Obtaining Abortions Is Even Harder If You’re Undocumented in a State With a Ban

This year’s abortion bans in Florida and Arizona — following an older near-total prohibition in Texas — threaten to make the procedure virtually unattainable for undocumented people living in those states.

Texas outlawed abortions after six weeks of pregnancy in 2021, and banned the procedure almost entirely after Roe v. Wade was overturned in June 2022. Florida’s six-week ban, which outlaws the procedure before many people discover their pregnancies, took effect May 1.

Things in Arizona are less clear cut. In April, the state’s supreme court upheld a near-total ban from 1864. Although the court has paused enforcement of the ruling pending a Supreme Court challenge, and the legislature recently repealed the law, it may still temporarily take effect in late September since the repeal will not have any legal force until 90 days after the legislature adjourns for the year. Until then, abortion in Arizona is outlawed after 15 weeks of pregnancy.

People in these three states seeking abortions after the legal cutoffs have few options: traveling to a state where the procedure is legal, finding an out-of-state service to mail them abortion pills — which is medically safe but legally tenuous — or finding community-based networks that would do the same. But pursuing these avenues is substantially more difficult for undocumented people. In most states, limits on what kind of government identification they can carry means they cannot have driver’s licenses. (Today, that option is only available in 18 states and Washington DC.) This can make it far more difficult to leave a state for care.

Travel can also create legal and immigration risks for undocumented people. Florida and Texas recently passed laws specifically banning transporting undocumented people into those states. The Texas law, which is currently blocked in court, would allow police to arrest people they thought had illegally entered the state, and pending legislation in Arizona would do the same if enacted. (That bill is likely to be vetoed by the state’s Democratic governor.)

An alternative to travel — ordering abortion pills online — could be seen as a violation of laws in all three states that prohibit the provision of abortion through telemedicine.

Even heated public rhetoric can create a culture of fear that discourages people from seeking health care, including abortions. “We’re looking at a system where already immigrants face huge barriers toward accessing health care — higher uninsured rates, less connection to the health care system overall — compounded by immigration-related fears,” said Samantha Artiga, director of racial equity and health policy at KFF, a nonpartisan health policy research organization. “It compounds the challenges significantly when accessing services is going to require additional steps, be it traveling out-of-state, be it figuring out how to use telehealth services.”

There is no reliable data about how many undocumented people seek abortions, nor how many have been denied care because of their states’ bans. Texas and Florida are home to more than a million undocumented people between the two of them; only California has a larger undocumented population. In both Texas and Florida, about 5 percent of women ages 15 through 44 — what’s commonly considered “reproductive age” — are undocumented, according to data analyzed by the Pew Research Center. In Arizona, about 4 percent are.

In all three of those states, the vast majority of undocumented people are Latinx. (In general, abortion bans disproportionately affect Latinx Americans, including citizens and permanent residents.) According to the Migration Policy Institute, a think tank, about half report speaking English “not well” or “not at all,” which can make it incredibly difficult to navigate out-of-state travel or varying states’ abortion laws, because information is often only available in English.

It’s already hard for undocumented people living in Florida to access local clinics without driver’s licenses. It will be even harder for them to cross state lines if they can’t speak English, said Dr. Chelsea Daniels, an ob-gyn who works at multiple Florida-based Planned Parenthood affiliates, and who has cared for undocumented patients.

“The privilege that comes with having a driver’s license or passport can’t be overstated,” Daniels said.

The confluence of abortion and immigration laws has created “an absolute state of fear,” said Ray Serrano, director of research and policy at the League of United Latin American Citizens, or LULAC, deterring some from seeking care at all.

At a Woman’s Choice in Jacksonville, even before the state’s six-week abortion ban took effect, employees had been forced to refer a handful of undocumented patients out of state for care: those who weren’t able to get an abortion before the 15-week cutoff that was in effect prior to May 1. Now, with the six-week ban in effect and more Floridians leaving the state for pregnancy-related procedures, they anticipate the share will grow.

Undocumented patients have relied on a handful of groups for help with travel: some organizations offer volunteer drivers, and another called Elevated Access works with non-commercial pilots who fly people to other states. But coordinating that kind of travel is difficult and takes time, pushing patients further into pregnancy.

“It’s one of those things that would come into play that would — I don’t want to say 100 percent restrict their access, but would cause their access to be delayed even further,” said Gabby Long, the hotline director at A Woman’s Choice.

The logistics of this kind of travel are complex, said Serra Sippel, interim executive director of the Brigid Alliance, which provides practical support to people who need to travel for abortions, particularly people later than 15 weeks into pregnancy.

If someone cannot legally drive, her organization has provided extra funding for a companion who can take over driving responsibilities. In other cases, they’ve purchased bus tickets for clients, asking local abortion funds to make sure that the route does not include any immigration checkpoints. A bus ride from Miami to Virginia — the closest state where abortion remains mostly legal and does not require a multi-day waiting period — can take about 23 hours, or about 8 hours longer than driving a car.

But with the new bans in effect — particularly in Florida, where 84,000 abortions were performed last year — the burden on these support groups will intensify, straining their ability to coordinate travel at such a specific level.

“The efforts to help people have been helping them on a case-by-case basis,” said Usha Ranji, associate director for women’s health policy at KFF. “Whether they are scalable and sustainable — that seems really difficult, and I think we know that they don’t reach everybody who is in need.”