It’s harder to pay and travel for abortion care, but support funds are struggling

Getting an abortion can cost hundreds, if not thousands of dollars, especially if a patient must leave a state with a strict abortion ban.

But the organizations that provide financial support, sometimes known as abortion funds, are struggling financially and slashing their budgets, unable to meet the needs of the growing number of people asking for help.

Planned Parenthood of New England is warning of a projected $8.6 million deficit. Funds in Ohio, Chicago, Arizona and Florida don’t have enough money to meet demand.

Even the National Abortion Federation, which runs a national hotline that helps cover procedure costs, was forced to cut its monthly budget in half, due to fewer donations.

Previously, the Federation had covered up to 50 percent of an eligible patient’s costs in most locations. In July, it dropped that coverage to 30 percent.

“We’re in the midst of an abortion funding crisis,” says Oriaku Njoku, the executive director of the National Network of Abortion Funds, which provides an online search tool for patients to find a local or regional assistance fund.

Njoku and others at these funds point to intersecting pressures: increased demand for financial assistance for abortions, additional expenses due to some patients having to travel across state lines, and a decline in donor interest.

Donor attention has turned to electoral fights

The initial wave of “rage donations” that flowed into the national and regional funds, after the Supreme Court overturned Roe v. Wade in 2022, has subsided.

“It’s weird to see the divestment like, don’t you see the crisis anymore?” says Jenice Fountain, executive director of the Yellowhammer Fund in Alabama.

“We’re absolutely, very much still in crisis, potentially even worse crisis than when the ban first happened.”

In Florida, most abortions are banned after about six weeks. That leaves patients with a narrow window to come up with the money for the procedure. The fee can range from $600-800 dollars. Medicaid and some private insurance plans don’t cover it in Florida. Patients who are further along in pregnancy must travel to other states, which can cost thousands of dollars.

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The Yellowhammer Fund supports pregnancy and prenatal care, and is involved in a lawsuit against Alabama’s Attorney General, after he threatened to prosecute groups like Yellowhammer for helping patients travel out of state for abortion care.

“People ask ‘Why should we donate if Alabama doesn’t have an abortion clinic?’” Fountain says.

“And it’s like, well, that’s a reason to double down on support in Alabama. We’re fighting the thing. We have to exist the whole time that we fight the thing.”

More donations for ballot initiatives and pro-abortion political candidates

But abortion hasn’t faded from the news, or become less politically potent. In fact, reproductive rights have become a prominent issue in this year’s presidential election.

Ten states will put ballot measures on abortion rights before voters in November, and many Democratic candidates have made it a central issue to their campaign.

The cumulative effect has been to divert donations away from the funds that support patients directly — and towards specific candidates and ballot initiatives.

In August, more than 30 local abortion funds across the U.S. signed an op-ed criticizing national reproductive rights organizations for focusing too much on advocacy rather than patient care.

“I think there’s this false hope and illusion with putting the right president in place, or winning this ballot initiative,” says Eloisa Lopez, executive director of the Abortion Fund of Arizona.

“None of that is actually funding abortion care,” Lopez says. “You can have all those things in place and people are still not going to be able to get their care.”

Even after the election ends, Lopez fears that donors will continue to assume that grassroots abortion funds like hers don’t need as much support — especially if voters approve state-level ballot initiatives that affirm reproductive rights.

“I think when people see progress is being made, it’s translating into people’s minds, like ‘We’re not going to have struggles trying to get abortion anymore.’”

But advocates say that the struggles to pay out-of-pocket for abortion care, or travel elsewhere for care, will continue in all states.

In Florida, scrambling to help desperate patients as budgets shrink

Bree Wallace, an employee at the Tampa Bay Abortion Fund, typically spends her days glued to her laptop, messaging back-and-forth with pregnant clients who need help paying abortion care — and fast, if they want to comply with Florida’s six-week ban.

One afternoon in July, a woman texted the fund from the waiting room of a clinic. She needed an abortion, but couldn’t pay.

The National Abortion Hotline had pledged to cover 30 percent, leaving her with a fee of $490.

“It can be pretty hefty for people,” says Wallace, 27, the fund’s director of case management.

The Tampa Bay Abortion Fund spent more than $100,000 in July helping patients access abortion care — double what it budgeted. If donations can’t keep up with the pace of current spending, Wallace says the Fund could run out of money in 3-6 months.

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Within minutes, Wallace committed to help. All the woman had to do was share her first name and last initial. The clinic would directly charge the Tampa Bay Abortion Fund for the balance, and the woman could move forward with her appointment.

Raising enough money, quickly enough, has become harder 

In Florida, an abortion can cost between $600 to $800, during the first trimester. Florida law requires a mandatory in-person consultation and an ultrasound, followed by a 24-hour waiting period.

Since 1977, the Hyde Amendment has severely restricted the use of federal funds for abortion care. In practice, that means Medicaid doesn’t cover it — unless individual states cover the entire cost with state funds.

Florida Medicaid does not cover abortion care, and state law also bans coverage by insurance plans sold on the Affordable Care Act marketplace.

Many patients must therefore pay for the entire cost, and have little time to gather the funds under the state’s six-week ban.

Bree explained that many women don’t even know they’re pregnant by six weeks. But if they do, they often have just days to act.

“Especially with six weeks right now you’re kind of working against time, you don’t even have time to even get that money,” Wallace says.

Before Florida’s six-week ban went into effect last spring, some patients could have saved up their own money. But now they need the fund’s help, says Wallace.

At the Abortion Fund of Arizona, declining donations have forced spending cuts. In September, the Fund spent about $18,000 assisting patients — half of what the Fund spent in July.

Often, that monthly allotment is gone in just two weeks, and staffers must turn down requests for aid, or tell patients to try again next month.

“It’s a really terrible position where we’re having to give people ideas about how to raise money on their own,” says executive director Eloisa Lopez.

“’Can you ask your family or friends? Do you have a credit card? Could you take out a line of credit? Do you have items in your home you can sell?’”

Costly trips out-of-state are becoming more common

Since most states near Florida also ban abortion, patients past the state’s six-week mark are traveling to places like Washington, D.C. or Illinois for care.

Between last-minute airfare and hotel stays, that can push the price up another $1,000.

“There’s also taking off work. That can be hard for a lot of people, finding childcare,” Wallace says. “Sometimes this is the first time people have ever been on a plane, ever left Florida…it can be really confusing and stressful.”

Earlier this year, the Tampa Bay Abortion Fund decided it could spend fifty thousand dollars a month helping pay for procedures and travel. But since May, it’s regularly blown past that limit.

The fund doesn’t want to turn down someone who really needs help, Wallace says. She read out loud a grateful text she recently received from a client.

“‘Thank you,’ with a million exclamation points,” Wallace reads from the screen. “’Thank you so much,’ with even more exclamation points. ‘I appreciate you for what you do, you just helped me more than you know.'”

The Tampa fund hopes to do more fund-raising this fall. But if future donations don’t keep up with spending, it will completely run out of money in 3-6 months, according to Wallace.

Taxpayer funds are flowing to crisis pregnancy centers 

Because of the federal Hyde Amendment, abortion funds must turn to private donations from individuals, community groups or foundations.

But in many states, federal and state funds are used to support crisis pregnancy centers that oppose abortion and often try to dissuade people from getting an abortion. In the last 5 years, about $400 million dollars in federal money flowed to crisis pregnancy centers across the country.

In addition, states have also allocated millions for these centers – last year Tennessee funneled $20 million, and in North Carolina legislators set aside $12.5 million for the next two years.

This story comes from NPR’s health reporting partnership with WUSF and KFF Health News.