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By Jennifer Spinosi

Though the fragility of Roe v. Wade and thus the right to an abortion made headlines after Supreme Court Justice Anthony Kennedy announced his retirement, the rollback of abortion access has been taking place for the better part of the last decade in states just like Ohio, which is already one of most difficult states to access abortion care.

Most observers now believe that, if abortion opponents bring the right case before a Supreme Court with a Trump-nominated replacement to Kennedy, Roe v. Wade could be overturned and further jeopardize access to legal abortions in the US.

And, make no mistake: If the federally protected right to abortion access is eliminated, the current anti-abortion supermajority in the Ohio Legislature will compete in a race to the bottom to completely ban abortion. When that happens, all Ohioans seeking care will have to travel beyond our borders to get to a clinic that can help them.

The rollback of abortion access has been taking place for the better part of the last decade in states just like Ohio.

Ohioans already face so many challenges when they seek abortion services because, since 2011, more than 20 anti-abortion laws have been passed. They've been effective at eliminating access: In January 2011, there were 16 clinics providing abortions in Ohio but, as of today, there are only eight. Ohio has also seen a trend of private hospitals that formerly performed abortions — particularly in the case of severe fetal anomalies — refusing to provide abortions because of political pressures and required signage and literature in facilities that provide abortion.

Ohio law now also requires that a patient have two in-person appointments with the doctor who will perform the procedure. In the first appointment, the patient is required to participate in a “counseling and education session” and mandated ultrasound (all medically unnecessary). The second appointment, often scheduled 2 days later, is for the abortion procedure. Ohio law further requires parental consent for minors seeking an abortion; if a minor cannot get parental consent, a judicial bypass process exists but must happen in the county in which the minor lives or an adjacent county — even if one of the eight remaining clinics isn't in one of those counties.

In part, because of these restrictions that require additional time and financial resources of those seeking abortions, there is already an undeniable gap in abortion access between people who have money and privilege and those who don’t. In Ohio, the cost of abortion care can vary from $400 to well over $1,000 because (generally speaking) the cost increases depending on how late in pregnancy a patient is able to see a provider. Because the restrictions increase the cost (by, for instance, requiring two appointments and an ultrasound), the need to delay care in order to gather financial resources often results in even greater costs. All too often, patients forgo food, risk eviction and sell or pawn their possession as they attempt to raise money for an abortion.

Abortion restrictions have been effective at eliminating access: In January 2011, there were 16 clinics providing abortions in Ohio but, as of today, there are only eight.

Beyond that, Ohio and federal law forbid Medicaid coverage for abortion unless the pregnancy was the result of rape or incest, or the patient’s life is at risk. State and local government employee insurance plans also prohibit abortion coverage so, even when a patient has an otherwise qualified health insurance plan, Ohio law forbids covering abortion procedures if they are public employees.

Ohio legislators have supported even more restrictions — most notably the so-called “heartbeat bill,” which would have made abortion illegal if the fetus had a heartbeat, which happens as early as six weeks. It passed the Ohio General Assembly but was vetoed by Governor John Kasich in 2016, who reasoned that the bill was “clearly contrary to the Supreme Court of the United States’ current rulings on abortion.” Those current rulings are, of course, expected to change if Trump gets his Supreme Court nominee confirmed and Ohio law might.

Nonetheless, people like me continue to fight to protect abortion access.

In many states and for many communities, a post-Roe reality already essentially exists and so, while a complete ban on abortions is a worst-case scenario, it’s one for which we are prepared.

Since 1992, Women Have Options — Ohio’s statewide abortion fund, on whose board I sit — has been connecting those needing abortion to financial assistance. We believe that all people, regardless of their financial resources, have the right to make decisions about their reproductive health and work to make that a reality for all.

For instance, many Ohioans already travel out of state to receive care — to Michigan, Pennsylvania, sometimes as far as Maryland or Colorado — particularly if they are in rural parts of the state or if they are beyond 20 weeks in pregnancy because of the lack of local clinics and a recent Ohio law prohibiting abortion after 20 weeks even in cases of fetal abnormalities or pregnancy complications. And despite Ohio’s current restrictive landscape, people from other states are occasionally forced to travel to Ohio for abortion access — many from Kentucky and West Virginia, states which have only one clinic today. If Roe is overturned and Ohio completely bans abortion, these individuals will be forced to travel even further to seek abortion services.

In many states and for many communities, a post-Roe reality already essentially exists and so, while a complete ban on abortions is a worst-case scenario, it’s one for which we are prepared. We have already been mobilizing supporters, raising funds and expanding the scope of our support services while focusing on the core of our mission to fund abortions. Many who receive funds from us have saved almost enough to pay for their abortion costs on their own but need just a bit more — sometimes only $20 — to cover the total.

If Roe is dismantled, abortion care is only going to get harder to access for Ohioans, and we expect that even more support will be needed. But our endurance during what has long been a growing crisis has prepared us to do the work that will be needed if abortion becomes illegal in Ohio.

Jennifer Spinosi is on the Board of Directors at Women Have Options and lives in Columbus, Ohio.