In early May, a leaked draft from the U.S. Supreme Court indicated the Court would soon overturn Roe v. Wade. Notably, this made headlines because it was the first time a preliminary Court ruling had been made public. But likewise, the assumed verdict sent shock waves throughout the nations. The nearly 50-year-old ruling that banned abortions at a federal level may soon come to an end. And as a result, states are already positioning themselves along ideological lines based on their view of abortion rights. Once the dust settles, it’s expected that half the states will have legislation in place that makes abortions illegal.
Regardless of whether one views this turn of events as favorable or not, changes in obstetrical care are inevitable. For women in states banning abortion rights, their only option will be to seek such services in abortion-permissive states. It’s therefore obvious that medical tourism among states will increase substantially. But this type of medical tourism is not the norm, and many notable barriers exist. This is particularly true for women with limited income or resources. How the nation deals with this new version of medical tourism will be quite interesting. And a handful of states are already taking action in this direction in preparation the future.
“If you look back through history, [women have] always done this. Women will need to travel to states that make these [abortion] services available, and already Connecticut and California have decided they’re going to be haven states…” – Dr. Ellen Wright Clayton, Law Professor and Pediatrician
Medical Tourism and Interstate Obstacles
While women have the choice to travel other states that advocate for abortion rights, barriers do exist. The most notable one typically involves cost. Seeing an obstetrician in another state involves travel costs and usually lodging arrangements. At the same time, some health insurers do not pay for out-of-state services. That means interstate medical tourism typically requires out-of-pocket expenses that may be prohibitive. While it may seem as easy as driving across a state line, there’s more involved than that. And for those with limited income, out-of-state services may not be an option.
Cost and travel are not the only limiting factors, however. In the aftermath of the pandemic, there remains significant delays in receiving some healthcare procedures. In many places, abortions are among those experiencing delays in scheduling. Even with the financial resources available for medical tourism, access to a physician may still limit a woman’s choices. In addition, there remains a shortage of medical providers in the country, and this includes obstetricians and gynecologists. Given these challenges, many women will find it hard to pursue their abortion rights in a nearby state.
“There is definitely an urgency to get some of these things in place and get prepared, because this is happening regardless of whatever timeline our legislature is on. We are doing everything we can to make sure we are as ready as we can be.” – Lisa Matsubara, General Counsel and VP of Policy for Planned Parenthood Affiliates of California
State Strategies to Promote Medical Tourism
Over the course of the last year, many state legislatures have anticipated the Supreme Court overturning Roe v. Wade. Some states like Texas and Oklahoma have already passed laws banning abortion at early gestation. Many others have what is known as “trigger laws,” which ban abortion as soon as the Supreme Court overturns the case. But at the same time, other states in favor of abortion rights are also taking action. Seeing medical tourism as an answer to the issue, their state legislatures are moving in opposite directions. For many women, these efforts will make it much easier to seek care in states in favor of abortion rights.
Several states have gone on record already as saying they wish to be a safe haven for women seeking abortion rights. California is perhaps among the most vocal with its ongoing efforts to pass new legislation. Senate Bill 1142 in California seeks to establish an Abortion Practical Support Fund for low-income, out-of-state women. Grants would be administered by the Commission on the Status of Women and Girls in the state. Likewise, Oregon has also set up a $15 million fund to provide financial assistance for women seeking abortion from out-of-state. Clearly, these actions attempt to offset cost and insurance barriers. And these same states plan to boost provider training and recruitment as well to support the assumed medical tourism coming.
“There are some centers here in Las Vegas where you can go and get a safe [abortion] procedure. They’ll end up driving here… So yes, I would imagine it would depend on what the other states do.” – Dr. Joseph Adashek, OB/GYN, Desert Perinatal, Las Vegas
A Broader Picture of the Issue
It should also be recognized that medical tourism in general is quite a lucrative practice. Prior to the pandemic, 1.4 million Americans traveled to other countries annually for medical procedures. Likewise, U.S. hospitals and providers earn billions of dollars from foreign travelers. Extrapolate that to a state level, it’s not surprising that some states see a ban on abortion rights as a financial opportunity. For states favoring abortion rights, the economics will provide incentives that will drive policy changes. Investments made now could prove even larger in the years to come if interstate medical tourism thrives.
In considering interstate medical tourism, the last few years have been rather enlightening. The COVID pandemic forced the nation, and perhaps the world, to finally embrace telemedicine and telehealth. Prior to this, interstate obstacles were in the way that prevented widespread use. Today, however, changes in policies and laws now enable these practices. Providers with specific expertise now routinely patients who live out-of-state. While the abortion rights issue is more complicated in theory, it’s not beyond reason to expect similar solutions will emerge. States in favor of medical tourism for abortions will certainly strive to find the answers.