Molly Redden has spotlighted another aspect of the relentless war on women’s reproductive rights. Anyone who follows such matters is well aware of the impact the forced-birthers are having on abortion clinics in states under right-wing control. Several states now have only a single available clinic, and others have seen their numbers sharply cut. Many of those still in existence are barely hanging on, awaiting the next piece of medically unnecessary legislation that will finish them off, or litigating to halt implementation of already-passed legislation.
But, as Redden points out, these authoritarian efforts to control women aren’t just causing harm in those states with right-wing legislatures and governors. Clinics in blue states are also shutting their doors:
“The trend is disturbing,” said Nikki Madsen, executive director of the Abortion Care Network, a group representing independent abortion providers around the country. “It’s taking root in states we traditionally think of as ‘friendly’ to abortion rights, without many people noticing.”
Exact numbers for clinic closures are hard to come by. A rough count by the Abortion Care Network, though, found that for every three clinics that closed in a red state in the past few years, two clinics closed in a more liberal state – one of the 17 states where Medicaid covers abortion, or one of 23 states that the Guttmacher Institute, a think-tank that supports reproductive rights, does not consider hostile to abortion access. A list compiled by the Guardian of more than 50 clinics that closed for good in 2014 shows that a little more than half were located in blue states.
One reason for this is that clinics aren’t being reimbursed for Medicaid abortions at a level matching the cost of the procedures, and those running them are pressed for time to negotiate higher reimbursements. Moreover, given hostility to abortion even in blue states, they fear rocking the boat by asking for higher reimbursements will bring more legislative and other unwanted attention to them.
Elizabeth Nash, a senior researcher at the Guttmacher Institute, says that if abortions were integrated into healthcare matters the way so many other procedures have been, the need for standalone abortion clinics would be greatly reduced. But any clinic that provides even a handful of abortions a year runs the risk of harassment and worse from forced-birthers. Thus, says Nash, most abortion providers must depend financially on this one procedure, a risky way for any business to operate.
Although Planned Parenthood gets most of the headlines connected to forced-birther attacks—both political and physical—many of the organization’s clinics are thriving. That, in part, is because Planned Parenthood has an excellent fundraising operation allowing it to subsidize abortions for low-income women with tax-deductible donations. But the organization only provides about a third of the nation’s abortions. Most are done at independent clinics that don’t have the political clout or sophistication of Planned Parenthood. And even for those operating in blue states, the government may not be as amenable as, say, Massachusetts, California or Washington in providing higher Medicaid reimbursements.
If we as a nation actually followed the spirit as well as the letter of Roe v. Wade—and we had a saner healthcare system unhampered by the dictates of misogynist politicians determined to meddle in decisions that should be made by women and their doctors—access to abortion would be as easy as any other outpatient treatment. Until all the obstacles to abortion are removed, women will remain second-class citizens.