In June 2022, the Supreme Court overturned Roe v. Wade, marking the end of a federal constitutional protection for abortion in this country. It is anticipated that as many as 26 states will ban or severely restrict access to abortion, impacting more than 36 million people with the capacity to become pregnant. People living in those states in need of abortion will face significant barriers trying to access that care – the cost of that care when they lack health care coverage, traveling hundreds of miles, while needing to take time off from work and find childcare. For some those barriers will be insurmountable, and they will be forced to either self-manage their care, remain pregnant, placing their health and wellbeing at risk.
Even when Roe was in place, the right to abortion was and still is in name only for far too many. Decades of tenacious efforts by anti-abortion policy makers led to the enactment of over 1380 abortion restrictions since the landmark decision in 1973. Restrictions that deterred, delayed and denied many from exercising that constitutional right. Restrictions that are built upon and operating within our country’s legacy of racism and discrimination, and thus disproportionately impact Black, Latino, Indigenous and other people of color, young people, disabled people, and people experiencing poverty. Today we find ourselves not in a fight to restore Roe, instead we must reimagine the future. It is incumbent on us to build a system of policies and care that is anchored in equity – where everyone who needs an abortion can truly access abortion care. To fight not just for the right to abortion, but for policies that at the core effectuate that right and advance equality and justice for all.
PPESA strives to use gender-inclusive terms such as “pregnant people” or “people seeking abortions” as often as possible. We may opt to use gendered language in specific circumstances, such as to reflect the language used in a statute/regulation or research finding, or to align our language with the language people use themselves. PPESA seeks to continually learn and change the language we use to be as inclusive as possible, and we welcome your questions and suggestions on how to improve.
Strengthening Access through Increased Medicaid Reimbursement for Sexual and Reproductive Health Care.
If New York is going to be a true access state, it must ensure providers are adequately reimbursed for the care they provide. A decade of stagnant Medicaid reimbursement and inflation factors mean providers are significantly unreimbursed compared to what it costs them to deliver care today. Other access states, like California, Oregon and Illinois have all recently increased reimbursement for reproductive and sexual health care services – through rate increase supplemental payments on key abortion and reproductive health care services.
Increasing Grant Funding for Reproductive and Sexual Health Care.
As stated above, it is estimated that 26 states will move to ban or severely restrict access to abortion in the wake of the overturn of Roe, impacting 36 million individuals with the capacity for pregnancy. Unfortunately, the stark reality of millions losing access to abortion care is not just a crisis of today but will be a crisis we are facing for years to come. Prior to Governor Hochul’s historic investment of $35m in access and security funding for abortion providers, there had been no intentional investment in abortion access. This reality coupled with insufficient Medicaid reimbursement and rising costs of delivering care, has throttled the ability of providers to grow their capacity to meet the present need, and invest in their infrastructure to enhance their delivery of care. Before the fall of Roe, New York’s abortion care infrastructure was at or near capacity. As we face the mounting pressures of access to abortion care drastically dwindling across the country, continued grant investment is paramount to addressing the challenges of uncompensated care, provider training and capacity, facility enhancements, and the need for practical support to ensure access to care for all.
The State must continue these grant funds and enact the Reproductive Freedom and Equity Program – legislation that would create a sustained funding mechanism through the NYS Department of Health to provide grants to support the operational and programmatic needs of abortion providers and abortion fund – to ensure they can address the growing need for care in New York.
The State must also continue to invest in the Comprehensive Family Planning and Reproductive Health grant. In 2016, it was estimated that roughly 1.2 million New Yorkers with low incomes needed publicly funded primary reproductive and sexual health care services. This program facilitates affordable access to a range of critical services like birth control, cervical cancer screening, sexually transmitted infection testing and treatment, and more for New Yorkers with low incomes. However, decades of stagnant funding has made it challenging for providers to deliver care to all who need it. 2022 was the first year in over a decade when providers experienced an increase in their family planning grant funding, however, this increase still fails to meet the needs of providers as they seek to respond to the demand for care in their communities.
This is the time to ensure the State’s continued investment in this critical program meets the realities that providers face as they strive to expand access to these vital services throughout NYS. The FY24 NYS budget must provide an annual Cost of Living Adjustment (COLA) to the Family Planning Grant.
Advancing an Equal Rights Amendment.
Our New York State Constitution is wholly inadequate when it comes to ensuring equality. We must amend our constitution to be protective and reflective of us all. Today, our state Constitution fails to prohibit discrimination against groups who have been historically targeted and marginalized – those with disabilities, LTBTQI+ individuals, immigrants, women and pregnant people. In the wake of the Supreme Court’s overturn of Roe, the legislature passed a resolution that begins the process of amending our State Constitution, to add a broad and inclusive Equal Rights Amendment that will prohibit discrimination based on ethnicity, national origin, age, disability, and sex – including sexual orientation, gender identity, gender expression, pregnancy and pregnancy outcomes. It would also protect against government actions that would impact one’s access to reproductive health care and their reproductive autonomy. The legislature must again pass the Equal Rights Amendment in 2023, so it can go to the voters for approval in 2024, sending a strong message that New York believes in equality for all.
Ensuring Comprehensive Sexuality Education for all New York Youth.
Information is power. When young people have the tools they need to make healthy decisions about their bodies and their relationships, they have a brighter future. Comprehensive sexuality education has been shown to improve health outcomes and benefit our youth. Unfortunately, there is no consistent requirement for this education in New York, creating a patchwork system where not all kids receive this education and in some cases are not receiving accurate information. PPESA supports legislation that would require the inclusion of comprehensive, medically accurate, culturally, age and developmentally appropriate sexuality education in publicly funded K-12 schools statewide. Your ability to access this vital information should not be dependent upon your zip code.
Increasing Access to Medication Abortion on Campus.
Abortion is time sensitive and delays in care due to factors that are common to the university experience can have a significant and potentially negative impact on a student’s finances, education goals, and quality of life. PPESA supports existing legislation that would require State University of New York (SUNY) and the City University of New York (CUNY) to provide medication abortion on their campuses via student health centers or contract with a third party to provide those services. Through providing medication abortion on campus via student health centers or facilitating students receiving this care from qualified abortion providers, public colleges and universities can support students in exercising their right to bodily autonomy.
Ensuring Transparency and Access to Sexual and Reproductive Health Care and Gender Affirming Care.
New Yorkers across the state are at risk of being turned away from hospitals when they need reproductive health care, end-of-life care, gender-affirming care, and other types of sensitive health care, due to policy-based exclusions that are not based in medical science or public health. No one should be turned away from a hospital when they need health care, yet some hospitals deny treatment based on the decision-making of non-medical personnel. To make matters worse, because information about what care hospitals provide is often impossible to access, patients cannot determine whether their local hospital provides the care they need.
PPESA supports proposed legislation surrounding hospital transparency that would offer patients the tools they need to determine whether the hospital in their area provides the care they seek prior to admission. In addition, it will give New York the tools to identify regions in the state where particular types of care are unavailable and to understand the impacts of such gaps on communities and individuals statewide.
Further, when hospitals choose to implement these policy-based exclusions, it can operate to limit both communications between health care practitioners and their patients regarding treatment options and the types of care they can provide, as well as the provision of those services. We support legislation that would prohibit hospitals from preventing practitioners from communicating accurate and comprehensive information about a diagnosis or medically accepted course of treatment or preventing delivery of a medically accepted course of treatment for pregnancy-related complications or miscarriage management.
Addressing Reproductive Health and Rights of Incarcerated Persons.
Every individual has a right to be treated with dignity and to have the necessary resources and support that enable them to truly exercise agency in their reproductive decision-making. However, we live in a society where these fundamental rights are constrained by conditioned beliefs as to who is deserving of or entitled to this respect and treatment under the law. These dynamics are even more pronounced in the criminal law system. Inherently, incarceration undermines reproductive autonomy. This is distinctly true for Black women and women of color, whose lives lie in the intersections of identities that are devalued and forced to exist within systems of oppression. PPESA supports legislation that will require NYS correctional facilities to provide access to comprehensive sexual and reproductive health care services for all incarcerated individuals.
Continuing to Combat Maternal Mortality and Expanding Access to Doula Services.
Rates of maternal mortality in this country and state are unacceptably high – particularly for Black women. It is estimated that 84% of maternal deaths are preventable. Over the past few years New York has taken many important steps towards combating maternal mortality, and we must continue to pursue policies and investments that reduce maternal mortality and support safe and healthy pregnancies and births for all pregnant people.
Expanding Access to Affordable Health Care Coverage.
Everyone’s health depends on access to care and coverage. Hundreds of thousands of New Yorkers cannot enroll in health insurance because of their immigration status. The Essential Plan for All will make access to affordable care a reality for undocumented New Yorkers by establishing a state-funded Essential Plan program for immigrants whose status makes them ineligible for other state and federally funded coverage. PPESA stands with the #Coverage4All campaign in calling for passage of the Essential Plan for All to ensure coverage for all New Yorkers.
Protections for Patients and Providers.
As states continue to pass new restrictions on abortion in the wake of the Dobbs decision, New York must continue to act to ensure that providers and patients receiving care in the state are protected to the best of the State’s ability. While New York acted swiftly at the end of the last legislative session to enact broad legal protections for abortion providers and patients, in this ever-evolving landscaping more can be done to ensure both providers and patients are protected. Accordingly, we support legislation that would extend existing legal protections to a broader range of reproductive health and gender-affirming care and provide protections to all types of providers who deliver these services, individuals receiving these services and those who aid in accessing these services.
Now is the time for New York to be bold. Our State must lead the fight for abortion justice by investing in access and expanding key policies that benefit every individual providing or seeking care in New York.