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As originally published in the New York Times California Today on Thursday, May 12, 2022.

In anticipation of Roe v. Wade being overturned and abortion quickly becoming illegal in at least a dozen states, California is gearing up to become the nation’s abortion provider.

About one out of six abortions in the U.S. are already performed in California, a figure that’s expected to rise as access constricts elsewhere. Gov. Gavin Newsom on Wednesday proposed a spending plan that includes $40 million in grants to offset the cost of abortions for uninsured women from both inside and outside the state.

“We’re going to fight like hell, making sure that all women — not just those in California — know that this state continues to recognize and protect their fundamental rights,” the governor said in a statement.

Twenty-eight states are expected to ban or tightly restrict access to abortion if the landmark 1973 ruling is overturned, as a leaked draft opinion by the Supreme Court indicates. Democrats in the Senate tried and failed on Wednesday to push forward legislation that would have safeguarded abortion rights nationwide.

So California, as the nation’s most populous state and one with the fewest barriers to abortion, is likely to see a major influx of patients if Roe falls, experts say.

Already, the number of out-of-state patients seeking abortions in California has jumped in recent months.

After Texas’ rollout of the nation’s strictest abortion law, the number of women from other states showing up at Planned Parenthood clinics in Orange and San Bernardino Counties increased to 20 per month from four per month, the chapter’s medical director, Dr. Janet Jacobson, said.

Last week, a 26-year-old mother from El Paso arrived at the Planned Parenthood health center in Orange for an abortion. She had left her children with her sister, gotten in her car after work and driven through the night to reach the clinic.

“That is a 750-mile drive — for a five-minute procedure,” Jacobson told me. “Those stories are no longer unusual for us.”

Jacobson’s Planned Parenthood chapter has started a program that helps defray the costs of lodging and travel for patients seeking abortions. There’s a proposal in the State Legislature that would set up a similar program at the state level, part of a package of 13 bills that would make abortions easier to get in California.

If Roe were to be overturned, the number of out-of-state women whose nearest abortion provider would be in California would jump to 1.4 million from 46,000, according to a report from The Guttmacher Institute, a research group that supports abortion rights.

That figure doesn’t include women who may have clinics closer to their homes, but choose to come to California because there are fewer barriers to care here or because the clinics near them are overwhelmed. In other words, it doesn’t account for the women from Texas already choosing to come to California.

“We know that people, especially as wide swaths of the country become hostile to abortion services, will chose to fly rather than drive,” Brandon Richards, spokesman for Planned Parenthood of California, said.

But there will remain people who cannot afford to travel to California or other abortion-friendly states.

Before the pandemic, Dr. Moira Rashad regularly traveled from the Bay Area to Phoenix to perform abortions there. She pointed out that in Arizona and elsewhere, women who seek abortions are more likely to be poor, so it’s difficult for them to take time off work or afford travel to California.

“These laws always more heavily impact marginalized communities,” Rashad told me. “It’s something we’ve kind of been anticipating would happen since this case got to the Supreme Court, and it’s still so devastating.”

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