In the wake of Idaho's recent ban on nearly all abortions, Oregon is investing millions in its abortion infrastructure as it prepares to receive an influx of patients seeking the procedure.
Barring legal intervention, the Idaho law will take effect April 22 and allows family members of what the law called a "pre-born child" to sue abortion providers for carrying out the procedure after six weeks. Many women are unaware they are pregnant at this early stage.
New Oregon legislation establishes a $15 million fund to cover costs for patients traveling to the state to receive abortions and the providers performing the procedure. Washington and California are among other states that have also recently fortified abortion access, but Oregon is the first state in the nation to pass a law of this kind.
The money is part of a strategy that abortion rights advocates have been advancing in states for more than a year.
"This conversation started to take place really immediately after Justice Ginsburg's passing," says Christel Allen, executive director of the group Pro-Choice Oregon and part of a coalition that lead the legislative effort.
When Supreme Court Justice Ruth Bader Ginsburg died in 2020, many recognized the potential opportunity the court would have to gain a more conservative member and reconsider legal precedent protecting abortion. With Justice Amy Coney Barrett now installed on the court and a legal ruling on this issue expected in June of this year, advocates like Allen say they are preparing for the worst-case scenario.
"This situation that this state has never been in – this country has never been in – is going to require resources and the creation of new best practices," she says.
Some of the new state money will likely go to groups such as Northwest Abortion Access Fund that help patients pay for travel costs for abortion and associated expenses such as childcare or time off work.
Other money will go to places like Lilith Clinic in Portland. It is the only clinic in the state that provides later abortions, typically up to 22 weeks. For some, it is the only option. Patients often go to Lilith to end a pregnancy when they find out a fetus has a life-threatening abnormality, for example.
Christine Riewer, a medical assistant at Lilith Clinic, says she is committed to the work.
"I love it," she says. "I started doing it, and I was like, 'This is incredible I want to do it forever.' "
The job comes with unique challenges. Riewer points to the clinic's security cameras, which provide staff with a view of both the front and back door. "Our doors are always locked," she says. "We check ID."
Security at this clinic is one expense the new money from the state could cover. Oregon has designated the fund for creative uses exactly like this.
"What we are concerned about is the small amount of people for whom violence is possible," says Grayson Dempsey, a spokesperson for Lilith Clinic.
The majority of protests at the clinic are peaceful, says Dempsey. But security will become paramount if facilities have to close in other states and anti-abortion activists across the country are left with fewer protest targets.
"We not only need to hold the line here but we need to be prepared to be the focus of that attention," says Dempsey.
Other providers say the money could be used to create systemic changes in the state's healthcare system.
Dr. Helen Bellanca was providing abortions before she took a job at a clinic in the town of Hood River, Ore., that relied on federal funding. Restrictions prevent federal money from paying for abortions.
Bellanca couldn't offer the procedure to her patients, many of whom were migrant farmworkers. "I wanted to continue to provide abortions in my practice, but that was not possible," says Bellanca. "I think this fund is so important because it would allow communities to have flexibility to access that care."
She's since left that clinic, but she says using state dollars to pay for abortion costs would offer a workaround for providers in similar positions. "It's not about having a clinician willing to perform an abortion. It's about having systems in place and infrastructure in place to provide it."
Other uses for the $15 million fund could include support for telemedicine or the purchase of ultrasound equipment for rural clinics.
If the Supreme Court overturns Roe v Wade in a few months, as most legal analysts expect, Oregon could see an increase of 234 percent in incoming abortion patients from all over the country, according to the Guttmacher Institute, an abortion rights research group.
That disruption could set in motion a health care crisis in every state.
Christel Allen from Pro-Choice Oregon says it's time for states that support abortion rights to bring a full court press, as other states across the country are moving to restrict abortion access. "This gives us a chance," she says, "to actually start being an incubator for solutions that we then can help other states in passing, and moving forward."
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