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As originally published in The New York Times on July 11, 2022.

Since the Supreme Court struck down Roe v. Wade last month, California has embraced its role as a primary abortion refuge.

With the right to abortion guaranteed in California’s Constitution, state leaders and abortion rights advocates have been preparing for an influx of patients from states where abortion is now banned or severely restricted.

“California has led the way in showing what a state can do proactively to protect abortion rights and access,” said Mini Timmaraju, the president of NARAL Pro-Choice America. “In a post-Roe world, this kind of forward-thinking action is more important than ever.”

In the two and a half weeks since Roe was overturned, there’s been a flurry of activity:

  • State legislators agreed to put a constitutional amendment on the November ballot that would enshrine the right to abortion in the state.
  • Lawmakers passed a state budget that commits $200 million to abortion and reproductive health care, including $40 million to cover abortions for people who can’t afford them, including those from out of state. (The budget does not include funding for the cost of travel for out-of-staters, however.)
  • Gov. Gavin Newsom signed a bill to shield California abortion providers from liability or prosecution related to out-of-state bans on abortions. Plus, more than a dozen additional bills fortifying access to abortion have been moving through the Legislature.
  • Newsom also announced an agreement with Oregon and Washington leaders to establish a West Coast abortion firewall that would protect providers and patients from the legal reach of other states.

California already has adopted measures over the past several years to make abortion more accessible and affordable, long before Roe was overturned. The state is home to a quarter of the nation’s health facilities that offer abortions, and already about one in six abortions in the U.S. are performed here.

In 2013, California passed a law allowing nurse practitioners to perform first-trimester abortions — part of an effort to address a shortage of physicians willing to do the procedure, especially in rural areas. In 2019, Newsom signed a law requiring all public universities to provide medication abortion on campus, landmark legislation in the eyes of abortion rights advocates.

“It really changed what was considered acceptable and normal health care in a lot of ways in California,” said Ushma Upadhyay, an associate professor at the University of California, San Francisco, who studies abortion access. “California has a very long history of being at the forefront of abortion rights.”

A California doctor has proposed a floating abortion clinic in the Gulf of Mexico to help provide abortions to patients from southern states. Without options closer to home, the fall of Roe means that approximately 10,600 more people will travel to California each year for abortion care, with the majority coming from Texas or Arizonaaccording to a U.C.L.A. report.

Just hours after the Supreme Court ruling in Dobbs v. Jackson, patients from outside California began calling Planned Parenthood clinics in Orange and San Bernardino Counties. The chapter has started a program that helps defray the costs of lodging and travel for patients seeking abortions.

The clinics experienced a fourfold increase in out-of-state abortion patients after Texas enacted a strict abortion law last fall, said the chapter spokeswoman Nichole Ramirez. Since the Roe decision, those figures have jumped even higher, as women from Arizona and other states make the hourslong trek to the clinic for care.

“In the 12 days post-Dobbs, we saw the same amount of out-of-state abortion patients that we would typically see in an entire month,” Ramirez said in an email.