Abortion was the focus of the Democratic National Convention last week, and Illinois was celebrated for taking in thousands of women in need of treatment after access to the treatment was lost across much of the South and Midwest.
But the abortion funds that are essential for so many people who travel to states like Illinois – they pay for their flights, hotels, child care and their abortions – are the money runs outProviders and advocates say this threatens access to reproductive health care.
Megan Jeyifo, for example, said she is exhausted. She runs the Chicago Abortion Fund, one of the largest of its kind in the country.
“Access has always been an issue in this country, and access is not what is being discussed,” Jeyifo said. “It’s about legality, and we know we need much more than legality. As we wait for someone to be elected and Congress to pass something, I say, ‘I’ll sign this as soon as it’s on my desk.’ That’s going to take a long time. And what are we doing as a country? What are we doing as a community to meet the real needs of the people right now?”
There is a lot at stake in Illinois — more people travel here than any other state when it comes to access to abortion, according to the Guttmacher Institute, a research and policy organization that advocates for abortion rights. This state is as a model to protect reproductive rights under Democratic Governor JB Pritzker.
Sarah Garza Resnick, president and CEO of Personal PAC, which works to elect pro-abortion political candidates, calls raising the money needed for equal access “the next challenge in our fight.”
All of this raises the question of who might step in to fund abortions and even expand access to them. In Illinois, some point to Cook County’s public health system, one of the largest in the country with a legacy to treat everyone regardless of whether they can pay, and yet are relatively silent on the subject of abortion.
The turning point
The Chicago Abortion Fund has been around for about 40 years. In 2019, when abortion was still a constitutional right, the fund spent about $160,000 to help people obtain abortions.
This amount has risen to about $8 million since the U.S. Supreme Court Roe v. Wade decision overturned in 2022.
Jeyifo seems to be everywhere, asking for financial support.
“If you tell the story of the Chicago Abortion Fund, which received 1,700 calls for support in one month, supported people in 32 different states and spent $600,000 in one month, people are actually writing checks,” Jeyifo said. “But not at the scale that we need right now.”
The Chicago Abortion Fund is expected to receive about $5 million from the state to cover travel and accommodation expenses for patients from out of state, Jeyifo said.
Jeyifo estimates that the fund needs at least an additional $200,000 per month to cover the cost of abortions.
And as national abortion fund that the number of support providers and patients is declining, and more people need assistance in covering their costs and are turning to local organizations like the Chicago Abortion Fund.
Meanwhile, more and more women are coming to Illinois for abortions. In 2023, just over 37,000 people will travel here from out of state to terminate their pregnancies – a more than threefold increase in three years, Guttmacher said. Those estimates show that about four in 10 people who had an abortion in Illinois came from out of state. And that doesn’t even include the women who have come here since then. Bans in Florida And Iowa came into force in recent months, said a spokesman for Guttmacher.
Jeyifo said the fund has drawn on its reserves, and after five years of helping anyone in need, it must now limit its assistance to patients who live or have an abortion in Illinois or Wisconsin, Iowa, Nebraska and Arkansas, where the Chicago Abortion Fund has partnerships.
Jeyifo said the reduction was “devastating” and hoped it would only be temporary.
What this means for patients
Dr. Allison Cowett sits in her office in Chicago’s West Loop district in Family planning partnerone of the largest independent abortion clinics in the country, and helps explain what it all means.
She is particularly concerned about the roughly 30 percent of her patients who come to her clinic from other states. For example, a fund that has paid 100 percent of the costs for patients from other states who have an abortion in the first three months of their pregnancy since the Roe case expires on September 1.
A first-trimester abortion typically costs about $500. Most of Cowett’s patients are low-income and covered by state-funded health insurance (Medicaid) in Illinois, which pays for abortions. The others, who come from other states, are largely covered by abortion funds that are currently being cut.
“Will people stop coming if we tell them on the phone, ‘This is how much money you have to bring?'” said Cowett, medical director of Family Planning Associates. “It’s heartbreaking.”
She said her staff had these conversations with patients for years, before Medicaid and abortion funds covered the costs. They are preparing to have them again.
There was no comment from spokespeople for the national abortion funds that are cutting or eliminating their funding.
Possible solutions
The governments of Illinois and Chicago have supported abortion through money or other protective measures, such as Special zone around Cowett’s clinic to calm the protesters. Pritzker used his own money to start Think Big America, an organization that advocates for the protection and expansion of abortion rights in the United States
But Cook County Board President Toni Preckwinkle has stepped back from the abortion spotlight and instead championed other programs that have gained national recognition – and a piece of $1 billion in federal funds for pandemic relieffor example by providing a guaranteed income and waiving medical debt for the poorest residents.
The district offers abortions John H. Stroger Jr. Hospital on the Near West Side — nearly 660 in 2022, the year Roe was overturned, to about 900 last year and an expected 1,200 by the end of this year, according to a health system spokeswoman. That’s comparable to some other local hospitals, although the other hospitals perform more surgical abortions for women in the later stages of their pregnancy.
In comparison, Family Planning Associates offers at least 200 abortions per week. A low percentage of abortions happen in hospitals.
Although the county is the largest medical safety net in the region, it is not part of a government-funded program the patient refers with complicated medical conditions who need an abortion to four Chicago hospitals. A spokeswoman for the county health system said the county accepts patient referrals from those hospitals.
“I think abortion is still a dreaded word for a lot of people,” said Cook County Democratic Commissioner Bridget Degnen.
But she and Democratic Commissioner Donna Miller, former CEO of Planned Parenthood Illinois, said they wanted the county to prioritize and publicize abortion access.
“Our mission in the county has long been to support disinvested communities, and affluent women have no problem getting an abortion,” Degnen said. “This is all fully consistent with the county’s mission.”
She suggested that the county expand access and explore funding for other abortion providers, similar to how the county provides grants to nonprofits.
Miller said she wants to see the county’s abortion doctors who live in states where they can no longer work. She stressed that the county should help women and not go back to the days when the health system had a unit dedicated to treating women who botched, illegal abortions before Roe became law.
In a rare interview about reproductive rights, Preckwinkle said she supports abortion and pointed out that she has a daughter and granddaughter, but she acknowledged that as county manager she did not disclose medical services due to safety concerns.
“Protecting our patients and our health care providers has to be our top priority, and that takes precedence over promoting the services we provide,” Preckwinkle said. “Frankly, I don’t want to be in a situation where everyone who comes into our hospital has to cross a line of protesters.”
Dr. Claudia Fegan, chief medical officer at Cook County Health, which includes Stroger, Provident Hospital and clinics throughout Chicago and the suburbs, remembers an abortion doctor who worked for the county who had a rat nailed to a tree in her front yard years ago. The clinic is receiving threatening letters these days, the health system spokeswoman said.
Fegan said there was a time before Illinois Medicaid paid for abortions when the county was “the only choice.” Now those patients have more providers to choose from, she said.
Still, people needing abortions are being referred to the county by other doctors in the area and neighboring states, Fegan said. The county has added more walk-in hours for patients this summer and is working with the Chicago Abortion Fund to coordinate patient referrals.
Kelly Hall, executive director of the Fairness Project, said she is working on another way to take financial pressure off abortion funds: getting voters in several states to support abortion through ballot measures.
In other words, if abortion became more accessible in other states, organizations like the Chicago Abortion Fund wouldn’t have to pay as much to help women cross state lines.
But Jeyifo says abortion is still not available to people in states where referendums have been passed. Clinics in MichiganFor example, still sends patients to Illinois, she said.
Jeyifo wants to see a creative solution at the federal level, similar to how the government pulled together during the Covid-19 pandemic and provided money to local governments like Cook County to help their communities recover.
What motivates Jeyifo in the meantime is the memory of her own abortion about 25 years ago.
“It was a really horrific experience, I had no financial or emotional support and I drive past this clinic every time I’m here,” Jeyifo said while in Milwaukee.
Still, she said, “I know exactly what access to abortion has meant to my life.”
Kristen Schorsch covers public health and Cook County government for WBEZ.
