Abortion pills could come to California community college health centers

Community college students in California could gain access to medication abortion through campus health centers under a proposal that would extend reproductive health services already required at the state’s public universities.

Assembly Bill 2540 would require community colleges with student health centers to offer access to medication abortion beginning in 2029, if the Legislature provides funding. The bill builds on Senate Bill 24, a 2019 law that requires University of California and California State University student health centers to provide medication abortion beginning in 2023.

Supporters say the bill would close an access gap for community college students who may face transportation, cost, privacy or insurance barriers when care is only available off campus. But campus health center directors warn that many community colleges may not have the funding, staffing or clinical capacity to provide the service.

Authored by Assemblymember Catherine Stefani, a Democrat from San Francisco, the bill would apply to community colleges with student health centers — estimated at roughly 92 campuses statewide. If the Legislature provides funding, those campuses would have to offer access to abortion by medication techniques beginning in 2029.

“We are closing a critical gap by ensuring that community college students, one of the most diverse and economically vulnerable populations in our state, have the same access to care as their peers at four-year institutions,” Stefani told lawmakers during an Assembly Health Committee hearing in April. 

The bill would also require all campuses to promote awareness of the service, provide information to students and post availability online. The awareness requirement would extend to universities, which were not compelled to publicize medication abortion services under the previous law. 

Community colleges fill healthcare gap for students

“Healthcare is a basic need for any human,” said Stephanie Goldman, executive director of the Faculty Association of California Community Colleges, a statewide advocacy organization that represents community college faculty and supports AB 2540. “And of course, abortion access and abortion is a healthcare issue.”

Goldman said community colleges increasingly operate under a “whole student” model that goes beyond academics to include food access, housing support, childcare, mental health and healthcare services. Reproductive healthcare access can directly affect whether students are able to remain focused on school, she said.

“It’s helpful that they understand that they have this kind of healthcare on campus and available to them, should they need it,” Goldman said.

Student leaders backing the bill say community college students often face challenges accessing reproductive healthcare outside campus systems, particularly in rural areas.

“Where you go to school should not determine what access you get just because you went to a community college system versus a four-year system,” said Alisha Nagpal, a student at Folsom Lake College who serves as vice president of legislative affairs for the Student Senate for California Community Colleges.

Nagpal said some community college students live hours away from providers, lack transportation or may not know what health services already exist on campus. She pointed to online-only students, low-income students and undocumented students as groups that may face additional barriers obtaining reproductive healthcare off campus.

Community college health centers vary in size and services

But while supporters frame the bill as a matter of equal access, health center directors say implementing the proposal statewide may be far more complicated than applying the UC and Cal State models.

According to the Assembly Appropriations Committee analysis, the community college health centers “vary widely in structure and capacity, with many operating under limited staffing models or contracting services out to community providers and hospitals.”

The Health Services Association of California Community Colleges, which represents student health programs across the system, opposes the bill. In an April 15 letter to lawmakers, the organization said many community college health centers do not prescribe medication, nor do they have sufficient staffing or the infrastructure needed to provide medication abortion onsite.

Michelle Barkley, president of the association and a nurse at Cosumnes River College, said many community college health centers function more as public health entry points than full-service clinics.

“Some of our campuses have 5,000 students,” Barkley said. “Their health center is run by a single registered nurse.”

Barkley said many campuses currently rely on referrals to outside providers rather than onsite reproductive healthcare services. 

Funding may be a challenge

The bill’s projected cost has become a key point of disagreement between supporters and community college health center directors.

The California Community Colleges Chancellor’s Office estimates implementing the bill could cost between $7 million and $27.9 million in one-time startup costs across all 93 community college health centers, plus between $5.6 million and $9.3 million annually to maintain services. Those estimates are not limited to the cost of medication. The appropriations analysis says the expenses could include staffing, training, equipment, telehealth services, billing support and other infrastructure needed for campuses to provide or coordinate care.

Community college health centers may be partially funded through student health fees, though not all campuses charge them. The analysis said most campuses charge an average health fee of about $23 per academic term. The California Community Colleges Chancellor’s Office lists the 2025-26 maximum health services fee at $27 per semester and $22 for summer, intersession or quarter terms.

Supporters of the bill argue the projected costs may overstate the financial burden. According to the committee analysis, Stefani’s office argues medication abortion services could become financially sustainable through Medi-Cal reimbursement, private insurance billing, third-party vendors and telehealth partnerships.

Nagpal pointed to language making the bill contingent on legislative funding, saying community colleges would not be expected to implement the requirement without state support.

“If funding is not provided at community college campuses, there’s no legal expectation for (community colleges) to provide the service,” Nagpal said.

The bill was put on hold in the Assembly Appropriations Committee on May 6 because of its potential cost. On May 14, the committee advanced the bill on an 11-4 vote after making amendments.

The amendments changed how the bill would apply to community colleges. Earlier language would have required community colleges with student health centers to offer medication abortion onsite, but the amended bill now says campuses must “offer access” to the service beginning in 2029. The bill still allows care to be provided by campus staff, through telehealth or through contracted external agencies, but it now also includes partnerships with community health providers “as appropriate.”

The amendments also broadened what colleges would report to the state, allowing campuses to count services provided through outside healthcare providers instead of only those performed at campus health centers. 

AB 2540 was referred to the Senate Health and Education committees on June 10. After additional amendments, the bill was re-referred July 2 to the Senate Appropriations Committee, where lawmakers will review its fiscal impact.

The latest amendments further define how community colleges could comply, including through referrals, “warm handoffs,” written partnerships with licensed providers or a statewide provider agreement through the Chancellor’s Office. They also clarify that state funding could support costs such as telehealth, staffing, training, billing support, outreach and reporting.

Andrea Baltodano is a contributor with the College Journalism Network, a collaboration between CalMatters and student journalists from across California. CalMatters higher education coverage is supported by a grant from the College Futures Foundation.