Updated April 13, 11:30 a.m. PST.
Governors and other state officials across the United States are deciding whether abortion care is an “essential” health-care service, as many states halt nonessential surgeries to create capacity for the expected crush of COVID-19 patients.
Declaring a medical procedure as “nonessential” would mean postponement for those seeking care. In a March 18 joint statement, medical organizations, including the American College of Obstetricians and Gynecologists and the American Board of Obstetrics and Gynecology, urged state officials not to group abortion services with nonessential health care.
The statement reads:
To the extent that hospital systems or ambulatory surgical facilities are categorizing procedures that can be delayed during the COVID-19 pandemic, abortion should not be categorized as such a procedure. Abortion is an essential component of comprehensive health care. It is also a time-sensitive service for which a delay of several weeks, or in some cases days, may increase the risks or potentially make it completely inaccessible. The consequences of being unable to obtain an abortion profoundly impact a person’s life, health, and well-being.
Already, there’s indication that state governments hostile to abortion rights will use COVID-19 preparations to temporarily end abortion access by classifying the procedure as“elective,” terminology often used to stigmatize abortion care.
We will continue to update this piece with state policies on abortion care throughout the COVID-19 outbreak to help you understand whether abortion will be restricted or accessible in your state.
On April 10, the U.S. Court of Appeals for the Fifth Circuit stayed most of a federal judge’s order blocking Gov. Greg Abbott’s (R) COVID-19 abortion ban. Under the Fifth Circuit’s order, Texas can enforce its abortion ban except for patients who, based on the treating physician’s medical judgment, would be unable to access an abortion under the state’s 20-week ban.
U.S. District Judge Lee Yeakel on April 9 ruled that some abortions could proceed in Texas while the state’s COVID-19 abortion ban stands. Medication abortions and abortions for patients who “risk meeting the state’s gestational age cutoff for abortions” before the ban expires can proceed, the Texas Tribune reported.
The Fifth Circuit ruled March 31 that Texas’ ban on abortion during the COVID-19 outbreak could go into effect after a federal judge on March 30 blocked Texas from closing abortion clinics as part of Abbott’s response to the pandemic, according to Kate Smith, a reporter for CBS News.
Aimee Arrambide, executive director of NARAL Pro-Choice Texas, said in a statement that people in Texas “will remember that when they needed help during a pandemic, their state leaders were too busy politicizing and banning abortion care.”
Planned Parenthood and other abortion care providers in Texas had filed a lawsuit on March 25 against the state’s restrictions on abortion during the COVID-19 emergency. Amy Hagstrom Miller, president of Whole Woman’s Health, said the state government classifying abortion care as “nonessential health care” had resulted in more than 150 cancellations at three Whole Woman’s Health clinics across Texas, the Associated Press reported.
Most abortions would be put on hold until at least April 21, under orders issued March 22 by Abbott, a longtime abortion rights foe. The state’s COVID-19 health policy stops medical procedures unless a patient faces “serious adverse medical consequences or death, as determined by the patient’s physician.” An Abbott spokesperson confirmed to the Associated Press that the order applies to abortion in most cases.
Texas Right to Life cheered Abbott’s decision to stop most abortions, claiming without evidence that abortion providers are “hoarding medical supplies” needed for the COVID-19 outbreak. The anti-choice organization urged the governor to use the emergency COVID-19 efforts to end medication abortion in the state, too.
Amanda Williams, executive director of Lilith Fund, which provides financial assistance for abortion patients, said the organization would “do everything we can to be there for our callers” during the COVID-19 crisis.
“If there’s one thing abortion funds know it is that our community can come together to support people who are shut out of accessing healthcare,” Williams said in a statement. “We see it every single day. When someone decides to have an abortion, it is critical that they are able to get care on the timeline that works for them, with the support of physicians and health-care providers they trust.”
Arkansas’ only surgical abortion facility must stop providing abortion care during the COVID-19 outbreak, the Arkansas Department of Health announced April 10. The department sent a letter to Little Rock Family Planning Services clinic saying the facility had violated a state order suspending all procedures that “are not immediately necessary to protect the life or health of the patient,” the Associated Press reported.
Meanwhile, Arkansas Attorney General Leslie Rutledge (R) signed an amicus brief supporting Texas’ COVID-19 abortion ban.
Alaska updated its COVID-19 response policy on April 7 to include surgical abortion care among procedures that can be delayed, the Associated Press reported.
The state’s policy update “requires cancellation or postponement” of so-called elective procedures “until June 15 and is accompanied by a list of surgeries or procedures that would fall under that category,” the AP reported. Alaska Attorney General Kevin Clarkson (R) signed on to an amicus brief in support of Texas officials’ push to suspend abortion as part of the state’s
Mississippi Gov. Tate Reeves (R) on April 10 issued an executive order banning all “elective” medical procedures, including abortion.
“It shuts down all electives surgeries,” Reeves said of the order, according to the Jackson Free Press. Medical organizations have said that abortion care should be considered an essential health service during the COVID-19 outbreak.
The order expires on April 27. Jackson Women’s Health Organization is the only facility providing abortion care in Mississippi.
On April 8, Tennessee Gov. Bill Lee (R) released an executive order stating health-care providers in Tennessee “shall postpone surgical and invasive procedures that are elective and non-urgent.” The order took effect April 9 and expires April 30.
Lee’s order defines “elective” medical procedures as procedures that “can be delayed until the expiration of this Order because they are not required to provide life sustaining treatment, to prevent death or risk of substantial impairment of a major bodily function, or to prevent rapid deterioration or serious adverse consequences to a patient’s physical condition if the surgical or invasive procedure is not performed, as reasonably determined by a licensed medical provider.”
A spokesperson for the Memphis Center for Reproductive Healthdeclined to comment on Lee’s executive order.
Utah Attorney General Sean Reyes (R) is one of 18 attorneys general to sign an amicus brief supporting Texas’ COVID-19 abortion ban, according to Kate Smith of CBS News. “If there ever was a situation where the individual’s rights yield to that of the public at large, it is during an epidemic,” according to the amicus brief.
However, Charla Haley, director of communications for the Utah Department of Health, said the state was following federal guidelines during the COVID-19 pandemic. Haley told Rewire.News that “a doctor will have to decide whether the abortion is medically necessary or elective.”
On April 6, a federal judge issued a temporary restraining order against Oklahoma Gov. Kevin Stitt’s (R) COVID-19 abortion ban, NPR’s Sarah McCammon reported.
Stitt’s executive order on COVID-19 states abortion care is a nonessential, or “elective,” procedure, along with routine dermatological, ophthalmological, dental procedures, and orthopedic surgeries, the Oklahoman reported March 27.A spokesperson for the Center for Reproductive Rights, which brought the lawsuit challenging the order, confirmed to Rewire.News that clinics have been forced to stop providing abortion care under Stitt’s order, which is set to end April 7.
Abortion care can’t be blocked as part of Ohio’s response to the COVID-19 pandemic for now, a federal appeals court ruled on April 6. A three-judge panel dismissed Ohio Attorney General Dave Yost’s (R) appeal of a ruling that stopped state officials from using COVID-19 to suspend legal abortion in the state, Cleveland.com reported.
U.S. District Judge Michael Barrett, who temporarily blocked the Ohio policy, “indicated he may issue a more final ruling” on the matter while abortion providers in the state pursue legal action, according to Cleveland.com.
Abortion providers in Ohio, along with Planned Parenthood and the ACLU, filed a lawsuit on March 30 against the state attorney general’s order to stop abortion care during the COVID-19 outbreak. The lawsuit sought a temporary restraining order to keep the state from banning surgical abortions, according to a local NPR affiliate.
Officials at Women’s Med Center in Dayton and Planned Parenthood of Greater Ohio told the Dayton Daily News a week earlier that they would continue providing abortion care despite efforts by state Republicans to stop surgical abortion services.
On March 20 and March 21, Ohio Deputy Attorney General Jonathan Fulkerson sent letters to three abortion clinics, acting on complaints that the clinics were performing surgical abortions using personal protective equipment. Fulkerson accused the clinics of violating a March 17 health department order requiring “non-essential and elective” surgeries to be canceled, to preserve personal protective equipment for health-care workers “battling the COVID-19 pandemic.” Fulkerson’s letters ordered the Ohio clinics to “immediately stop performing non-essential and elective surgical abortions. Non-essential surgical abortions are those that can be delayed without undue risk to the current or future health of a patient.”
In response, the clinics have publicly insisted that abortions are an essential procedure and they are therefore already complying with the state order to halt nonessential surgeries.
“Under the [department of health order], Planned Parenthood can still continue providing essential procedures, including surgical abortion,” the Planned Parenthood of Southwest Ohio Region said in a statement posted to Twitter.
An attorney for the Women’s Med Center in Kettering said the clinic was complying with the order and had taken steps to “minimize the use” of personal protective equipment before the order went into effect, the Dayton Daily News reported.
Fulkerson operates under Yost, a Republican abortion rights opponent who in 2019 supported a near-total ban on abortion. “This is not an abortion issue,” Bethany McCorkle, a spokesperson for the attorney general, told Rewire.News. She added that the attorney general’s office had also sent a warning letter to the Urology Group in Cincinnati.
“The idea that any abortion can be delayed or is nonessential is beyond comprehension,” Mallory McMaster, a reproductive rights advocate in Ohio, told Rewire.News. “It’s despicable that Attorney General Yost is using this moment, during a deadly global pandemic, to attack Ohioans with his extreme, unpopular political rhetoric. My heart goes out to everyone seeking abortion care during this time, when we’re more alone than ever. We’re the experts in our own lives though, and we’re the ones who get to decide if the health care we need is essential.”
Indiana Attorney General Curtis Hill (R) signed an amicus brief backing Texas’ push to suspend abortion services during the COVID-19 pandemic.
However, in an email to Rewire.News, Indiana’s Joint Information Center said the state’s COVID-19 order “directs all healthcare facilities, hospitals, surgical centers, veterinarians, dental offices, dermatologists and abortion clinics to postpone or cancel all elective or non-urgent procedures, unless doing so would cause harm to the patient as determined by a healthcare provider.”
Chris Charbonneau, CEO Planned Parenthood of Indiana and Kentucky, said in a statement that the organization is complying with the state’s COVID-19 directive.
“Planned Parenthood’s top priority is ensuring that every person can continue accessing essential health care, including abortion,” Charbonneau said. “Medical experts recognize that abortion is an essential, time-sensitive medical procedure.”
Kentucky Attorney General Daniel Cameron (R) has asked the state’s top health official to confirm that abortion providers are violating Gov. Andy Beshear’s (D) order banning elective medical procedures during the COVID-19 pandemic.
Cameron said he would take action against abortion clinics in Kentucky if Cabinet for Health and Family Services Acting Secretary Eric Friedlander certifies that they’re in violation of the state’s COVID-19 policy, Kentucky Today reported. Republicans in the Kentucky legislature have sought to circumvent the Beshear administration and empower Cameron to hassle clinics with regulatory enforcement.
In a March 26 press conference, Beshear said he would “leave it to our health professionals to determine what falls in the elective or the essential.”
“I’m not going to get out there on any other issue or any other cause no matter how important they are to me,” Beshear said, adding that addressing the spread of COVID-19 was his “sole focus.” He said he was unaware of legislation seeking to give Cameron the power to shut down abortion clinics.
Chris Charbonneau, CEO of Planned Parenthood of Indiana and Kentucky, told Kentucky Today that the organization would continue providing care.
U.S. District Judge Myron Thompson on April 12 issued a preliminary injunction preventing Alabama officials from suspending abortion services during the COVID-19 pandemic.
Thompson ruled that state “efforts to combat COVID-19 do not outweigh the lasting harm imposed by the denial of an individual’s right to terminate her pregnancy, by an undue burden or increase in risk on patients imposed by a delayed procedure, or by the cloud of unwarranted prosecution against providers.”
Thompson on March 30 granted a temporary restraining order against the Alabama Department of Public Health’s ban on abortion as part of the state’s COVID-19 emergency order, AL.com reported.
In October 2019, Thompson blocked the Alabama legislature’s near-total ban on abortion.
Louisiana Attorney General Jeff Landry (R) in a March 28 statement said June Medical Services, one of the state’s last facilities offering abortion services, should stop providing abortions during the COVID-19 pandemic. Landry said he hopes the state’s health department “will recognize that elective abortions are not essential procedures” and should therefore be banned during the COVID-19 crisis.
In a March 24 email to Rewire.News, a spokesperson for the Louisiana Department of Health said the state had not prohibited any specific health procedures as part of its COVID-19 response. Kelly Zimmerman, a spokesperson for the state health department, told Rewire.News that doctors would “have to use their medical judgment to determine what is and what isn’t an emergency medical procedure.”
“Louisiana has not issued guidance or directives to any specific medical field,” Zimmerman said. “The Louisiana Department of Health has, in an attempt to conserve our limited hospital bed space and personal protective equipment, issued an emergency rule requiring any and all medical and surgical procedures to be postponed. However, medical and surgical treatments necessary to treat an emergency medical condition are still allowed.”
West Virginia: Contentious
On April 1, the director of West Virginia’s only abortion provider told the Charleston Gazette-Mail that the facility would continue offering reproductive health services, including abortion care, during the pandemic.
Meanwhile, West Virginia Attorney General Patrick Morrisey (R) on April 2 said he would consult with the governor’s office and the West Virginia Department of Health and Human Resources about enforcement of the state’s order to limit so-called elective medical procedures during the COVID-19 outbreak, according to the Gazette-Mail.
West Virginia Gov. Jim Justice (R) referred to Morrisey during a press conference when asked about abortion access. Morrisey said there’s “no categorical exemption for abortion. There’s no categorical exemption for any procedure.”
“There will be a reduction in dental procedures, there will be a reduction in orthopedic procedures, and yes, there will be a reduction in procedures within abortion facilities,” Morrisey said.
Health officials in Massachusetts declared abortion an essential procedure during the week of March 16.
“Terminating a pregnancy is not considered a nonessential, elective invasive procedure for the purpose of this guidance,” Elizabeth Kelley, director of the Massachusetts Bureau of Health Care Safety and Quality, wrote in a memo, Mass Live reported. “However, the ultimate decision is based on clinical judgment by the caring physician.”
Abortion care will continue in Iowa amid the COVID-19 pandemic after the state and abortion rights advocates came to an agreement before an April 1 court hearing, the Des Moines Register reported.
The American Civil Liberties of Iowa and Planned Parenthood Federation of America had filed a legal challenge on March 30 against Iowa Gov. Kim Reynolds’ (R) order to stop procedural abortions as the state grapples with COVID-19.
“To choose this moment—while we are in a global pandemic—to take on a political fight is not only misguided, it’s dangerous,” Sarah Stoesz, president and CEO of Planned Parenthood North Central States, said in a statement announcing the lawsuit.
On March 29, Reynolds said abortion would be considered an elective medical procedure as part of the state’s emergency COVID-19 policy.
Diana Philip, executive director of NARAL Pro-Choice Maryland, told Rewire.News that abortion care has continued in the state during the COVID-19 emergency. The organization in a March 23 statement said the “directive from the Maryland Department of Health makes it clear that medical care necessary for the health of the patient is essential, and not elective.”
“A patient seeking abortion care is not going to consider it as ‘elective’—it is healthcare that is critically necessary to obtain without delay,” the statement continued.
WYPR reporter Rachel Baye tweeted on March 23 that after asking Gov. Larry Hogan’s (R) office if abortion would be considered an “essential” medical procedure during the COVID-19 outbreak, the “initial answer seemed to be that the governor’s office doesn’t make that call.”
Abortion care will remain accessible in Colorado during the COVID-19 crisis.
An order from Gov. Jared Polis (D) said a medical procedure would be considered essential if “there is a risk of metastasis or progression of staging of a disease or condition if the surgery or procedure is not performed.”
The Washington state government does not consider abortion services as part of the “nonessential” category for COVID-19 emergency response policy, according to the Washington Post.
New York: Accessible
Abortion services at Planned Parenthood clinics have continued in New York amid the COVID-19 outbreak, according to a March 20 BuzzFeed News report.
Reproductive health-care providers were included in a list of essential health services released March 20 by Illinois Gov. J.B. Pritzker’s (D) administration, according to NBC Chicago.
Beginning March 23, Planned Parenthood of Illinois consolidated its services to six clinics. Staff from the other 11 Planned Parenthood health centers will work out of the six clinics that remain operational, NBC Chicago reported.
New Jersey: Accessible
New Jersey Gov. Phil Murphy’s (D) March 23 order ending “elective” medical procedures has an exemption for family planning services, including abortion care. “The order provides that it shall not be interpreted in any way to limit access to family planning services, including termination of pregnancies,” Murphy’s order said.
“During this unprecedented public health crisis, New Jersey is listening to medical experts and expressly names abortion care as an essential medical service, ensuring outpatient and hospital-based care can remain available,” Roxanne Sutocky, director of community engagement at the Women’s Centers in New Jersey, said in a statement. “The state of New Jersey has long served as a leader in reproductive healthcare access and pregnant people can access the abortion care they seek without the interference of mandated waiting periods, forced parental involvement, or insurance restrictions.”
Reproductive health services will be considered essential and remain available as part of Minnesota Gov. Tim Walz’s (D) COVID-19 emergency plan, according to the Star Tribune.
Oregon Attorney General Ellen Rosenblum (D) said the state’s COVID-19 emergency order “exempts abortion services from its delay of non-urgent surgical procedures.”
Rosenblum said in a statement that Oregon “will never budge from our guarantee of reproductive rights—including timely access to abortion services.”
The Hawaii state government’s COVID-19 order recognizes abortion care as an essential health-care service.
“While the current situation is burdening many sectors of our society, there is no basis to infringe upon a woman’s right to safe medical services, including reproductive health care, as part of the government’s response to COVID-19,” Hawaii Attorney General Clare Connors (D) said in a statement.
The March 25 COVID-19 order released by Virginia Gov. Ralph Northam (D) and the Virginia Department of Health said restrictions on medical procedures do “not apply to the full suite of family planning services and procedures.”
Niki Forbing-Orr, a spokesperson for the Idaho Department of Health and Welfare, told Rewire.News on March 31 that the state “has not explicitly changed any policies around providers who offer abortion services because of COVID-19.”
North Dakota: Accessible
Abortion care remains available in North Dakota during the COVID-19 pandemic, according to the North Dakota Department of Health.
“We’re not in a place where we’ve had to designate what an essential health service is,” Nicole Peske, a spokesperson for the department, told Rewire.News. “All health care facilities are operating as they normally would and decisions at this point are at the discretion of the facility.”
Abortion services continue in Florida despite anti-choice organizations urging Republican Gov. Ron DeSantis to ban abortion care during the COVID-19 pandemic.
Florida’s COVID-19 Call Center told Rewire.News on April 2 that the “decision on providing elective vs. non-elective services is made by the healthcare provider,” in accordance with the governor’s executive order on medical procedures during the virus outbreak.
Anti-choice activists in Florida are hoping DeSantis, an abortion rights foe, will use the crisis to stop abortion care in the state, according to the Palm Beach Post. None of DeSantis’ executive orders during the outbreak have prohibited abortions in Florida, the Post reported.
Arizona’s health department confirmed on April 3 that abortion services would remain available amid the COVID-19 pandemic.
Holly Poynter, a spokesperson for the Arizona Department of Health Services, told Rewire.News that the executive order on medical procedures during the crisis “does not specify any particular procedure as elective or essential. Instead, it leaves the decision up to the medical provider.”
Abortion care has not been restricted in California, according to the California Department of Public Health.
“It is up to each facility to develop its own policy on … what elective surgeries or other elective care to provide,” a health department spokesperson told Rewire.News by email. “The California Department of Public Health is assisting health facilities across the state in order to ensure high quality, safe, and effective care is provided to all patients in California, whether for COVID-19 or any other need.”
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