is too high to be able to afford this on their own. Some people are unemployed and looking for work. Some people are already parents and think there is no way they can even think about bringing another person into this world when they’re already struggling to care for my family as it is now. Because there has been practically no Medicaid expansion in the South — and those states that have it, that expansion is now in jeopardy [under the Trump administration] — people just don’t have the means to afford abortion care,” Njoku says. “Folks cross state lines to access this care, especially because of gestational age barriers that make abortion care even harder to access because of regulations involving mandatory waiting periods.”
“Not many people know that we’re out here,” Njoku continues, “but there are abortion funds all over the country doing beautiful work. And especially in this moment when we are trying to protect our rights — and we have had the right for 44 years now of abortion being legal — people are realizing what’s at stake. And they’re saying, ‘What can I do? What can I do to support people in my community? What are things we can do for folks we live with and work with and love with and how can we support them?’ Abortion funds are one way — we help ensure that the access to abortion care is not taken away.”
And with the Trump presidency just beginning, Njoku says abortion funds are more critical than ever, especially in the South.
“Abortion funds have the potential to be organizing powerhouses. Because of the relationships we have with the people we work with every day, we can be a place to create an environment to amplify the voices of the people we serve and to ensure that they continue to have rights,” Njoku emphasizes. “Being from the South, active resistance and revolution and social change is not something that is new. Southerners and people of color in the South have gone through so much historically that we’re ready for this. We’re ready for what’s coming. It’s not just the abortion piece. Our helpline will not stop because there is a new person in office. We will keep trying to fund abortion and increase access. The new administration is a catalyst for us to keep doing the work we do, and we hope people will join us and mobilize and protect rights here and make the world better for everyone.”