How an influx of out-of-state patients could impact abortion access in McLean County
Last year, just 6% of abortion patients at Planned Parenthood's Bloomington center were from out-of-state. Since Roe was overturned, that's increased to 33% of patients, according Julie Uhal, Securing Access For Everyone (SAFE) abortion expansion program manager with Planned Parenthood. They're coming from Ohio, Indiana, Kentucky, Missouri, Wisconsin, Alabama and Tennessee, Uhal said.
"The Bloomington Health Center, while not near a state border, is still experiencing an increase in appointments because there may be more availability at that location. They are seeing an increase in out-of-state patients and patients coming from other health centers closer to state borders," Uhal said.
Following the Supreme Court’s ruling to overturn Roe v. Wade, Planned Parenthood said it was expecting up to 30,000 more out-of-state people will travel to Illinois to seek an abortion every year. If that happens, the influx would represent a 64% spike in the number of annual abortions in Illinois – potentially straining providers. Other estimates are even higher.
By the numbers
The impact on McLean County specifically is hard to predict, but abortion data from the Illinois Department of Public Health (IDPH) offers a little guidance on what to expect.
The number of McLean County women and girls who’ve received an abortion has been relatively steady over the past three decades. There were 372 abortions involving patients from McLean County in 2020, according to the IDPH data; the annual average is 319. For context, in 2020 there were about 40,425 girls and women between ages 15 and 44 living in McLean County (the age range in which most abortions take place in Illinois). That means less than 1% of girls and women in McLean County received an abortion in 2020.
Statewide, there were 46,243 girls and women who received an abortion in 2020, down slightly from 2019. One in 5 of those patients were from out-of-state, with 67% of those coming from one state – Missouri – where abortion has been nearly inaccessible since 2019. That’s the number that’s likely to spike in the next few years, because four of Illinois’ neighboring states immediately banned abortion after the Supreme Court’s decision June 24.
Planned Parenthood's Bloomington center (one of 17 in Illinois) offers many services beyond abortion, including birth control, HIV services, and STD testing and treatment. It’s unclear how many women and girls from outside of McLean County use it for abortion services each year; Planned Parenthood says it does not share specific information about past abortion numbers.
“I would not be human if I didn’t say I am concerned about our health care providers. They’re already taxed,” Nikita Richards of Bloomington, who serves on the Planned Parenthood of Illinois board of directors, told WGLT in a recent interview.
Estimates vary for how many out-of-state abortion patients Illinois should expect. Right after the Supreme Court ruling, Planned Parenthood of Illinois said it was expecting an increase of between 20,000 to 30,000. Robin Fretwell Wilson and Jason Mazzone, two law professors from the University of Illinois at Urbana-Champaign who’ve studied the issue, say it could be even higher.
They looked at the rate of abortions generally for people of reproductive age, for whom Illinois is the nearest travel state.
“And we just did some basic math, and it nets out to something like three to four times the number of abortions coming our way than we did this time last year. With what’s basically a stable number of facilities,” said Wilson, who co-directs U of I’s Epstein Health Law and Policy Program.
Illinois’ abortion providers are concentrated in Chicago, Wilson said. And the cost of an overnight stay in Chicago may be too high for some patients, she said.
“In the center of the state, you don’t have the desert effect that you have at the bottom of the state. But I think you’ll have (in cities like Bloomington) an inundation effect if people are driving.”
Who’s first in line?
Thus far, Democrats like Gov. JB Pritzker have positioned Illinois as a safe haven for reproductive rights, welcoming out-of-state visitors. But it’s possible that demand will outstrip supply, and in-state residents may find themselves waiting for care.
“I don’t think ordinary people have yet processed what this means for their own personal access within the state, absent some reform. I think they’ll be some tremendous pressure from Illinois residents going, ‘Are you kidding me? That can’t be right.’ That’ll be the reaction you hear,” Wilson said.
"They’ll be some tremendous pressure from Illinois residents going, ‘Are you kidding me? That can’t be right.'"Robin Fretwell Wilson, University of Illinois law professor
It’s a complicated legal question as to whether a state can prioritize abortion care for in-state residents, even if it wanted to, said Mazzone. Generally, states are constitutionally required to treat visitors equally in certain respects, such as for emergency medical care, he said. Interestingly, the Supreme Court ruled in a companion case to Roe v. Wade that a Georgia law restricting abortions to only Georgia residents was constitutional. But that case didn’t speak directly to a scenario where provider capacity was maxed out, or whether partially publicly funded abortions could be treated differently, Mazzone said.
“We’ll just have to see what happens when it shakes out in court,” Mazzone said.
Planned Parenthood of Illinois says it has no plans to prioritize patients in this way.
"PPIL does not deny care to a patient based on geography. We are committed to providing essential healthcare to all of the patients who need us, no matter their ZIP code," Uhal said.
Planned Parenthood has taken steps to mitigate the strain from out-of-state visitors, said Richards, the PPIL board member. That includes building new health centers near the Wisconsin and Indiana borders and expanding telehealth services. Since 2021, Planned Parenthood has been able to prescribe the abortion pill through the mail after a telehealth visit for qualifying patients with an Illinois address, she said.
And Planned Parenthood already has been assisting out-of-state patients who want to travel to Illinois for an abortion. The Chicago-based Midwest Access Coalition is another group that helps people traveling to, from, and within the Midwest access an abortion.
“We’re confident with these particular measures we’d be able to assist the influx of patients that will be coming to Illinois,” Richards said.
What we don’t know
IDPH’s publicly available abortion data does not provide much demographic data at a county level for 2020. But as of 2018, when 332 McLean County women had an abortion:
- 86% took place between the first 4-11 weeks of the pregnancy.
- 15% of patients were married; the rest were not.
- Two-thirds of patients were between ages 20-29.
The publicly available IDPH data also does not provide patients’ race and ethnicity or household incomes, even at a statewide level. Some of that data is collected, but has not been disclosed to the public. As WBEZ reported in May, it’s unclear whether it’s legal to withhold that, and IDPH now says it’s looking into whether this information should be made public.
That data could help policymakers and the public identify gaps in reproductive health care access, especially as providers serve potentially thousands of more patients from out-of-state.
“Not everyone has the resources and opportunity to travel for an abortion,” Richards said. “Patients who may already face these immense barriers to health care — such as Black and Latinx and indigenous folks, and disabled people, and people in rural areas, young folks, immigrants, people who are on the poverty line. This extreme and restrictive (Supreme Court ruling) is going to make things that much more difficult.”