In the wake of the U.S. Supreme Court’s opinion in the Dobbs v. Jackson Women’s Health Organization (JWHO) case that overturned Roe v. Wade, it has become clear that access to legal abortion in the United States is in grave danger. As it stands, abortion is now completely banned in at least seven states, with trigger bans expected to go into effect in several more. By turning the issue of abortion rights back to the states, the Supreme Court has put the reproductive freedom of the roughly 40 million women of reproductive age who live in states hostile to abortion rights in jeopardy. However, there are a number of levers that states can take to protect and expand access to abortion, whether that is expanding prescriptive authority, removing reporting requirements, or implementing state coverage mandates.
Spotlight on Colorado
There are 1.4 million women of reproductive age in Colorado who may at some point need an abortion. That is not counting those living in neighboring states that are less friendly to abortion access, such as Kansas, Texas, Oklahoma, or Utah. People from these states may travel across state lines in order to access care in Colorado, especially because Colorado is one of the few states in this part of the country without a mandatory waiting period for the procedure after required abortion counseling. It must be emphasized that, as in all states across the United States, the people that are most negatively impacted by the fall of Roe v. Wade and the ensuing unraveling of abortion rights are women and birthing people of color and low-income people.
In 2017, there were eighteen clinics in Colorado providing abortions. Unfortunately, 80 percent of counties in the state still lack an abortion provider.
Colorado was the first state in the United States to decriminalize abortion, and remains a model for progressive reproductive health policies. Abortion is not restricted based on gestational age; qualified health care providers outside of physicians can perform abortions; there are no Colorado state laws limiting access to telehealth for medication abortion; and there are protections in place for patients and abortion clinic staff in the form of a protected “bubble zone” of eight feet within a 100-foot radius of a clinic door—meaning protestors cannot get closer than eight feet from anyone seeking care. In April 2022, Colorado Governor Jared Polis signed into law the Reproductive Health Equity Act, enshrining the legal right to abortion and contraception in state law. However, there are also some restrictions—for example, parental consent is required for a minor’s abortion and state Medicaid coverage of abortion care is banned except in cases of life endangerment, rape, or incest.
Additional Levers for Protecting and Expanding Access
Following the Dobbs v. JWHO decision, there are a number of people of reproductive age living in nearby states who now rely upon Colorado for abortion access. This was the case even before the Supreme Court decision. In late 2021, for example, one third of people in need of financial support for abortion care from Cobalt Abortion Fund in Colorado were Texans. An increased influx of people from other states seeking abortion care could create access challenges for those seeking an abortion who already live in Colorado. There are some actions that Colorado’s state government can take in order to bolster equitable access to abortion care.
- Repeal the ban on using public funds for abortion. Despite Governor Jared Polis signing into law a state bill codifying the right to abortion, abortion remains a right in name only to those in Colorado who cannot afford abortion care and who do not fall under the category of the narrow exceptions allowed. The inability to use state Medicaid to fund all or most medically necessary abortions is an issue of health equity as it disproportionately impacts people of color. Over 50 percent of those covered by Medicaid in Colorado are Black, Hispanic, Asian/Native Hawaiian and Pacific Islander, or American Indian/Alaska Native.
- Remove parental consent requirements for young people to access abortion care. Requiring parental involvement in order for young people to get an abortion is not only unecessary, as most young people already do consult their parents before seeking abortion care, but it can put young people living in unsafe environments at further risk by forcing them to disclose their pregnancy to their parents. One in five pregnant young people have experienced physical abuse by a parent or other caretaker. Parental consent laws also disproportionately impact young people of color, who are more likely to experience unintended pregnancy.
In addition to these measures specifically for lawmakers, advocates and nonprofit organizations can help facilitate equitable access to abortion care by highlighting the critically important role that abortion funds and independent clinics have played and will continue to play in the absence of Roe.
Even with legal access, abortion is still often out of reach for many people. Abortion funds make accessing care financially possible for those who may not be able to afford it otherwise. In Colorado, the Cobalt Abortion Fund is “a nonprofit organization dedicated to abortion access and reproductive rights.” They help those seeking abortion care find services, know their rights, and afford their health care.
Independent clinics are where three out of five patients in the United States go to access abortion care. They are community-based clinics staffed by highly trained health care professionals that provide time-sensitive abortion services, often to low-income pregnant people or those with the fewest resources to access care. In Colorado, the Boulder Abortion Clinic in Boulder, Healthy Futures for Women in Englewood, and Partners in Women’s Health in Denver are all independent clinics offering abortion care.
Reproductive justice (RJ) groups are also important voices to uplift in the fight for abortion rights. The RJ movement was started by and is led by women of color and uses holistic approaches to achieving health equity and justice for all people. In Colorado, the Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR) is “a community-rooted nonprofit organization that works to enable Latinx individuals and their families to lead safe, healthy, self-determined lives.”
In the days, weeks, and months following the Dobbs v. JWHO decision, proactive state-level policy efforts and community care in the form of uplifting abortion funds, independent clinics, and RJ organizations in order to protect and expand abortion access will be necessary in order to accomodate the influx of out-of-state patients seeking care from states where abortion is expected to become criminalized. In a post-Roe world, everyone still deserves access to safe, equitable, and compassionate abortion care, regardless of what state they live in.