A year after Kansas abortion vote, both sides still adjusting to state’s role as access point

Operating abortion clinics in Kansas in the last year has “felt like drinking out of a fire hose.”

Emily Wales, the president of Planned Parenthood Great Plains, said clinics in the state have had to adjust quickly as patients flood in from states where abortion is no longer legal. Wednesday marks one year since Kansans voted overwhelmingly to retain abortion rights in the state constitution, making Kansas a key access point for the procedure in the Great Plains.

“Patients have been scrambling to get out of their home states and that has just spread,” she said.

“Right now when people walk into the state they literally have more rights to control their lives and their medical choices.”

As Planned Parenthood and other clinics scramble to manage the need, anti-abortion activists in Kansas see their worst fears coming true – the GOP-leaning state has become a major access point or “destination” for abortion. And abortion providers, emboldened by last year’s landslide vote, have sued to challenge a long-standing law imposing a 24-hour wait time and requiring information for patients.

“As predicted, the abortion industry is suing Kansas’s very reasonable pro-life laws one-by-one,” Danielle Underwood, a spokeswoman for Kansans for Life, said in an email. “While these legal battles play out, we will pursue all available options to expand women’s access to life-saving resources and compassionate circles of care.”

Advocates on both sides of the abortion issue are still finding their footing in the year since Kansas voters overwhelmingly rejected a constitutional amendment that would have stripped the right to an abortion from the Kansas constitution.

Abortion providers in Kansas have expanded capacity dramatically over the past year and are contemplating further expansions to manage the influx of patients from Texas, Oklahoma, Missouri and other states with strict abortion bans.

With major restrictions on the procedure unlikely to stand up in Kansas state courts, anti-abortion advocates have pivoted to more minor regulations and a focus on crisis pregnancy centers in an effort to persuade women to carry their pregnancies to term rather than seek abortions. Often, those centers are placed directly across the street from abortion clinics. Some have faced criticism for tactics that deceive patients seeking abortion.

The vote reverberated nationally, sending an early message to Democrats and reproductive rights advocates nationwide on how to campaign on abortion after the U.S. Supreme Court overturned the protections for the procedure held within Roe v. Wade. It was a precursor to votes later that year on ballot measures in five other states, where voters either enshrined abortion rights or rejected limits on the procedure.

Advocates on both sides of the issue will mark the occasion Wednesday.

Kansans for Life is holding a volunteer events statewide at crisis pregnancy centers.

And in the evening, Planned Parenthood Great Plains will hold a grand opening for its Kansas City, Kansas, clinic — more than a year after opening its doors and beginning to provide abortion care.

Out-of-state patients drive abortion rate in Kansas

Last year Kansas saw a 57% increase in abortions driven entirely by out-of-state patients traveling from states where most abortions were no longer legal. Nearly 100 fewer Kansas women obtained abortions in 2022 than 2021.

Shortly after the U.S. Supreme Court overturned Roe v. Wade, and triggered Missouri’s near-total abortion ban, Planned Parenthood Great Plains opened its third abortion clinic in the state in Kansas City, Kansas.

In December the organization began providing abortion medication via telemedicine to patients who could come into the clinic on days when a physician was not physically available. The organization is considering whether another clinic will be needed in another part of the state.

The extraordinary, Wales said, has become ordinary in clinics. She referenced consistent work helping patients plan trips to Kansas for their procedure mapping their plans down to the minute so they could be back home in time to pick kids up from school. Constant conversations with patients learning for the first time that they cannot get an abortion in their home state.

Zack Gingrich-Gaylord, a spokesman for Trust Women Foundation, an abortion provider in Wichita, said the organization’s capacities have been scaled up two or three times in the past year. He calls it triage.

“These have to be short term solutions because in the long term what it means is that we’ve basically institutionalized the trauma of these abortion bans,” he said.

The work of reproductive rights advocates nationwide and in Kansas, Gingrich said, should be more focused on restoring access in local communities nationwide.

“This is not a story about how bad things are in Kansas, this is a story about how well Kansans are really taking this on and caring for other people and how poorly other states are doing for their residents,” Gingrich-Gaylord said.

But the reality is horrifying to abortion opponents in Kansas who expect the number of abortions to only go up in future years.

“Kansas has become what we had warned, that we will be a destination state for abortion, is in some regard actually happening,” said state Rep. Susan Humphries, a Wichita Republican. “Going forward the thought is making sure women have safety precautions in place.”

Speaking to conservative radio host John Whitmer after the data was released in June, Underwood, the Kansans for Life spokeswoman, repeated a refrain the organization used throughout last year’s campaign that Kansas would become a destination for unlimited abortions.

“The path that we’re on is ugly and people need to realize this,” Underwood said.

“We’re going to continue to work for a day that the sunflower state is a place that empowers women and gives them the tools to choose life, not this ever growing destination for cruel abortions that we’re becoming.”

Legislative changes

In 2023 Kansans for Life advocated for, and lawmakers passed a host of new state laws governing abortion.

One imposes criminal penalties against abortion providers who fail to give life-saving care to infants “born alive” during an abortion. Federal law already requires that care.

Another mandates abortion providers tell patients the first pill in a medication abortion may be reversible even though the science is unproven. Lawmakers also established a new “alternatives to abortion” program which funnels state dollars to crisis pregnancy centers.

“There was a recognition that there still is a right to abortion in the Kansas constitution and we must take that into consideration,” Humphries said. These policies, she argued, focused on safety and informed consent of patients which she believed would stand up to court review.

But abortion rights supporters say the new laws are an extreme infringement on abortion rights and a signal that lawmakers were not listening to the voters.

In May, abortion providers, including Planned Parenthood, challenged the abortion pill reversal policy in Johnson County Court alongside the rest of the requirements in Kansas’ “Women’s Right to Know” law. If the law is struck down the state’s 24-hour waiting period and an extensive set of information required for abortions will be eliminated.

Underwood has pointed to the lawsuit as evidence that abortion providers are unwilling to accept any regulations. But Wales said the abortion pill reversal policy added to the law this year was a step too far bringing the law from problematic to dangerous for patients.

“Kansans have had the opportunity to functionally ratify what the state supreme court identified and recognized and the right to abortion access. And so we should stand up on behalf of all those Kansans who don’t sit in the Legislature,” she said.

Moving forward, state Rep. Brenda Landwehr, a Wichita Republican, said she wants to continue to focus on ensuring pregnant women have options outside abortion.

She said she wanted to help existing crisis pregnancy centers build the capacity to provide medical care for patients in addition to the counseling and free supplies they already offer.

Additionally, she said, there’s work underway to study how Kansas can make adoption more affordable for parents.

“Those are the gaps that we’re trying to fill in to make sure we’re there for the mother,” Landwehr said, arguing abortion providers provided no support to patients after the procedure.

Though abortion rights won the popular vote last year, Senate Minority Leader Dinah Sykes, a Lenexa Democrat, said the past legislative session proved there was still a strong institutional opposition to abortion in Kansas.

“We are still playing defense because Kansans for Life still have a strong hold on the Legislature,” she said.

Influence on 2024 campaigns

Lessons from the 2022 race are all but certain to reappear in 2024 campaigns.

“We really listened to voters in Kansas last year, we were able to better understand how they think about the issue of abortion and we found out that for the vast majority of Kansans it’s not a partisan issue, it is a personal medical issue,” said Ashley All, a former spokeswoman for the vote no campaign.

“That did play a big role nationally. It was a new way of looking at and understanding the conversation about reproductive freedom and we saw that in several different states.”

Heading into 2024 Wales said Planned Parenthood will work to oust anti-abortion lawmakers. And in the wake of the 2022 vote, Democrats and abortion rights advocates believe a new door has opened to talk to voters of all stripes about abortion and the role of politicians in a physician’s office.

“That resounding victory, nearly 20 points, definitely confirmed for us in a galvanizing way again that people are able to have those conversations. That certainly has focused at least some of the strategies that we want to put into place over the next couple years in terms of getting out to communities and knowing that it’s not as hostile as it may be in the Legislature,” Gingrich-Gaylord said.

During Kansas’ November elections anti-abortion legislative candidates retained supermajorities and Republican Kris Kobach won the race for attorney general with an anti-abortion message as part of his campaign.

Katie Daniel, state policy director for the anti-abortion group Susan B. Anthony Pro-Life America, pointed to those races as proof that those who oppose abortion hadn’t lost the issue debate despite the ballot measure defeats.

While candidates clearly define themselves early in a campaign. Campaigners on ballot issues last year did not, Daniel said.

“Advocates for the issue need to clearly and consistently define what the issue is about,” Daniel said. “We’ve really got to treat this like a campaign, approach it in a comprehensive way statewide and make sure that voters really do understand the stakes.”