Columnist Carrie N. Baker: Taking stock of abortion access in Massachusetts

  • Carrie N. Baker speaks at a rally at Northampton City Hall in May. Gazette file photo

Published: 8/24/2022 3:03:48 PM
Modified: 8/24/2022 3:00:12 PM

The wave of anti-abortion laws in the U.S. and the overturn of Roe v. Wade has made abortion much harder to obtain in much of the country. But here in Massachusetts, we now have greater access to abortion health care than we did just a few years ago — a shift ironically fueled by anti-abortion developments in the rest of the country.

In 2018, shortly after Donald Trump nominated Brett Kavanaugh to the Supreme Court, Massachusetts legislators concerned about the possible overturn of Roe passed An Act Negating Archaic Statutes Targeting Young Women — known as the NASTY Women Act — repealing bans on abortion and contraception still on the books but unenforceable at the time because of Roe and other court decisions.

Then in December 2020, shortly after the Senate confirmed Amy Coney Barrett to the Supreme Court, the Massachusetts Legislature overrode Gov. Charlie Baker’s veto to pass the ROE Act, creating an affirmative right to abortion health care, expanding access to abortion after 24 weeks in cases of fatal fetal anomaly, and making Massachusetts the first state ever to remove a parental consent requirement by allowing 16- and 17-year-olds to independently consent to abortion health care.

Then just last month, our Legislature passed a sweeping new law, An Act Expanding Protections for Reproductive and Gender-Affirming Care, with robust protections for health care workers who provide these services to patients living outside the state — both those who travel to Massachusetts for care and those who receive care in their home states from Massachusetts providers via telemedicine.

The law shields Massachusetts providers from extradition and investigations originating outside the state for providing legally-permitted health care in Massachusetts. It protects providers’ professional licenses and keeps malpractice insurance affordable if they face out-of-state civil lawsuits for providing lawful abortion care in Massachusetts. And it creates a new civil remedy to countersue if they are the subject of criminal prosecution or civil lawsuits brought by someone outside of Massachusetts, enabling them to recover an amount equal to the damages assessed in any out-of-state lawsuits.

The law defines legally-protected health care activities to include health care provided via telemedicine to patients in other states. This means people living in states with abortion bans or telehealth abortion restrictions can now access telehealth medication abortion care from Massachusetts providers. We are the first state to do this. The law will also allow Massachusetts providers to offer telemedicine abortion services to minors in states with parental notification requirements because Massachusetts does not require parental consent or notification for minors aged 16 and 17.

Other provisions include requirements that insurance cover abortion without copays or deductibles and that Massachusetts public colleges and universities provide medication abortion at campus health centers. The new law expands access to abortion after 24 weeks to include cases of “grave fetal diagnosis that indicates that the fetus is incompatible with sustained life outside of the uterus without extraordinary medical interventions” as determined by “the best medical judgment of the physician.”

The law also expands access to contraception by allowing pharmacists to provide emergency contraception, making no-cost insurance coverage possible for all forms of emergency contraception without delay and authorizing the sale of over-the-counter emergency contraceptives in vending machines. Boston University now has a vending machine that allows students to buy emergency contraception for $7.25, much lower than the retail price of $40-50.

The rapid passage of this recent law contrasts dramatically to the years we fought for the ROE Act, which Baker vetoed. This much more expansive bill passed in a little over four weeks after the Supreme Court overturned Roe, and the governor quickly signed the bill. The same week he also signed the fiscal 2023 budget that includes $2 million for abortion funds in the state.

All of these laws have significantly expanded access to abortion health care in our state. But another factor increasing access was the U.S. Food and Drug Administration’s decision to loosen restrictions on the abortion pill mifepristone last December. As a result, Massachusetts now has at least nine telehealth abortion providers, many of whom charge far less than clinic-based care. Aid Access, for example, offers this service on a sliding scale up to $150. If you can’t afford to pay, you can receive the service for free. Pills arrive by mail within a couple of days, avoiding the need to cross picket lines of condescending, hellfire-and-brimstone anti-abortion protesters at clinics. As a result, people in Massachusetts can obtain and use abortion pills conveniently, privately and safely at home in the first trimester of pregnancy.

The anti-abortion tidal wave across the country has propelled sweeping action to increase access to abortion health care in Massachusetts. I’m proud to live in a state that respects the lives, choices and dignity of women, girls, trans and nonbinary people who are pregnant.

Carrie N. Baker is a professor in the Program for the Study of Women and Gender at Smith College and a regular contributor to Ms. Magazine.

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