In summary

The governor should take executive action to eliminate cost-sharing for abortion services under health insurance plans.

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By Sydney Kamlager, Special to CalMatters

Sydney Kamlager is a Democrat from Culver City who represents Assembly District 54, She wrote this commentary for CalMatters.

Lee este artículo en español.

We live in a state with a staunchly pro-choice governor, yet even in California, we still see major inequities in accessing abortion through insurance. Legal and safe abortion is available, but only in theory and not in practice, if cost-prohibitive.

Last December I authored the Abortion Accessibility Act, Assembly Bill 1973, to stop insurers from charging for abortion services. 

One in four women in the United States will have an abortion, according to the Guttmacher Institute, a research and policy organization committed to advancing reproductive health and rights. 

Abortion care costs a patient about $500 at 10 weeks gestation. That cost rises significantly as women delay in their struggle to pay for the procedure. The median cost of an abortion at 20 weeks gestation is $1,195. Charges can leap above $3,000 for women with high insurance deductibles and may serve as humiliating or insurmountable barriers to treatment.

I authored the legislation months before COVID-19 ravaged our economy and prevented millions of people from paying rent or feeding their families, let alone spending $500 or more on a medical procedure. I introduced the bill in part because abortion foes in state legislatures across the country had been approving bans or serious restrictions on abortion. When COVID-19 hit, normal legislative activity, including my bill, was put on hold. Yet the pandemic didn’t stop abortion foes from exploiting the disaster. 

Republican governors began banning abortion. At least 25 states implemented the federal recommendation to delay elective surgical procedures. Anti-choice activists and politicians in various states labeled the procedure “nonessential” to stop people from accessing abortion. Some governors claimed that their states did not have the personal protective equipment to provide abortion care. 

I dare you to tell a woman who has an unsafe or unwanted pregnancy that the abortion she needs is not an essential service. Incidents of sexual violence surely do not stop while we are under stay-at-home orders. 

During a pandemic, people need more access to birth control, abortion and other reproductive health care, not less. Carrying a pregnancy to term requires on average 11 visits to the doctor. Just a guess, but I imagine that at each of those visits, doctors would require PPE. 

Because of these bans, abortion patients have been coming to California to access services. On the same day that Texas Gov. Greg Abbott announced that he considered abortion nonessential, patients in Texas were on the phone with Planned Parenthood Los Angeles to book appointments. 

Yet having an appointment doesn’t mean that a person can pay for the procedure. With unemployment soaring – almost 25% in Los Angeles, the region I represent – the cost of abortion is a huge barrier to care. Barriers to care disproportionately affect people of color, young people and poor women, perpetuating systemic health care disparities. COVID-19 already has shown us how pronounced those disparities are.

ACCESS Women’s Health Justice, California’s only statewide abortion fund, runs a phone line for people navigating barriers to sexual and reproductive health care. ACCESS experienced a 5% increase in calls from people with copays or deductibles in 2020 even before the pandemic. Since shelter-in-place orders were issued, ACCESS has received calls from people who have been furloughed or laid off who, despite having health insurance, cannot afford their care. 

If California is committed to fighting against the pernicious attacks upon reproductive health care, we need to fight harder to expand care. We need to be a haven for women in other states who face judges who ignore women’s constitutional rights. If California is committed to reducing disparities in health care that have become obvious during COVID-19, we need to ensure that access to abortion does not depend on a person’s status, privilege or bank account.

I have requested that Gov. Gavin Newsom take executive action to eliminate cost-sharing for abortion services under health insurance plans. Abortion care is health care, and health care is a human right. Health care costs that are prohibitively expensive and inconsistent are unacceptable. I hope that you will support my effort to turn this bill into law next legislative session. 


Sydney Kamlager is a Democrat from Culver City who represents Assembly District 54, She wrote this commentary for CalMatters.

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