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No One’s Access to Abortion Is Guaranteed — No Matter Where You Live

Living in a “blue state” does not guarantee the availability of abortion care to everyone who needs it.

People chant during a protest in response to the U.S. Supreme Court ruling to overturn Roe v. Wade at Civic Center in San Francisco, California, on June 24, 2022.

Last year, travelers to the Oakland airport were greeted by a billboard touting the availability of abortion in California paid for by Gov. Gavin Newsom. The billboard was one of many in a 2022 campaign highlighting the state government’s new website for people seeking abortions, with the majority of billboards erected on California’s dime in states that had banned abortion following the U.S. Supreme Court’s decision to overturn Roe v. Wade and Planned Parenthood v. Casey. Some of the billboards, like one in Texas, featured an image of a white woman wearing a white dress in handcuffs beside the words, “Texas doesn’t own your body. You do.” (The irony is that California does prosecute women for stillbirth and other pregnancy outcomes.)

Planned Parenthood ran similar billboards in five states reminding travelers that they were entering New York or New Mexico “which protects abortion rights.” The goal was to let people in states where in-clinic abortions are unavailable know that there are places for them to travel to and receive care. The billboards also fueled the never-ending fight between “red states,” where abortion is criminalized, and “blue states,” the safe havens for abortion access. But is the situation actually that simple?

Since the conservative supermajority in the Supreme Court issued its Dobbs ruling, Republican-led legislatures have gutted or eliminated abortion access in their states while some Democratic-led legislatures have sought to expand abortion care. This has resulted in an unequal patchwork of access to abortion. But rather than see this abortion landscape as one problem affecting us all, some supporters of abortion rights tend to pit so-called blue states against the so-called red states. It’s common to see comments on social media and articles declaring that states that have banned abortion should be discarded, or that everyone who supports abortion should just move to a better blue state. The problem with this idea is that no one’s access to abortion is guaranteed, no matter where you live. We know because we’ve lived in these blue states and seen people struggle to reach the clinic, just like in the red states.

If we are to liberate abortion — which is the only goal that would meet the needs of people who have abortions by abolishing all laws that restrict or criminalize abortion— we need to be honest about the reality of abortion access across the country, including the barriers in the “abortion havens.”

Let us be clear: No, your liberal state is not an abortion safe haven. There is no state where abortion is available to everyone who needs it free from unnecessary financial, logistical and legal barriers. Even in states where abortion is legally permitted later in pregnancy, people still have to travel across the country for care. This might surprise you; it surprises people who talk to us all the time. And the sooner we recognize this reality, the sooner we can do something about it. The idea that abortion is “good” in “blue” states means that people in those states don’t critically examine the structural failures of their health care systems that leave many folks, especially low-income folks, without access.

There are creative and courageous state lawmakers fighting hard to expand access to abortion, and their efforts are worth acknowledging. But what we’ve seen is supporters of abortion rights resting on their laurels assuming that because abortion is legal in their state, they’re better off than people in states with criminalization laws. Even the most progressive states limit abortion access based on gestational limits, insurance coverage restrictions, immigration checkpoints, or because there isn’t a provider in their community or even a few hours’ drive away that offers care in the second or third trimester for any number of reasons.

It’s hard to pinpoint exactly when this false dichotomy of “good” and “bad” states began to take root, but we know that state-level access to abortion was gutted following the Tea Party backlash to the Obama administration. Right-wing white supremacists ran for office during the 2010 midterms and took over Congress and state legislatures, giving them the ability to gut voting rights and enact over a thousand abortion restrictions.

While it might seem like gutting voting rights and abortion access are strange bedfellows, they’re not. They are bound together by deep-seated anti-Blackness, the core of the anti-abortion movement’s politics that motivated them to move from organizing around school segregation to abortion in the 1970s and 1980s. Though Democratic-majority state legislatures responded to these attacks by doubling down on their protections for abortion access, like using state funds to cover the procedure or removing outdated restrictions, it wasn’t enough to actually increase access on a systemic level.

But the absence of restrictions does not mean the presence of access. Someone could live across the street from an abortion clinic, but if they don’t have insurance or money to pay for the procedure, time off of work or someone to watch their children during their appointment, their proximity is meaningless.

In order to liberate abortion, we have to be willing to be critical of the “safe haven” states. Can someone get an abortion at any time and for any reason? Are there abortion providers in every county? Does the state ban the prosecution of people for the outcomes of their pregnancies? Does the state allow young people to have an abortion without asking a judge for permission for an abortion? Does the state use its Medicaid funds to pay for an abortion? Does the state provide support for local abortion funds and practical support organizations? Can undocumented immigrants use Medicaid funds to pay for an abortion? Can someone get an abortion throughout their pregnancy? Has the state decriminalized self-managed abortion? There is no state that can say yes to every single one of those questions.

Although New York’s Medicaid program covers abortion care, patients still need help paying for the procedure or getting to a clinic, whether they’re in rural areas or in the city itself.

When it comes to state funding of abortion, it’s important to note that “good” states don’t make it easy for organizations to access the money lawmakers have allocated to expand care. In fact, it’s quite the challenge, as Chelsea Williams-Diggs of the New York Abortion Access Fund told us in an episode of our new podcast from The Meteor, “The A Files: A Secret History of Abortion.”

While New York City was the first municipality to allocate funding for abortion access, it uses a reimbursement model, where it pays the New York Abortion Access Fund only after it spends the money it was awarded, putting the group in a difficult position, since it — like other funds — is regularly running out of money.

Many of us know what it’s like to front a friend or family member a large amount of money, unsure of when they’re going to pay it back. Not to mention, the New York Abortion Access Fund serves people seeking abortions from across the country — and even outside of the country — all with only one paid staff member and a community of dedicated volunteers. Any funding to abortion funds should be barrier-free, which would go a long way toward serving the needs of people who have abortions.

So, what’s the solution? Well, this moment calls for a radical rethinking of our system. Legislators must have the courage to decriminalize abortion once and for all — abolishing all of the laws dictating when, where and how someone can have an abortion.

They need to put real dollars, not just billboards, behind their plans, and not only fund abortion care but all reproductive health care through a national health system so that everyone has the ability to decide if, when, and how to grow their families based on their own decisions, not how much money is in their bank accounts, whether they can get to the clinic within a time frame, or if they’re afraid of being deported.

Before you dismiss this as a pipe dream, know that this was the original goal of the abortion rights movement pre-Roe. Organizers wanted to abolish all abortion laws and demanded safe, legal and free abortions.

In order to liberate abortion this time, we have to start with recognizing the lies that we’ve been sold and confronting the reality that abortion access is not great anywhere in this country. There are just some states that have fewer restrictions than others. To make real change, we have to be willing to call on pro-choice politicians to do more and better, and not allow “blue states” to rest on their laurels. We all have a lot of work to do to liberate abortion. Let’s get to it.