Here is how the Supreme Court's decision in Dobbs v. Jackson Women's Health Organization will play out in California.
Abortion will be a major focus of November election
Expect to hear a lot about abortion rights in the months ahead, as candidates tout their endorsements from Planned Parenthood and flood the airwaves with advertisements warning of the bleak future for access if their opponents win.
Since the draft ruling leaked in May, Democrats in California and across the country have latched onto protecting abortion rights as a key issue for the 2022 midterm elections. With decades of public polling showing that a majority of Americans believe abortion should be legal in all or most cases, it has put the party back on the offensive as it faces mounting voter dissatisfaction with President Joe Biden and withering Republican attacks over inflation and crime.
A poll conducted last month by Monmouth University found that abortion was nearly tied with economic policy as the top concern for voters nationwide, a considerable increase from four years ago driven by its rising importance among Democrats. Another recent survey from UC, San Diego asked Californians whether they planned to vote in November, before and after reading an article about the possibility of a national abortion ban if the Roe decision was overturned; researchers determined it had a significant mobilizing effect on independent voters.
The potential for Republicans to pursue a national abortion ban should they win back control of Congress is likely to feature prominently in a number of battleground House races across the state. Gov. Gavin Newsom and Attorney General Rob Bonta have already made abortion rights central to their reelection campaigns, and even some candidates with less of a direct connection to ensuring abortion access, including Democratic state controller hopeful Malia Cohen, have tried to raise alarms about the beliefs of their GOP opponents.
Abortion rights also will literally be on the ballot in California in November. Democratic legislators in Sacramento are rushing to qualify a measure that, if approved by voters, would enshrine "reproductive freedom" in the state Constitution.
More legal support for abortion providers
As dozens of conservative states laid the groundwork for the end of Roe, passing abortion bans triggered by the Supreme Court ruling, California has been scrambling to build a bulwark for reproductive rights and accommodate a potential influx of patients from beyond its borders.
Last fall, Newsom convened the Future of Abortion Council, a coalition of reproductive rights, health and justice groups, to explore how to make the state a "sanctuary" for abortion. Its recommendations, released in December, formed the basis for a sweeping package of more than a dozen bills currently moving through the Legislature.
They include Senate President Pro Tem Toni Atkins' Senate Bill 1375, which would increase the number of providers by allowing some nurse practitioners to independently perform first-trimester abortions without a doctor's supervision, and Assembly Bill 1918 by Assemblymember Cottie Petrie-Norris, a Costa Mesa Democrat, which would create a "reproductive health service corps" for underserved parts of the state.
Several measures would protect doctors from legal and financial penalties if they travel to other states to perform abortions or treat out-of-state patients: AB 1666 by Assemblymember Rebecca Bauer-Kahan, an Orinda Democrat, won final legislative passage last week and would nullify civil judgments from other states. (The bill was signed into law by Gov. Gavin Newsom on June 24).
AB 2091 by Assemblymember Mia Bonta, an Alameda Democrat, would prohibit medical providers and health insurers from sharing information in cases that seek to penalize abortion. AB 2626 by Assemblymember Lisa Calderon, a Whittier Democrat, would prevent the state medical board from suspending or revoking the license of a physician who is punished in another state for performing an abortion in accordance with California law.
Abortion opponents have showed up at the state Capitol in force to protest AB 2223 by Assemblymember Buffy Wicks, an Oakland Democrat. Seeking to protect Californians from overzealous law enforcement and district attorneys who may be hostile to abortion rights, it would end a requirement that coroners investigate the cause of fetal deaths resulting from suspected self-induced abortions, clarify that women cannot be held criminally or civilly liable for pregnancy loss or abortion, and create an ability to sue prosecutors and others who violate that protection.
Though some legislation would take effect immediately if approved, including the three bills expanding legal protections for doctors, others would not become law until January.
Increase the number of providers?
Despite California's reputation as a reproductive health safe haven, 40% of California counties do not have any abortion clinics. Lawmakers are pushing to increase the number of abortion providers by offering financial incentives and streamlining regulations that govern who can perform abortions.
Newsom's proposed budget includes $20 million to give scholarships and loan repayment options to clinicians who commit to providing reproductive health care services. The Legislature's spending plan invests an additional $21 million in existing reproductive health workforce programs and commits a one-time $20 million investment for recruiting and training clinicians that work at reproductive health centers.
Another measure aimed at allowing nurse practitioners to perform first trimester abortions without physician supervision has been billed as a way to increase the number of abortion providers, but even advocates say the impact may be limited.
In 2013, California adopted a measure allowing nurse practitioners, physician assistants and certified nurse midwives to perform first trimester abortions after receiving special training. Since then, however, training opportunities have remained limited.
"Very few nurse practitioners have been trained since the law went into effect," said Debbie Bamberger, the first nurse practitioner in the state to be trained to perform abortions, who works for Planned Parenthood in Oakland.
Part of the problem is that nursing schools and physicians assistant programs do not have abortion curriculum or training opportunities for students who want to learn the procedure. Most training is limited to medical residency programs for physicians, who don't want to give up their limited spots to other kinds of clinicians.
Bamberger said her clinic has trained five nurse practitioners to perform abortions in the past two years and Planned Parenthood of Northern California does not offer widespread training.
"It's mostly trying to remove barriers, but it's not necessarily going to hugely increase access if there's still no training available," she said.
The state is investing in abortion access
Both the Legislature's Democratic leadership and Newsom administration have made it clear they're willing to commit a significant amount of the state's record surplus to abortion rights.
In his latest budget proposal, Newsom pledged $125 million to reproductive health care, including $60 million to directly subsidize the cost of providing abortions to low-income or uninsured patients. Of that $60 million, $40 million can be used to reimburse abortion providers for procedures conducted on anyone who can't pay — even those from out of state.
His proposal, which is supported by the Legislature, also includes $20 million to improve physical and digital security at abortion clinics and $15 million for community-based organizations to provide sexual and reproductive health education.
The Legislature's spending plan goes even further, earmarking an additional $156 million in reproductive health spending to train more providers, increase funding for clinics that serve Medi-Cal patients, and open an abortion "Safe Haven" pilot program in Los Angeles.
One headline-grabbing investment the Legislature and governor haven't agreed on yet, is the creation of the California Abortion Support Fund. The fund would give grants to organizations that help defray travel, lodging, child care and other costs that advocates say prevent women from getting to an abortion clinic. While the money would go to California-based nonprofits, women seeking abortions from any state could apply for grants.
This story contains 1315 words.
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