Providing abortions rarely paid Kwajelyn Jackson’s bills in 2024.
As executive director of the Feminist Women’s Health Center, an abortion clinic in Atlanta, Georgia, Jackson spent the year navigating Georgia’s six-week abortion ban, which reduced financial support for abortion patients and soared inflation. The clinic spent more money than it made from providing abortions, largely because Jackson strove to pay her staffers a decent wage and the clinic often subsidized the abortions of patients who could not afford to pay.
“Essentially, we charge about half of what it costs to provide the care,” Jackson said. “Our ability to maintain payroll and operating costs on an ongoing basis was under significant pressure for part of 2024. We were kind of living paycheck to paycheck.”
The Feminist Women’s Health Center is still open, but it is one of the lucky ones. Eleven independent abortion clinics have closed in the past year, bringing the nationwide total of brick-and-mortar indie clinics in the U.S. to 363, according to a report released Tuesday morning by the Abortion Care Network (ACN), a network of independent abortion clinics. providers. That is less than the more than 500 in 2012.
In the US there are ‘independent’ abortion clinics that are not affiliated with a hospital or run by Planned Parenthood. Their closures could have an outsized impact on abortion access, as independent clinics provide nearly 60% of all abortions in the U.S., the ACN report said. More than 60% of clinics that perform abortions after the first trimester of pregnancy are independently run, as are all clinics that perform abortions after 26 weeks. If America’s network of independent clinics continues to shrink, countless numbers of potential abortion patients will likely be unable to end their pregnancies.
“Whether it’s abortion bans or extremists outside the clinic, or the financial challenges associated with moving services, relocating a clinic, complying with new regulations – clinics are under enormous financial pressure,” says Jay Thibodeau, communications consultant. director of the Abortion Care Network. “The help they need is not available now.”
A total of 76 independent abortion clinics have closed since the U.S. Supreme Court overturned Roe v Wade in 2022 and allowed more than a dozen states to ban nearly all abortions. But the closures are not limited to states with restrictive laws. Of the 11 clinics that closed their doors last year, eight were located in states where abortion is common protections.
After Roe fell, millions of dollars in donations flowed into the coffers of abortion rights groups. But in the years since, much of that money has dried up – especially the funds that go there independent clinics and abortion funds, which help patients pay for the procedure and the logistical costs associated with it, such as travel and accommodation costs.
Meanwhile, patients’ needs have increased. Despite the clinic closures, U.S. abortion rates have risen over the past two years, largely because people have traveled across state lines for the procedure or accessed abortion pills through telehealth. Medication abortions — which now account for roughly two-thirds of U.S. abortions — require fewer resources to administer and can also be sent by mail, easing the burden on brick-and-mortar clinics.
Yet there is no real replacement for abortion clinics, which provide surgical abortions when medication is not an option, and other services such as ultrasound and counseling.
“As a provider that offers both medication and procedural abortion, we know people need multiple options,” Jackson said. “Medical abortion is not for everyone.”
In the summer, when donations dropped, The National Abortion Federation (NAF) announced this that it cut back on the financial assistance it provided to abortion patients. Instead of covering 50% of the cost of an abortion in most states – and 100% in some states, including Georgia – the NAF began covering only 30%.
A few weeks later, an organization called Resources for Abortion Delivery ended the Access Fund (TAF), another program that helped pay for abortions. providing approximately $1 million in financing every month, according to the Nation. An employee of Resources for Abortion Delivery declined the Guardian’s request for comment on why the organization ended the program. “As a matter of policy, we do not comment to the press,” the employee said in an email.
For the Feminist Women’s Health Center, these policy changes dramatically impacted their work.
“Our patients were essentially receiving free care,” Jackson said. “Now, most patients get about 30% of the cost of their care covered by NAF funding, and other abortion funds are scrambling to fill even more of that gap.”
Economic forces have made matters worse. In part because about half of abortion patients live below the federal poverty line, providers have stayed put the costs of abortions are relatively low. But inflation has caused the cost of everything else to skyrocket. If Jackson were to charge patients the actual cost of performing an abortion — including the cost of equipment and labor — she says she would would probably have to double clinic prices.
Another source of tension is fatigue among potential donors, more than two years after the fall of Roe. The Abortion Care Network has been running a fundraising campaign for years called Keep Our Clinics, which helps clinics pay rent, security, legal fees and other services. In 2022, the campaign raised $5 million. In 2023, it raised $3 million.
“We can’t sustain an entire health care system based on people donating small amounts at a time,” Thibodeau said. “We need massive systemic change.”