If the Supreme Court reverses Roe v. Wade — as a leaked draft opinion suggests the court is poised to do — thousands of out-of-state residents seeking abortions may head to Washington.
It is unclear if the draft, leaked Monday to Politico, represents the court’s final decision in Dobbs v. Jackson Women’s Health Organization, a case challenging the constitutionality of a Mississippi abortion ban.
As many as 26 states are certain or likely to ban abortions if the legality is left entirely up to states, according to the Guttmacher Institute, a research organization that supports abortion rights.
Of those 26 states, 13 have passed trigger laws, bans that would immediately take effect if the ruling is overturned.
Total bans in 26 states would lead to a 385% increase in the number of people traveling to Washington for abortion care, the institute projects.
In 2019, Washington recorded 11.4 abortions per 1,000 women ages 15-44, according to the latest available data from the CDC. Of the 17,262 abortions performed, 848, or 5%, were obtained by out-of-state residents.
The institute estimated driving distances to the nearest abortion clinics (should total abortion bans take effect in 26 states) for women of reproductive age (15-49). Driving distances were calculated based on census data and abortion clinic locations.
Most people traveling to Washington for abortions would come from Idaho and Montana. Idaho has a trigger law that would ban abortions six weeks from conception. In Montana, laws restrict access to abortion pills and pregnancy terminations at 20 weeks. Although the Montana laws were passed in 2021, a court order currently preventing enforcement.
Patients are also expected from Oregon and Nevada, where there are fewer abortion facilities per capita.
Although Oregon fully legalized abortion in 2017, the Guttmacher Institute projects the state will not record an increase in patients driving to its facilities in the event of a total ban or a 20-week ban. As of 2017, close to 80% of counties in Oregon did not have abortion facilities. Most clinics are along the Interstate 5 corridor, making access to abortion harder for about the quarter of Oregon women who live in remote parts of the state, such as Eastern Oregon.
Some states are exploring options to stop residents from having out-of-state abortions, after lawmakers in Missouri earlier this year floated a bill to allow individuals to sue anyone helping a patient cross state lines for an abortion. The Missouri House blocked the law and further legal challenges are expected.
Access to abortion clinics in Washington state
In 1970, three years before Roe v. Wade, Washington legalized abortions within the first months of pregnancy, becoming the first state to do so.
The Reproductive Privacy Act, passed in 1991, codified Roe v. Wade into state law.
Since then, Washington has enact a range of statutes focused on reproductive health. In 2018, Washington passed a law requiring insurance plans to cover abortions and abortion care if they cover maternity services.
Many protections established by these laws are circumvented when hospitals don’t offer abortion services, said Kim Clark, senior advocate with Legal Voice, an organization focused on rights of women, girls, and LGBTQ+ people in the Pacific Northwest.
“People don’t realize that over 50% of the hospital beds in Washington are controlled by hospital systems that don’t provide certain types of care, which includes certain types of reproductive health care,” she said. “And with the latest Supreme Court case, I think we’ll see a dramatic increase in private institutes claiming religious freedom to undermine individual rights.”
Abortion bans and restrictions will have less of an effect on those with money, who have the ability to travel and access to vacation and sick leave, said Terry Price, a law professor at the University of Washington.
“They disproportionately affect poor women, especially Black, Indigenous and other women of color,” Price said.
A 2019 CDC study on abortions in the US found women in their 20s accounts for the majority of people seeking abortions. In the areas that reported marital status, 85.5% of the women were unmarried. Nearly a quarter already had a child and more than half had never had an abortion before.
The study also found white women had the lowest abortion rate among the areas that reported data on race and ethnicity. In 2019, abortion rates among non-Hispanic Black women were 3.6 times higher than among white women, and 1.8 times higher than among Hispanic women.
“Structural factors, including unequal access to quality family planning services, economic disadvantage, and distrust of the medical system, might contribute to observed differences,” the CDC said in the study, adding that there need to be strategies to address these issues.