A potential national ban on abortion will disproportionally affect Black, Latino, immigrant, and low-income Texans, who already face barriers to accessing basic resources like health care.
A draft U.S. Supreme Court opinion leaked Monday indicated that the high court could upend the landmark 1973 Roe v. Wade decision that established constitutional protections for abortion. Such a move also could affect rulings that have guaranteed access to other reproductive health care, such as contraception, some legal experts say.
Abortion under Texas Senate Bill 8 is still permitted in the state, although the procedure is prohibited after six weeks of pregnancy, which is often before people are aware they are pregnant.
But overturning Roe could worsen the livelihood of people living in poverty — many of whom are people of color. A ban on abortion in Texas could also worsen the maternal mortality rate in Texas if those who are pregnant are forced to have an unsafe "do-it-yourself" abortion, experts told the American-Statesman.
Texas is among 13 states, including the bordering states of Oklahoma, Louisiana and Arkansas, that would ban abortions relatively quickly if the higher court upends Roe in a final ruling next month.
Who is more likely to get an abortion in Texas?
According to 2019 data from the national Centers for Disease Control and Prevention, 60% of people who have an abortion in Texas have given birth more than one time. That same year, 27.9% of people who had abortions were Black, 38.8% were Hispanic and 26.3% were white, according to the Texas Department of Health and Human Services.
"This is a racial justice issue because the women and pregnant people who will have the least means to travel to get an abortion are overwhelmingly people of color," said Sheila M. Katz, a University of Houston associate professor of sociology. Her research is focused on the experiences of low-income women and families.
"Women, because of the gender wage gap, get paid less than men for similar jobs. (Women) are more likely to be impacted by recessions or other economic forces. And they're also much more likely to have dependents: children and parents," she said.
Most people seeking abortions are poor and many don't have jobs that pay above the minimum wage or provide such benefits as paid time off or family leave, Katz said.
The nation lacks universal paid family leave for workers, and accessing child care can be difficult.
"Most jobs that low-income women have are in the service industry. These are not 8-to-5 or 9-to-5 jobs. So the evening or overnight child care is much more expensive If it's available," Katz said. "But also the quality of care in Texas particularly is quite low. There's not as much regulation on the child care industry as there needs to be in order to ensure quality care for low-income women's children."
Gaps in health care coverage
Marginalized communities would be affected by an abortion ban and any other potential restrictions to reproductive health care because Texas lacks affordable health care options for people living in poverty.
Health care access advocates told the Statesman that Texas has the nation's highest uninsured rate and the largest uninsured population.
In Texas, about 5 million people are uninsured, said Stacey Pogue, a senior policy analyst with Every Texan, an Austin-based nonprofit organization that researches, analyzes and advocates public policies to expand equitable access to health care.
The state uninsured rate is 17.5%, but that number is 24% among working-age adults between the ages of 19 and 64. Texas also has the highest uninsured rate among women and people of childbearing ages, Pogue said.
"Essential workers, people in health care centers, people who work in fast food, people who stock the shelves at grocery stores, who have low wage jobs — and their job doesn't come with insurance benefits, even if they work full time, and a lot of them do," Pogue said. "Some states have expanded their Medicaid program to cover low-wage adults. But in Texas, we haven't."
If your wages put you above the poverty line, she added, "there's some help through the Affordable Care Act or Obamacare health insurance to get affordable coverage. But if you're in poverty, if you're below poverty, there is essentially no affordable coverage for you as an adult in Texas."
Based on a report by the CDC, as of 2018 in Texas, the maternal mortality rate is 18.7 deaths per 100,000 live births — that's above the national average.
"We have a whole bunch of women who don't have good access to the health care they need and don't have health insurance. And then we also have some family planning programs in Texas that make contraception, and a very limited range of health care outside of contraception, available to serve low-income uninsured women," Pogue said. "But the numbers of women served in those programs are nowhere near the numbers of women in need of those services. There's this huge gap between who we serve and who needs contraceptive care."
A ruling that criminalizes abortion also could affect those experiencing domestic violence, Katz said.
"Women are at most risk of domestic violence when they're pregnant, and they're at most risk of being murdered by a violent partner in the days or weeks right after they leave a partner," Katz said. "And being able to terminate a pregnancy and leave the partner, increases women's safety and the safety of the children they already have."
In September, state lawmakers adopted SB 8 and Gov. Greg Abbott swiftly signed it into law.
During the Texas Rally for Life in January, where thousands of abortion opponents gathered at the Capitol, Abbott told the crowd that he is prioritizing help for pregnant people in need.
He said Texas is providing $100 million for programs that can be alternatives to abortion to support expecting mothers in need.
In a statement Wednesday, a spokesperson for the Texas Alliance for Life said the leaked Supreme Court draft opinion gives the anti-abortion organization "reason to be hopeful."
"We will continue to work to promote compassionate alternatives to abortion available to (women) through the state's highly successful Alternatives to Abortion program, the Texas Healthy Women Program, and more," the statement says.
Catholic Diocese of Austin Bishop Joe S. Vásquez said in a statement the church's commitment to protecting human life "from conception to natural death remains steadfast."
"So, too, is our commitment to accompany mothers who face an unplanned pregnancy. As we await the Supreme Court’s final decision, my hope is that people of goodwill will continue to pray for a just decision that upholds the dignity of life,” Vásquez said.
'A domino effect' of hardship
Because of a so-called trigger law, an abortion ban in Texas would take effect 30 days after a ruling from the high court and would not require the involvement of the Legislature or any official to be implemented.
Abortion rights organizations and providers said the need for funds to travel to seek an abortion has increased since SB 8 was implemented.
“Pre-SB 8, we used to get 40 to 50 calls a month, and we were able to help about 95% of those callers every time,” said Anna Rupani executive director of Fund Texas Choice, a nonprofit that pays for Texans’ travel to abortion clinics. The organization has been assisting people since 2013. “Post-SB 8, we get nearly 300 calls a month.”
The organization helps pay for gas, flights, food, hotels, ride-hailing service costs, child care costs, medications and other needs.
Rupani said that 73% of Fund Texas Choice’s clients identify as Black, indigenous, or other persons of color. And 62% of clients are already parenting and 5% are minors.
The organization already pays for clients' 1,300-mile round trips, but if Texas bans abortions, people will have to go farther, which will increase travel costs.
“If you need to go to Kansas, if you're going into Colorado, California, Washington, you're going to have to take multiple days off work, and a lot of our clients don't have salary jobs. If they can’t take off work, they're not getting paid and they lose money,” Rupani said. “And then clients are already waiting anywhere from one to four weeks from when they call a clinic to get an appointment. That means they're going to be further in their pregnancies which increases the abortion costs itself. … This is like a domino effect in how this is going to impact folks.”
Where to get reproductive care in Central Texas
For information and a list of locations in Austin go to plannedparenthood.org/planned-parenthood-greater-texas/patient-resources or call 512-477-5846.
Austin Women's Health Center
Gynecology, abortion and medical care services are provided.
For more information go to austinwomenshealth.com/our-unique-approach or call 512-887-7043.
Whole Woman's Health
Abortion services in Texas at Whole Woman's Health are currently free. Patients can book an appointment online at wholewomanshealth.com or call 877-835-1090.
CommUnityCare is a nonprofit health center that provides outpatient health care services to lower-income populations in Travis County and surrounding areas. Gynecology, family planning, pregnancy testing and care throughout pregnancy are available.
For more information go to communitycaretx.org/services/#WomensHealth or call 512-978-9015.
Austin Public Health's Health Equity Unit
The City's Health Equity Unit features a Maternal Infant Outreach Program that provides support to low-income African American women who are pregnant, have a baby or are planning a pregnancy.
For more information, residents can call 512-972-5059.
A full list of services can be found at austintexas.gov/department/health/services.
Other health care resources in Austin
Central Health helps connect low-income Travis County residents to quality health coverage and services.
For more information go to centralhealth.net/contact or call 512-978-8000.
Latino HealthCare Forum
The Latino HealthCare Forum's goal is to provide vulnerable populations access to comprehensive, culturally competent, quality primary health care services.
For more information call 512-386-7777 or go to lhcf.org.
Ventanilla de Salud
Ventanilla de Salud is based in the Mexican Consulate in Austin and offers free health care services and resources in Spanish.
For more information call 512-579-4559 or email email@example.com.
Austin American-Statesman reporter Natalia Contreras can be reached at 512-626-4036 or firstname.lastname@example.org. Follow her on Twitter and Facebook, @NataliaECG.
This article originally appeared on Austin American-Statesman: Expert: Black, Latino, low-income Texans hardest hit if Roe overturned