Parker Dockray has heard the budget trade-offs before: Does the cash go toward groceries, bills or rent? Or does it pay for an abortion?
She’s heard the brainstorming on what can be quickly sold, like furniture or electronics, to pay for the abortion.
She’s heard from the parents who already know the costs involved in raising a child — on the financial, time, emotional and career fronts — and say it’s a commitment they are not prepared to make.
“It takes a week to save $200 and then the procedure is $200 more expensive, so you are stuck in the same place,” said Dockray, the executive director of All-Options, a national organization with services including a talkline to help pregnant women with whatever steps they think are best. That could be support for parenting, adoption or abortion.
The nonprofit also has Indiana’s only statewide abortion fund, with an annual budget of around $100,000. In the requests it can fill, Dockray said, the fund pays $270 on average. Out-of-pocket costs for the procedure alone can cost between $500 and $900 for those not traveling outside of Indiana, which has several restrictions on abortion in effect.
Abortion access and affordability already pose a challenge for many women, even as Roe v. Wade, the 1973 Supreme Court ruling recognizing a federal constitutional right to abortion, still stands as law, Dockray said.
But the Supreme Court’s conservative majority appears poised to overturn the ruling and leave decisions on abortion access in the hands of state legislators and voters, according to a leaked draft opinion. More than 20 states already have statutes regulating abortion access, and many have “trigger laws” ready to ban abortion if Roeis overturned.
If abortion access becomes a state-by-state matter, “I think the reality is people with money will travel; they will find care somewhere else,” Dockray said. Some blue-chip corporations are already saying they’ll foot the bill for travel costs.
But salaried jobs may not be the reality for many women who are considering an abortion. Almost half of abortion patients were living below the poverty line in 2014 and another quarter were at or just a bit above it, according to the Guttmacher Institute, a think tank that supports abortion access.
Private insurance and health plans in Indiana on the state’s exchange, established via the Affordable Care Act, only cover abortion in instances of rape, incest and life endangerment, or the risk of a serious compromise to a woman’s health, the organization said. The Hyde Amendment also restricts federal funding for abortions for enrollees in Medicaid, Medicare, the Indian Health Service and the Children’s Health Insurance Program, though 16 states use their own funds for abortions under Medicaid.
Median out-of-pocket charges for medication abortion, which is now estimated to make up more than half of all U.S. abortions, rose from $495 to $560 between 2017 and 2020, according to research published last month in the journal Health Affairs. The median charges for first-trimester procedural abortion increased from $475 to $575, while charges for second-trimester abortion declined from $935 to $895. The share of clinics accepting insurance ticked down from 89% to 80%.
Read more: The next abortion battle could be over pills
Dockray estimates that All-Options has raised at least $50,000 from roughly 700 donors, most giving small-dollar pledges, since Politico broke the story on the draft Supreme Court opinion.
If the draft decision becomes the final result, Dockray expects more women to call organizations like hers, needing more money to cover steeper costs — with the financial fallout more widespread for some of the women who ultimately did not have an abortion. The potential toll “is hard to quantify, but it’s pretty intense,” she said.
“‘Our research provides strong evidence that these types of restrictions will have long-run negative effects on women’s financial and economic well-being.’”
— New York University professor Laura Wherry
Economists and abortion-rights advocates have issued estimates of the financial consequences of a world with and without Roe, particularly for low-income women and women of color. Anti-abortion advocates, for their part, say these estimates are overstated and cannot be traced to abortion access.
There’s “a substantial body of well developed and credible research that shows that abortion legalization and access in the United States has had — and continues to have — a significant effect on birth rates as well as broad downstream social and economic effects, including on women’s educational attainment and job opportunities,” according to an amicus brief 154 economists submitted last year to the underlying Supreme Court case involving Mississippi’s 15-week abortion ban.
The brief points to findings from several studies, including one that found women who ended an unplanned pregnancy had an 11% increase in hourly wages later on. With abortion access, the women in another study increased their chances of finishing college by almost 20%, and boosted their probability of entering a professional occupation by 40%. The effects were particularly pronounced among Black women, the authors said.
Another 2020 study cited in the brief from New York University and University of Michigan researchers asked what came of the finances for women turned away from abortion clinics because they were too far along in pregnancy.
Compared to counterparts who did receive abortions, the “turnaway group” of 180 women faced a 78% increase in past-due debts in the following five years, as well as “an 81% increase in public records related to bankruptcies, evictions, and court judgments,” the amicus brief said. (The study was an offshoot of a larger longitudinal study on the lives of women who did and did not have abortions at a certain point.)
If Roeis overturned, those findings could be replayed on a larger scale, New York University professor Laura Wherry, one of the study’s authors and amicus brief co-signers, told MarketWatch. “Our research provides strong evidence that these types of restrictions will have long-run negative effects on women’s financial and economic well-being,” she said.
There were nearly 630,000 legal induced abortions in 2019, according to the Centers for Disease Control and Prevention. That comes to 11.4 abortions per 1,000 women ages 15 to 44, and a ratio of 195 abortions per 1,000 live births, the agency said. The number of abortions decreased 18% from 2010, while the rate and ratio decreased 21% and 13% respectively, the data showed. Experts say the decline in abortions in recent years seems to be related to a decrease in pregnancies and births.
Women in their 20s accounted for roughly 57% of abortions in 2019 and the large majority, nearly 93%, were performed at or before 13 weeks of gestation. Four decades earlier, in 1979, there were 1.25 million legal abortions, according to CDC data.
“The potential overturn of Roe ‘will also dramatically impact the ability of women to participate fully in the American economy by reducing their labor-force participation, cutting into their earnings, and increasing turnover.’”
— C. Nicole Mason, president and CEO of the Institute for Women’s Policy Research
The Supreme Court decision, expected in June or July, comes at a time when the pandemic is stacking new workforce challenges for women onto longstanding ones like the narrowing but persistent pay gap. Women on average make about 83 cents on a man’s dollar, with even wider pay gaps between women of color and white men. That overall figure is up from 62 cents on the dollar earned in 1979, according to the Bureau of Labor Statistics.
Meanwhile, a separate amicus brief urging the landmark ruling’s reversal listed various laws predating Roethat pushed women’s economic power and protections to new heights, including the 1963 Equal Pay Act, the 1964 Civil Rights Act, the 1968 Fair Housing Act and the 1972 Equal Employment Act.
“Not one of these pre-Roelaws or cases was predicated on women’s access to abortion, yet they laid the foundation for subsequent legal developments that continue to contribute to sexual equality,” the filing noted. It also questioned research like the study on the financial records of the turned-away women, saying the small sample size was a flawed basis to suggest the economic harms.
(Wherry defended the study’s methods and statistical standards, and said the design accounted for the sample size.)
There is, regrettably, a “motherhood penalty” forcing too many women to choose between career, earnings and children, said Teresa Collett, an author on the anti-abortion amicus brief and a professor at the University of St. Thomas who directs the school’s Prolife Center — but an abortion isn’t the solution, she said. Indeed, life post-Roe would “actually incentivize both the state and federal government to get serious about pregnancy discrimination,” Collett said.
If the draft decision turns out to be the final product, Marjorie Dannenfelser, the president of the anti-abortion Susan B. Anthony List, said her organization “wholeheartedly applaud[ed]” it.
Dannenfelser said the organization recognized “the need for the pro-life movement to continue its existing work to support pregnant women and children in need.” “There are thousands of pro-life pregnancy centers and maternity homes nationwide and an ever-growing pro-life safety net,” she said. “The pro-life movement will continue to grow to meet the needs of these women and their families, walking and planning with them to love and serve both mother and child.”
While Collett questioned the link between abortion access and women’s economic power, C. Nicole Mason, the president and CEO of the Institute for Women’s Policy Research, said it’s there.
“The potential overturn of Roe will inflict enormous damage to women’s equality. But it will also dramatically impact the ability of women to participate fully in the American economy by reducing their labor-force participation, cutting into their earnings, and increasing turnover,” she said. “Add it all up, and the impact on women and their families of this dark day in history is potentially devastating.”
The various restrictions already in place are costing state economies a combined $105 billion annually from turnover, time off and reduced wages of women ages 15 to 44, according to the Institute for Women’s Policy Research. If all state restrictions were wiped away, women in that demographic would make almost $102 billion more per year, the Washington, D.C.-based think tank projected.
Those are big money projections, but back at All-Options, Dockray says the presence or absence of smaller sums — like the incidental travel costs many women face if they choose to proceed with an abortion, or the costs from missed work — already have decisive consequences.
“A lot of us don’t realize how on the edge how many people live,” Dockray said.