Illinois Will Be A Post-Roe Abortion Oasis, But For Now, Its Infrastructure Is Less Than Welcoming
Tens of thousands of women, many from hundreds of miles away, are set to stream across Illinois' borders in the coming months seeking abortion care services in the wake of the U.S. Supreme Court's Roe v. Wade reversal last week.
An inland island of reproductive freedom, the state is actively girding for between 14,000 and 30,000 new patients annually, with all that means for hotels, travel, and most of all, facility capacity itself.
The will is there. Top government officials are embracing the state's mecca status, clinic operators are in overdrive to further beef up their networks and at least three out-of-state practitioners have already announced they will set up new operations just inside state borders to accommodate the influx.
But a will is not a way. And nearly everyone agrees the state is woefully unprepared to handle the sudden influx, both medically and in terms of support services, particularly as surrounding states chip away at former rights and the radius around the state grows wider and starker.
Illinois, now one of a handful of national safe havens for abortion access, is surrounded on all sides by states with bans or significant plans to restrict access.
"Illinois is very supportive of access to abortion and the governor and the legislature have been great but there is a ton more that can be done,” Planned Parenthood Illinois spokesperson Julie Lynn told Bisnow. “We do not have the medical infrastructure for this. This is a system that has never worked for everyone, even prior to the decision [coming] down, when Roe was still the law of the land.”
Following the court’s decision last week, four of Illinois’ neighboring states immediately banned abortion, while Ohio and Tennessee restricted the procedure to six weeks into a pregnancy — which is before many women realize they've skipped a period since pregnancy is dated to the last menstrual cycle and not the date of conception.
Lawmakers in Indiana and Iowa are expected to consider six-week abortion bans in the near future, while reproductive rights in Michigan are temporarily blocked by a court there as it considers whether to revert to a 1931 law that would make abortion a felony with no exceptions for rape or incest.
Planned Parenthood and other reproductive rights activists have been preparing for the potential fall of Roe for years, and advocates repeatedly expressed concern over an overloaded and underprepared system at the state’s borders.
In the pre-reversal world, multiple clinics opened up near state boundary lines of access, including near St. Louis. The Illinois Department of Public Health reports nearly 10,000 patients crossed state lines to have an abortion in Illinois in 2020 — that was 29% more patients traveling than in 2019.
Meanwhile, in states like Iowa, where it's likely a revival of the six-week ban will take effect, access to abortion in adjacent Illinois has been virtually impossible, with four Quad Cities clinics having closed in the past five years and none at all sitting on the state's border.
A run on state resources is inevitable.
"The state of Illinois is among a handful of U.S. states that continues to affirm the right to safe and accessible reproductive healthcare. Indeed, the state has seen growing numbers of persons coming from outside the state in recent years," said Natalie Bennett, director of the Women’s Leadership and Resource Center at University of Illinois-Chicago. "Those numbers will continue to increase."
Planned Parenthood has attempted to close the gap, opening clinics in Waukegan, Illinois, near Wisconsin in 2020; one near Indiana in 2018; and one near the Missouri border, near St. Louis, in Fairview Heights in 2019. The Regional Logistics Center also opened up to assist patients with support when seeking abortions, from lodging and transportation to childcare and financial assistance for the procedure.
In the several days since Roe was overturned, CHOICES Memphis Center for Reproductive Health also announced plans to open a clinic at one of the state's southernmost tips, Carbondale, starting Aug. 1, albeit one that requires patients to travel for hours.
“CHOICES is committed to providing high-quality reproductive health care, and no SCOTUS decision or anti-choice law will change that,” CHOICES said in a statement on its website.
Other providers in bordering states are on a similar mission. In Wisconsin, where some women travel three or four hours to get abortions, physicians are in talks to relocate a new clinic in South Beloit to northern Illinois that would provide both surgical and pill abortions.
Meanwhile, Just The Pill medical abortion providers plan to roam states like Illinois and others bordering non-friendly abortion states with mobile medical Abortion Delivered vans.
"Through our new program, Abortion Delivered, a fleet of mobile clinics will offer expanded services — including mobile procedural abortion for the first time in U.S. history — to the major influx of people who will now need care," Just The Pill and Abortion Delivered Medical Director Julie Amaon said. "By operating on state borders, we will reduce travel burdens for patients in states with bans or severe limits. And by moving beyond a traditional brick-and-mortar clinic, our mobile clinics can quickly adapt to the courts, state legislatures and the markets, going wherever the need is greatest."
Since only licensed medical physicians are able to provide abortions in Illinois right now, both lawmakers and advocates in border states are pushing legislation for non-physician health clinicians, who can provide abortion pills, to facilitate procedural abortions without extensive travel.
For that reason, there might not be an extensive abortion boom to border tourism.
“There will possibly be a need for more hotels, but it depends on the type of services,” Lynn said. A patient may drive to Texas to get an abortion pill and then leave because they can’t stay overnight because it’s too expensive or they have family they need to take care of back at home, even if they’re not coming from that far.”
In the age of telehealth appointments, some patients will be able to access providers virtually and have pills shipped out to them, though anti-abortion states are against expanded online access. It’s unknown how long these appointments will be viable in the changing legal landscape.
In places like Arizona, Louisiana and Tennessee, telehealth services are banned, and in Texas, prescribing and sending abortion pills by mail is a criminal offense. More states are looking at banning abortion travel.
That it is happening under the radar is just one factor that makes the number of women in need of lodging and other services who will travel to seek abortions largely unknown.
Paramount Lodging Advisors CEO Sanjeev Misra said he expects abortion-related tourism will be limited to smaller border towns, versus big cities and clustered in leisure destinations that are already struggling with pandemic-era low occupancy.
Though services are not yet available along the border, especially in dead zones like the Quad Cities, they will likely crop up in short order, as the spate of new clinic announcements in just six days revealed. Yet Misra does not foresee a short-term supply challenge in those areas, already fraught with pandemic vacancies.
"[Services] could bring in 18% to 25% new business to those towns, but that is not a major economic impact, " he said. "I suspect the real effect will be [to] determine if new abortion clinics open near the borders of these states close to major metros."
While questions remain about the number of clinics and resources needed at the border, Chicago Mayor Lori Lightfoot and leaders of World Business Chicago, the city’s economic development arm, penned a letter to 300 CEOs of Fortune 500 companies reaffirming the city’s steadfast abortion rights stance.
“As you weigh the repercussions facing your employees, customers and vendors, we welcome the opportunity to highlight the ways in which Chicago remains a welcoming city for all," Lightfoot said.
