'People will travel': What overturning Roe v. Wade could mean for abortions across state lines

Editor's note: This story was originally published on May 5, and has been updated to reflect the Supreme Court's decision of June 24 to overturn Roe v. Wade.

Macy Haverda has seen plenty of people travel hundreds of miles – and drop large sums of money – to access out-of-state abortion care. With the Supreme Court  overturning Roe v. Wade on the horizon in May, she told USA TODAY she expects to see more.

Haverda is president of Wild West Access Fund of Nevada, a nonprofit that offers financial assistance and other support to pregnant people seeking abortions in Nevada. She said the organization helps each person who reaches out, but with travel costs on the rise and earlier-term abortions starting at $600 in Las Vegas, Wild West is often unable to provide as much funding as it would like.

Out-of-state abortion costs are "just untenable for most people," Haverda said. "As demand increases, it will be more difficult to schedule appointments with a fast turnaround, pushing people further along in their pregnancies. Costs rise exponentially the further along in the pregnancy the procedure is."

A growing number of Americans are traveling out of state for abortions due to restrictive laws in their home states. But the distances people will have to go to receive care may jump dramatically now that Roe v. Wade has been overturned by the Supreme Court.

"It's going to be pretty chaotic," said Nathan Cortez, a Southern Methodist University law professor who specializes in health law, among other kinds of law. "People who live in restrictive states may try to go to less restrictive states (for abortions). And this is going to set off kind of a complex series of arguments and debates."

WHAT IS THE SUPREME COURT?: Everything you need to know about the SCOTUS and its justices

WHERE IS ABORTION LEGAL IN THE WORLD?: Canada, other countries allow abortions and these ban them.

What's going on with abortion?

Once Roe v. Wade was overturned Friday, at least 20 states immediately made abortion illegal based on already-passed laws.

"This is going to have a huge, huge impact," said Glenn Cohen, a Harvard Law School professor who specializes in bioethics and the law. He literally wrote the book on medical tourism, "Patients with Passports," among other books. "A substantial part of the country would have abortion either completely prohibited or very much restricted."

According to David Vequist, founder and director of the University of the Incarnate Word's Center for Medical Tourism Research, restrictions on abortions will likely lead to more patients looking for out-of-state care.

"People will travel to different locations in order to get access to the care they want," Vequist said.

OVERTURNED: Supreme Court overturns Roe v. Wade, eliminating constitutional right to abortion

Can you travel to another state to get an abortion?

There are currently no state laws restricting travel to another state for an abortion, but lawmakers in Missouri are trying to pass one.

A bill filed there last year would restrict abortions outside state lines in certain circumstances. It's not clear whether states have the right to extend their influence across state lines in this way, but legal experts say more states could follow Missouri's lead if Roe v. Wade is overturned.

"I wouldn't be surprised to see Missouri and other states try to enforce it and use that as a deterrent to prevent a lot of people from traveling for abortion," Cortez said, noting that it could take years for the Supreme Court to invalidate such laws.

The bill has yet to be heard in committee, but could get a second wind in the next legislative session if Roe v. Wade is overturned.

WHERE THE ABORTION FIGHT GOES FROM HERE: Roe overruled but the battle will continue

Even if these laws don't come to pass, certain prosecutors may still try to indict and bring charges against medical providers offering abortions in other states, according to Greer Donley, an assistant professor of law at the University of Pittsburgh and co-author of "The New Abortion Battleground," a paper that examines potential legal issues across state borders if Roe v. Wade is overturned.

This wouldn't be the first time the country has seen prosecutors disregarding state laws while charging someone who had an abortion with murder. Donley pointed to the case of Lizelle Herrera, a Texas woman who was indicted for murder for a "self-induced abortion" despite state laws exempting people who terminate pregnancy from criminal homicide charges. A county prosecutor later dropped the charge.

"That's another way for states to chill abortion-related travel," Donley said.

Sixteen states and the District of Columbia have laws that protect the right to abortion. Some are working to ensure that right applies to visitors.

DEATHS TO RISE IF ROE V. WADE OVERTURNED: Pregnancy-related deaths could rise 20% or more in states that outlaw abortion, experts say

In late April, the Connecticut Senate approved a bill that would shield in-state medical providers and patients who travel to the state for an abortion from out-of-state laws.

States like Connecticut "are actively legislating to protect providers in their state from the kind of Missouri law that would reach outside of its border and seek to criminally or civilly penalize a provider in another state," said Rachel Rebouché, interim dean of Temple University's Beasley School of Law.

California Gov. Gavin Newsom's office announced Tuesday that lawmakers are proposing an amendment that will lock in abortion rights in the state's constitution.

Researchers with the University of Texas at Austin’s Texas Policy Evaluation Project found that from last September to December, nearly 75% of the nearly 1,400 Texans who traveled out of state for abortion care each month after the Texas Heartbeat Act took effect went to two states: Oklahoma and New Mexico.

But Oklahoma is no longer an option, having just adopted its own law banning abortions once a fetal heartbeat is detected, which can be before some people realize they are pregnant.

ABORTIONS IN MEXICO?: If Roe v. Wade is overturned, there will still be options

Is abortion legal in Canada, Mexico?

Other states aren't the only option for people seeking abortion access. Abortions are legal in Canada and as of last year, no longer criminalized in Mexico, though legalization varies by state in Mexico.

"I can't believe Mexico is moving forward, and we're moving backward," said Carli Pierson, an attorney and former human rights professor who serves on USA TODAY’s Editorial Board.

Her great-grandmother died of a botched clandestine abortion in the 1930s in Denver. Another relative needed a blood transfusion after an illegal abortion in Mexico City in the 1960s, but Pierson says options and outcomes have improved since then.

She said abortion pills are available at Mexican pharmacies and procedural abortions are available in Mexico City, Oaxaca, Veracruz, Hidalgo and Baja California, but warned "you're running a lot more risks" in states where abortion hasn't been legalized yet.

Canada has no laws restricting abortions. Canada's minister of families, children, and social development, says she can't see why Americans would not be able to access abortions in Canada if Roe v. Wade is overturned.

WHO IS AFFECTED IF ROE V. WADE OVERTURNED?: People of color, the poor and other marginalized people to bear the brunt

"If they... come here and need access, certainly, you know, that's a service that would be provided," Karina Gould told CBC News Network's "Power & Politics" in May.

Access can sometimes be limited by location and a patchwork of regulations from provincial, territorial and professional bodies.

The Detroit Free Press, part of the USA TODAY Network, also noted that abortions are publicly funded in Canada as medical procedures, and Americans would likely have to seek care from private clinics.

Getting to either Canada and Mexico is also more complicated than traveling to other states. Both countries require valid passports for visits. Canada also requires COVID-19 vaccinations. The U.S. requires negative COVID-19 test results to re-enter the country.

Cohen said most of the data he's seen has been on travel for abortions within the U.S. since it's typically easier and less expensive. But that could change.

"If enough states prohibit this, there might be some places where it's cheaper or easier to travel internationally to Mexico or Canada, in particular, than it is to travel to another state," he said.

The cost of travel for abortions

Traveling isn't a viable option for many people seeking abortion care.

One study from 2019 found that if Roe v. Wade is overturned, the average American would see an estimated 249-mile increase in travel distance to the nearest provider, and abortion rates would drop nearly 33% by the following year.

That could disproportionately affect lower-income populations, even with financial support programs or, in some cases, company policies available to help cover costs.

"They're going to be the ones who cannot, as a matter of practicality, afford to travel or take the time to travel," Cortez said. "You put something farther away, and you make it more expensive. Only so many people can have the resources and the freedom and flexibility to take advantage of that."

Haverda of Wild West Access Fund of Nevada called the costs "ridiculous," and pointed out that rising gas prices and hotel rates compound the cost of having an abortion in another state. Then there are the additional costs of missing work or care for children or pets who need to stay home.

"Most people don't have that kind of money lying around," she said.

Travel may also be more difficult for people with disabilities, Cohen noted.

"In and of itself, this travel is not a good solution for many women in America, even if they can do it," Cohen said.

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STATE BY STATE:Where abortion laws in each state will stand If Roe v. Wade is overturned

This article originally appeared on USA TODAY: Overturning Roe v Wade could add travel time, costs for abortions