Illinois abortion providers are hopeful a wave of upcoming abortion-related ballot measures in other states will favor reproductive rights, but they predict these initiatives are unlikely to immediately quell the crush of out-of-state patients who have been traveling to Illinois following the fall of Roe v. Wade.
On Tuesday, millions of voters in 10 states will weigh in on how their state regulates abortion, including in parts of the country where the right to terminate a pregnancy has been almost entirely banned or severely restricted after the U.S. Supreme Court overturned Roe in June 2022, ending nearly a half-century of federal abortion rights.
In neighboring Missouri, a ballot measure would enshrine abortion rights in the state constitution up to the point of fetal viability. Missouri prohibited nearly all terminations immediately after Roe was overturned.
In Nebraska, dueling initiatives could expand or restrict the right to terminate a pregnancy: One measure would ensconce abortion rights until viability — or later in cases that risk the health or life of the pregnant person — in the Nebraska Constitution. The other measure would prohibit most abortions past the first trimester. Nebraska now has a 12-week abortion ban, with some exceptions.
Various other abortion-related initiatives will also be decided by voters in New York, Florida, Colorado, Arizona, Maryland, South Dakota, Nevada and Montana.
Dr. Allison Cowett, medical director of the Chicago abortion provider Family Planning Associates, said she’s optimistic voters will generally support abortion rights. In previous ballot measures in seven states — California, Kansas, Kentucky, Michigan, Montana, Ohio and Vermont — voters have favored reproductive health freedoms.
“I do feel hopeful that the ballot measures will send a message that the majority of Americans want abortion to be available close to home,” she said.
But Cowett noted that abortion rights don’t always translate into access to reproductive care. She cautioned that even if voters support pro-reproductive rights measures in these states, that doesn’t mean abortion will actually be available and accessible there, at least in the short term.
She predicts most of these amendments will likely be challenged in court and are unlikely to go into effect “for months, if not years.”
At Family Planning Associates, about 12% of patients were from other states when Roe was the law of the land compared with 30% after the end of federal abortion rights, Cowett said. She doesn’t anticipate the outcome of the ballot initiatives will decrease the throngs of abortion seekers traveling to places like Illinois anytime soon.
“Interestingly I don’t think the ballot initiatives — regardless of the decisions — will have a significant impact on our patient population, at least in the immediate months,” Cowett added. “We believe we will continue to see many, many patients from out of state.”
After the demise of Roe, the number of patients traveling to Illinois for abortion care skyrocketed: Nearly 17,000 abortion seekers came here from other states in 2022, the year Roe was overturned, a 49% increase over the previous year, according to Illinois Department of Public Health data.
In response, several new clinics have opened in Illinois and existing abortion providers have extended their hours or added telehealth and abortion pill by mail services to try and serve the increase in demand.
Illinois has strong reproductive rights protections and has long been considered an island of abortion access amid the largely restrictive Midwest.
Nearly 10,000 patients crossed state lines into Illinois to have an abortion in 2020, when Roe was still intact, and the number had increased every year since 2014, state health department data showed.