WHAT IS THE FUTURE OF VALUE-BASED CARE?

Commercial risk will be a critical catalyst of progress – it’s complicated, but is it possible? We think so.

X
Blog Post

Over 100,000 women will be denied abortion in their home state each year

By Yemi Zewdu YimerTara Viviani

August 1, 2022

    More than 100,000 abortion-seeking women annually will no longer be able to access abortion services in their home state, following the U.S. Supreme Court's Dobbs v. Jackson decision overturning the national abortion rights regime first institutionalized by Roe vs. Wade in 1973.

    To help health care leaders understand the specific effects of these complex changes in abortion access, Advisory Board has modeled the number of women1 who now face barriers to receiving an abortion in the 21 states that have instituted abortion restrictions.

    Our analysis yields a conservative estimate that 132,229 abortion-seeking, pregnant women in the U.S. will not be able to receive an abortion in their home state, a number that is likely to rise as some states institute additional restrictions. Those who elect to travel to access a legal abortion will face an average commute of 276 miles each way.

    Stay posted: our estimates for how many of these people are likely to travel, carry to term, seek extralegal abortion medication by mail, and attempt self-induced abortions are coming soon.

    Both abortion policy and business implications are now best understood and managed on a state-by-state basis. To further explore these insights—and prepare for the impact of evolving gestational bans on women in the states in which your organization operates—use the interactive map below to visualize the number of women affected by changes in state abortion laws and read on to dive deeper into our insights and methods.

    To use the map below, navigate the tabs across the top of the map to choose between current and projected abortion policy and the estimated number of abortions banned or permitted in each state.

    Hover your mouse over a given state to see a summary of that state's abortion policy and the total abortions that occurred in 2019 that would or would not be banned today. Keep in mind that you may need to look beyond immediately neighboring states to forecast regional travel patterns.

    Our Analysis

    We set out to determine the number of women who received an abortion in 2019 who would not be able to obtain one today. To do this, we grouped abortion volumes by gestational age for each state based on that state's current total or gestational ban that is in effect 2,3.

    We relied on CDC data to obtain abortion volumes, which provide the most credible and comprehensive source of gestational age volumes on the national level.

    1. An estimated 132K abortion-seeking, pregnant women in the U.S. will not be able to receive an abortion in their state of residence each year given state-level restrictions as of July 2022.

    Overall, this figure is a conservative estimate of women impacted by overturning Roe. It represents the 132K women who received an abortion in 2019 who would not be able to receive an abortion today following the overturning of Roe v. Wade.

    Initial restrictions will also create general access barriers for many of the 62 million women of reproductive age in these states that prohibit or restrict abortions. Some women will lose access to other reproductive, non-abortion care as abortion clinics close while others will experience longer wait times for reproductive care as patient volumes coalesce around fewer remaining clinics.

    Even women in states where abortion is legal or protected may see longer wait times due to capacity constraints caused by patients traveling from more restrictive states for care.

    2. The number of women impacted by state varies widely due to variance in gestational bans

    As of July 2022, gestational bans across the nation vary from total bans to limits starting at fetal viability. For example, while 100% of abortions are banned in Texas, Arizona's current ban only extends to 1% of abortions. States with at least some restrictions are responsible for some of the highest number of women who obtained an abortion in 2019.

    Over half of the top 20 states for abortion volumes are designated as 'certain to ban' or 'likely to ban' abortions by the Guttmacher Institute. Health care stakeholders in these states will need to be prepared to treat a higher number of patients with worsened complications or downstream health outcomes because they lack safe abortion access.

    3. The number of women who will not be able to access abortion services in-state may increase significantly in areas with potential to expand their initial restrictions

    By the end of 2022, the number of states with total bans is expected to jump from nine states to 13 states, and an additional one state (Arizona) will have more restrictive gestational bans. As a result, an additional 6K abortion-seeking, pregnant women in the U.S. may not be able to receive an abortion in their state by year's end.

    Looking beyond bans that are certain, an additional 19K-33K women may not be able to receive an abortion in their state if additional proposed bans go into effect. This is a 15% to 25% total increase in the number of women impacted—and it doesn't even include all the states with room to expand their restrictions in new bills and proposals. There are states that are likely to further tighten restrictions and thus increase the number of pregnant women and abortions impacted.

    For example, Georgia started this summer with a 20-week gestational ban. At that point, about 1% of Georgia's 2019 abortion volumes would not have been legal in-state. Georgia then transitioned to a 6-week gestational ban following a state appeal.

    As a result, 56% of Georgians seeking an abortion (based on 2019 volumes by gestational stage) no longer have legal, in-state access. And if Georgia were to establish a total ban, 100% of the state's abortion volumes would be impacted—eliminating access for an estimated 37,000 abortion-seeking women annually.

    To prepare for the varying impacts on women in your community, we recommend monitoring local policy dynamics. Keep in mind the other impacts on access to related non-abortion care as well as patient outcomes. Our team is hard at work to project the extent of these downstream impacts.

    This table is an additional tool to help you characterize and monitor state abortion policies. It includes the total number of abortions in each state that occurred in 2019 that would be banned based on current and incoming abortion policies as of July 27th, 2022.

    Gabriela Marmolejos and Emily Heuser also contributed to this blog post.

    Footnotes

    1 Although a small proportion of abortions and pregnancies occur among transgender men or nonbinary people, we are limited to using abortion and population counts of women of reproductive age produced by the CDC and U.S. Census Bureau.

    2 Volume calculated by summing the volumes of abortion at each gestational age category as listed in CDC Abortion Surveillance Survey. There are seven categories: ≤6 weeks, 7 to 9 weeks, 10 to 13 weeks, 14 to 15 weeks, 16 to 17 weeks, 18 to 20 weeks, and ≥21 weeks. For each state, the gestational age category was determined based on that state's Gestational ban as of July 2022.

    3 Gestational ban information is from The New York Times Abortion Ban Tracker. Last update: July 27, 2022, 1:45 P.M. ET

    Abortion restrictions will disproportionately impact certain groups—here's how

    imageThe implications of the Supreme Court's decision to overturn Roe v. Wade and Planned Parenthood v. Casey are far-reaching, with over 250,000 reported abortions in 2019 taking places in states likely to ban them following the ruling.

    Check out our insights and interactive maps to see which groups will be most impacted by new abortion restrictions in each state.

    Read more

    Have a Question?

    x

    Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.