California Latinas for Reproductive Justice Group Fears Local Repercussions of Abortion Ruling

In the days since the U.S. Supreme Court’s controversial decision to strike down the longstanding constitutional right to abortion, huge protests and marches have taken place across the country. The ruling, which gives states the authority to ban abortion procedures, will force scores of pregnant people to consider crossing state lines to seek treatment.

Experts say the decision likely will have a disproportionate impact on lower-income communities and people of color, especially in areas like the Central Valley that already have limited access to reproductive health care, making it harder to access health services as people from out of state search for similar appointments. According to Dr. Herminia Palacio, president and CEO of the Guttmacher Institute, 26 states are certain or likely to ban abortion completely, including 13 states that have “trigger” laws in place that automatically enacted bans once the decision was announced.

KQED's Natalia Navarro spoke with Laura Jiménez, director of California Latinas for Reproductive Justice, about the impacts of the Supreme Court's recent decision to overturn Roe v. Wade.

This interview has been edited for brevity and clarity.

NATALIA NAVARRO: We had you on the show early last month when the draft opinion was leaked, suggesting the court would rule this way. We talked a lot about access to care and how organizations like yours were preparing. Does anything change now that the ruling is official? 

LAURA JIMÉNEZ: I don't think anything changes now that the ruling is official. I think we're still just in a defensive mode, I guess. We're really looking to see how we can best prepare ourselves to support not only the folks or residents here in California, but also any of our folks that need to come from out of state to seek health care services or seek abortions here in the state.

There's been a lot of stuff on the news, people talking about the influx of patients starting to come to California for care from nearby states now with abortion bans. But according to your organization, half of California counties already don't have an abortion provider. What is being done, if anything, to improve access within the state?

We have seen some really great forward steps from the governor and from the Legislature. I think they've got a total of $125 million that they put into the budget to put the money where their mouths are in terms of making California a sanctuary state for abortion. And so that means that there's funds, there's money going towards paying for abortions.

There's also commitment to funding community-based organizations and reproductive justice organizations for incentivizing people who are medical students of some kind to go into abortion, reproductive health, medicine, so that we have more providers. It's 40% of counties in California that don't have an abortion provider currently.

So we know that there is a shortage of providers. And if we have a larger influx of folks coming into the state, it's going to make that situation even more dire. Organizations like California Latinas for Reproductive Justice have been saying for years, we have great legal access to abortion in the state of California, but practically that legal access doesn't play out the same way for everyone.

And as you mentioned, for example, in areas of the state, such as the Central Valley that are remote or rural, people can't always just say, "Well, I'm just going to go to the clinic on the street." They may actually be looking at coming to the Bay Area or to Los Angeles or another part of the state where they can get access sooner or in the case of them just not having a provider in their county just at all.

Is there any special focus on rural communities getting more providers that will actually practice in those communities? 

That's been something that we've been working on for a long time. And several years ago, some legislation was passed to make sure that advanced practitioners, certified midwives and also physician assistants and nurse practitioners all can practice to the full scope of their license so that they could all provide first-trimester abortions, which was not something that was being practiced or always being allowed.

That was so people could see the practitioners they're used to seeing at home to get the abortion care that they need. There's about 15 bills going through the Legislature addressing this issue right now. And so there's a couple of them that I believe are really focusing on trying to make sure that there are more folks in the pipeline learning about abortion and how to provide it. So hopefully as they're trained, they can then be deployed out to some of the areas of the state that have the most need.

What policies should California be focusing on to increase access in the state? 

I think right now what is really important is that there is the constitutional amendment working its way through the Legislature so that it can get on the ballot. And I think that's a really important protection for California. We've been watching the Supreme Court, not just this session, but over the many years that they've been trying to chip away at Roe v. Wade.

It's important for us to really shore up the legislation that we have here in California to make sure that there aren't any loopholes. I think I just saw [that] some 19th-century law from Wisconsin is now going into effect because of the Supreme Court ruling. So focusing on that right now is really important for those of us that are advocates and also for everybody who is out there listening — it's really important to pay attention to what's happening because I think many folks don't really think about this until they or somebody that they love needs these services.

And then when they see how challenging it can be, even in a state like California, to access an abortion, then it hits home. We need to be really focused on understanding that sometimes, there is access where we live. But we also have the crisis pregnancy centers that operate in ways that don't always give people the full information that they need when they're pregnant and trying to make a decision, or are trying to actively dissuade them from getting abortions.

And we know that there are many more of these crisis pregnancy centers than there are abortion clinics, even in California. And because the Supreme Court ruled against our regulation of those clinics here in California a few years ago, we are basically stuck with them. And they use deceptive practices to dissuade people from getting abortions.

The constitutional amendment you mentioned earlier is working its way through the California Legislature to codify the right to an abortion in the California Constitution. Within California, is cost an issue? Is insurance coverage an obstacle here? 

I think cost can always be an issue, even if there is insurance coverage. And that is because for those that maybe don't know this, the cost of an abortion changes as the gestational age moves on, as you get further along into your pregnancy. And so if you can get an abortion very early in the pregnancy, that might be fairly affordable.

Once you start looking at going further into the pregnancy, it becomes more expensive. And so the reason that's challenging is that sometimes folks are trying to get funds together or they're trying to figure it out. For example, if somebody who's living in a remote or rural area needs to get to LA, they need to save the money for a train ticket or a plane ticket or child care. They need to take off work.

They might have a myriad of things that they have to consider, all of which may cost them money. So it's not always just whether or not the abortion is covered. It's also what they have to do and what they have to pay for to make it happen. And that is why we continue to say this is going to affect poor people, folks of color more severely. We need to really center the solutions that we are coming up with around those most vulnerable in our state.

A large portion of abortions in the U.S. are done by pill, not surgery. Is telemedicine going to be a big solution to focus on here? What role might it play in access?

Absolutely. I think that we work with a number of partners that have been trying to make this a more accessible way of getting abortions. And it has run into lots of barriers from the previous presidential administration. I do think now that states have those trigger laws, it is even more important that we look at how telehealth can be one of these lifelines for folks not only in those states, but here in California.

Even if you're in a remote area, being able to have a telehealth appointment and have those medications prescribed to you or that you can take in the comfort of your own home would be a huge advantage and cut down on significant barriers for many folks.