Health Care

Post-Roe, Vermont could see an influx of out-of-state patients seeking abortions

Planned Parenthood
Christine Cano of East Montpelier, center, attends a news conference held by supporters of a bill to preserve abortion rights at the Statehouse in Montpelier in January 2019. File photo by Glenn Russell/VTDigger

Abortion providers and activists have known for years that the U.S. Supreme Court was poised to severely restrict abortion accessibility at the federal level. But when a draft of the court’s decision to potentially overturn landmark abortion case law was leaked, organizers still felt the pang of shock.

“We knew this was coming, but can you believe it?” Lucy Leriche, vice president of public affairs at Planned Parenthood Vermont Action Fund, told VTDigger on Tuesday.

In a state like Vermont, where abortion would remain legal even without federal guarantees, medical providers and activists like Leriche are preparing to see an influx of out-of-state patients.

In the draft opinion, published by Politico late Monday, Justice Samuel Alito declares that Roe v. Wade and Planned Parenthood v. Casey — two landmark cases for reproductive health care decided in 1973 and 1992, respectively — “must be overruled.”

In a post-Roe nation, the question of abortion accessibility would fall to individual states and their legislatures. According to the Guttmacher Institute, a reproductive rights advocacy group, 26 states are poised to outright ban or severely restrict abortion access once federal protections dissolve.

In Vermont, abortion would remain legal even if the court’s ruling goes into effect. Act 47, which guarantees the right to abortion at the state level, has been on the books since 2019. And in November, Vermonters will vote on Proposal 5, also known as the Reproductive Liberty Amendment, which would enshrine the right to abortion and other reproductive health care services in the state Constitution.

Providers have been preparing for this moment. In addition to pushing for state-level legislative action, Leriche said Vermont’s six Planned Parenthood clinics that perform abortions are anticipating an influx of out-of-state patients who can’t access abortions at home.

Vermont is located in a “whole cluster of states where abortion remains safe and legal,” so Leriche anticipates no more than a 10% increase in patients — a rise that she believes Vermont has the infrastructure to accommodate. Vermont is also a difficult place to get to and lacks robust public transportation, so she predicts the impact will be lesser here than in nearby states like New York.

“In reality, guess what? Nobody knows,” Leriche said. “And we're not going to know until it actually happens.”

Vermont already sees out-of-staters crossing its borders to receive care. Of the 1,195 abortions performed in Vermont in 2019, 265 of those patients, about 22%, came from outside the state, according to the most recent available data from the Vermont Department of Health.

Within the region, 168 of those patients came from New Hampshire, 51 from New York, 24 from Massachusetts and five from Maine. But a few patients traveled from as far as Alabama, Arizona, Florida, Texas and more.

Lauren MacAfee, an OB-GYN with the University of Vermont Medical Center, said she also expects to see a rise in out-of-state patients, but she already sees them. 

MacAfee described one patient from Maine, who was under 18 and had irregular periods, and did not know she was pregnant until it was too late to obtain the procedure at home. She tried to go to Massachusetts, but that state required parental consent. Her parents were supportive, but they were out of the country, unable to sign the necessary forms. So her aunt drove her all the way to Vermont.

“It added this extra challenge for her to be able to access care eight hours away from home versus two hours away from home,” MacAfee said. “I just think it's really challenging to come up with laws when each situation can be so unique and so different.”

Not every patient can jump through those hoops. New England states are geographically smaller and quicker to travel between than the mammoth states of the West. But northern New England is still a rural region, and it lacks public transportation for patients who don’t have a car.

“Our poor patients are going to have the hardest time with this because they don't have the support resources and means to get transportation across state lines, to get child care (or) elder care for folks that they might already be caring for, to get time off work without the risk of losing their job,” MacAfee said.

Those costs for travel, dependent care and time off work add up. The procedure itself can cost hundreds or thousands of dollars. Unlike many other states in the country, though, MacAfee said Vermont health insurance plans do cover abortions.

The stakes are high. If pregnant people without access to safe abortions resort to unregulated methods, the results can be deadly. Vermont Health Commissioner Mark Levine said Tuesday that he’d “hate to see our country have to revert to practices of a historic era.”

“Things were done clandestinely and in the dark, so to speak, often by the person themselves, and infection rates were astoundingly high. Hemorrhaging rates were astoundingly high,” he said. “It was a very, very challenging time. And access to a procedure that is a medical procedure that actually could be done safely and effectively was viewed as a real advance.”

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Sarah Mearhoff

About Sarah

Sarah Mearhoff is one of VTDigger's political reporters, covering the Vermont statehouse, executive branch and congressional delegation. Prior to joining Digger, she covered Minnesota and South Dakota state politics for Forum Communications' newspapers across the Upper Midwest for three years. She has also covered politics in Mississippi, New York, Pennsylvania and Washington, D.C. Born and raised in Pennsylvania, she is a proud alumna of the Pennsylvania State University where she studied journalism.

Email: [email protected]

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