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When It Comes to Abortion, Money Is Key to Access

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When someone decides to have an abortion, one of the problems they have to solve is how to pay for it. For a lucky few, insurance plans cover their abortions, but the vast majority, 57 percent, are forced to pay out of pocket, whether they have insurance or not. With over 40 percent of women having an abortion living in poverty and 61 percent already parenting children, finding the extra funds proves challenging. That’s where the National Network of Abortion Funds (NNAF) comes in—it is a network of grassroots organizations that help those in need pay for their abortions.

“I first learned of abortion funds nine years ago when a young person that I worked with was willing to orchestrate her brutal beating by peers to terminate her pregnancy rather than have to pay for, or even talk about, abortion,” says Yamani Hernandez, executive director of NNAF. “That experience changed my life.” Last month, Hernandez took over the reigns to lead NNAF into its next chapter. Founded in 1993, NNAF raises money to defray the cost of an abortion for those who want one but cannot afford it. Excited by the “opportunity of scale and impact” that abortion funds have in making empowering everyday change, Hernandez leads more than 80 abortion funds across the United States and internationally and puts reproductive justice, a 20-year-old human rights framework created by women of color, into practice. “Reproductive justice is about bringing margins to center,” says Hernandez. “It’s about the people most affected being the leading voice and presence in the solutions to problems.” The reality is: rights are meaningless without an intersectional analysis and access.

Volunteer case managers at each local abortion fund take calls from clients needing assistance funding their abortion, often pledging a small amount, and then walking the client through the process of raising additional funds. “Women who are calling the fund are really reaching out and are probably the most desperate of the women because they’re reaching out to a stranger for money,” explained Amy Irvin, co-founder of the New Orleans Abortion Fund. Irvin says their clients are resilient and resourceful in finding ways to pay for their abortions, with one woman selling plates of food to her community to raise the funds. “She cooked up a pound of meat and sold it for $5 per plate and $7 for a drink and raised close to $100.”

Irvin began her work with abortion funds while in graduate school in Kentucky. Shortly after relocating to New Orleans, she found herself faced with an unintended pregnancy at the age of 43, and decided to seek an abortion. While at the clinic, she noticed a sign saying that public funds couldn’t be used for abortions in Louisiana, so she turned to the National Network of Abortion Funds for support and guidance and co-founded the New Orleans Abortion Fund.

A small but mighty resource, New Orleans Abortion Fund’s average pledge to a client is $71—the average abortion costs about $500. “Although we’re making a very small pledge, we’re making a huge difference,” says Irvin.

The story is similar at the Women’s Medical Fund in Pennsylvania. “The average first-trimester abortion is about $400, and the average income of the people we served last year was $494 per month,” describes Josephine Kabambi, program coordinator at the Women’s Medical Fund. In addition to funding abortions, some local funds help their clients navigate confusing laws and raise money to travel to and from their abortions. According to the Guttmacher Institute, 89 percent of U.S. counties do not have an abortion provider, and it is estimated that almost 40 percent of women live in those counties. As state TRAP (Targeted Regulation of Abortion Providers) laws shutter clinics, the distance a client has to travel just to obtain an abortion adds to the cost of the abortion and decreases their ability to access one. Laws like Pennsylvania’s 24-hour waiting period make the process more costly and time-consuming because of the need to get time off work and travel long distances to clinics. “Primarily we fund abortions, but we also help cover the costs of hotel and travel for people who have to leave the state for later [abortion] procedures,” says Kabambi.

While California is one of 15 states that allow their state Medicaid funds to be used for abortion care, local abortion funds like ACCESS Women’s Health Justice are still necessary to help clients fund and navigate travel, set up clinic appointments, and find overnight housing for multiple-day appointments.

In addition to its direct service work, NNAF fights to make the promise of Roe v. Wade a reality through its policy work—in particular by working to repeal the Hyde Amendment. An almost four decades-old ban on the use of federal funds for abortion care, the Hyde Amendment disproportionately impacts women of color and low-income families on Medicaid insurance. “Our mission has always been dual,” explains Hernandez. “We want to continue to increase direct funding for abortion. However, we also want to leverage our unity to shift culture and policies like the Hyde Amendment and others that require us to exist in the first place. I see this base being formidable and unable to be ignored as we dismantle barriers to abortion access.”

Activists in the fight to repeal the Hyde Amendment and the abortion fund movement see this work as a calling to shift the way our communities view the stigmatized three in ten women choosing abortion and families living in poverty. To them, funding abortions isn’t just about giving someone the money to make their decision to terminate a pregnancy a reality; it’s also about empowering communities often pushed to the outskirts by mainstream society. “I want the entry point of direct services to be a beginning of a relationship, not an end,” Hernandez says. “I want these relationships to move beyond transactional to transformational, and see the most affected supported, empowered, and activated to move the dial on culture and policy.”


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