Commentary

Abortions aren’t free. Neither is what’s called “abortion tourism.”

A controversy has erupted over how much Proposition 1, which if enacted Nov. 8 would put the right to abortion in the California Constitution, might cost state taxpayers. And how it would affect health care in general in California, especially for women wanting to keep their pregnancies—that is, have the beautiful, bouncing baby.

The initiative was put on the ballot by Gov. Gavin Newsom and the Legislature after the U.S. Supreme Court last June overturned the 1973 Roe v. Wade decision legalizing abortion nationally.

Writing in the Oct. 31 Orange County Register, Tak Allen, president of the International Faith Based Coalition, who favors the state’s current legalization law, charged:

California’s abortion laws are not in jeopardy and Proposition 1 is not only unnecessary—it is recklessly ambiguous, extreme and expensive ... as a Black woman who is currently pregnant, I am seriously troubled about the impact Proposition 1 could have on California’s health systems.

The United States holds one of the highest maternal morbidity rates in the world, with rates for Black women at 2.5 times the national average. This is before we overrun state health systems with unlimited passes for neighboring states to join as they see fit to utilize California abortion services and laws. And this is before we further exacerbate our health system and our quickly-depleting healthcare worker pool.

Prop. 1 threatens to increase the healthcare disparities of healthy moms who oftentimes do not walk out of their birthing experiences whole, and in some cases, do not walk out at all, due to death. By contributing to a surge of people coming from out-of-state to seek an abortion, Proposition 1 could actually jeopardize women’s reproductive health in California.

Indeed, Capital & Main reported in July, “According to estimates made in March 2021 by the U.S. Department of Health and Human Services, the number of OB-GYNs nationwide is expected to decrease by 7 percent, while demand is projected to increase by 4 percent, by 2030. Conversely, the workforce of certified nurse-midwives, women’s health nurse practitioners and women’s health physician assistants is expected to exceed demand, filling in some gaps in women’s health care.”

Late-term abortions are a complicated procedure. Diverting California’s OB-GYN scarce doctors to perform late-term abortions clearly would shortchange California residents seeking prenatal care.

What’s the Cost?

An exact number is impossible to figure out right now, but we still can get some idea of the cost of Prop. 1. Let’s start with California Healthline, a news service of the California Health Care Foundation, a philanthropic organization created when Blue Cross of California became a nonprofit. California Healthline will be heeded as an objective source.

California Healthline produced a study on this issue with PolitiFact, the supposedly unbiased media watchdog group, but which often has been criticized for its own bias. The study found, “In the end, the Legislative Analyst’s Office found ’no direct fiscal effect‘ if Proposition 1 passes because Californians already have abortion protections.” Thus:

While it could lead to more people coming to California for abortion services, that’s already happening, even before voters decide on the measure. ...

It’s speculative that Proposition 1 would expand abortion rights beyond what’s currently allowed or that the state would allocate more money for out-of-state residents.

Because the statement contains some truth but ignores critical facts to give a different impression, we rate the statement Mostly False.

At least California Healthline/PolitiFact provided a link to the LAO’s study. Which is identical to the wording in the LAO’s fiscal analysis in the official Voter Pamphlet mailed out to all voters by the Secretary of State. But here’s the full key wording (emphasis in original):

No Direct Fiscal Effect. Proposition 1 would change the California Constitution to expressly include existing rights to reproductive freedom. Because these rights already exist in California, the proposition would have no direct fiscal effect. However, whether a court might interpret the proposition to expand reproductive rights beyond existing law is unclear. If a court finds that the proposition expands these rights, there could be fiscal effects to the state.

That last sentence is the key wording: What the courts decide could mean “fiscal effects to the state.”

Legal Interpretations

Currently, California law limits abortions to 24-25 weeks. Would Prop. 1 expand that up to a second before birth? On Oct. 31, Calmatters ran an article discussing both sides. My conclusion: The initiative is purposely vague, so the California Supreme Court, now dominated by liberal Democrats appointed by Govs. Jerry Brown and Gavin Newsom, would interpret it as unlimited, right up to just before birth. But we won’t know for years.

There’s another factor. On Sept. 27, Newsom signed into law Assembly Bill 2223. The Legislative summary reads:

This bill would delete the requirement that a coroner hold inquests for deaths related to or following known or suspected self-induced or criminal abortion, and would delete the requirement that an unattended fetal death be handled as a death without medical attendance. The bill would prohibit using the coroner’s statements on the certificate of fetal death to establish, bring, or support a criminal prosecution or civil cause of damages against a person who is immune from liability based on their actions or omissions with respect to their pregnancy or actual, potential, or alleged pregnancy outcome, or who aids a pregnant person in exercising their rights under the Reproductive Privacy Act, as specified.

Critics have charged AB 2223 would legalize infanticide, because no inquiries could be made by law enforcement if a post-birth baby was killed.

Advertising for Abortions

Back to Prop. 1. Let’s assume that the most broad interpretation, that it allows abortion right up to a second before birth. Anticipating Roe v. Wade being overturned, last December Gov. Gavin Newsom proclaimed, “We’ll be a sanctuary,” for those seeking abortions from other states. “We are looking at ways to support that inevitability and looking at ways to expand our protections.”

The state budget for fiscal year 2022-23, which began on July 1, includes $200 million to pay for abortions for women from out of state. It includes $1 million to build a state website encouraging abortion tourism. Here’s what the website says:

People who live outside of California

If you live outside of California, you can get an abortion in California. There is no residency requirement for abortion in California. You can use the California abortion finder to find a provider. Some groups provide help with travel to get an abortion.

According to the CDC, abortions nationally on or after the 21st week are 1 percent of the total in 2019. California did not report that year. So the total reported to the CDC, 629,898 abortions, is basically those outside California. So 1 percent of that comes to 6,298 potential non-California abortions on or after the 21st week.

If Prop. 1 passes, and is interpreted as liberally as possible, potentially all of those 6,298 could come to California for an abortion vacation in the Abortion Sanctuary State. If it’s only a “procedure,” as abortion proponents claim, why not throw in a vacation paid for by California taxpayers?

Word gets around quickly on these things, especially in these days of social media. So we can expect some response to the generous California offer. How many? Let’s just guess 10 percent of that figure, or 630 a year coming to California for a late-term abortion.

According to AbortionClinics.org, which explains the procedure as much more involved than earlier procedures, just in case you wondered what they actually do (I’ll only provide the first, less grisly part):

Abortion After 27 Weeks California. Facts About Induction Procedure (25 Weeks And Up): This is normally a 3 day procedure depending on your medical history.

They don’t provide a cost estimate, but according to the Orlando Women’s Center in Florida, “late term” abortions can cost up to $35,000, compared to up to $2,000 for first-trimester abortions. According to TheCut, part of New York magazine, it could be “$8,000 to $15,000 or more” for a third-trimester abortion.

Let’s assume a $10,000 average for late-term abortions. Add $200 a day for a seven-day stay in California, or $1,400. That comes to $11,140 for each abortion vacation.

Our estimated number of late-term abortions in California was 630. Multiplied by $11,140, that comes to $7,018,200 a year.

The California Healthline/PolitiFact judgment was “Mostly False” for the contention there will be a cost; but that itself is totally false.

Yes, There Will Be a Cost

Perhaps my numbers are too high—or too low. Again, we won’t know the exact number for a couple of years—assuming the state even compiles the number. As noted above, the CDC didn’t even have overall abortion numbers for California for 2019.

But even with a conservative estimate, the number will be at least in millions. Even in a time of state budget surpluses, soon to evaporate, money isn’t free.

So Tak Allen is right: Prop. 1, if it passes, will divert scarce resources and scarcer OB-GYN specialists from California mothers, to performing abortions for abortion vacationers, risking the lives of California mothers and babies.

By the way, Tak, congratulations on your new baby. God bless both of you.