By Robin Marty
January 14, 2019
IDEAS
Robin Marty is a freelance writer and the author of Handbook for a Post-Roe America.

You’re always being told to be proactive when it comes to protecting yourself financially for the future. Investment advisors suggest siphoning earnings into company-matched 401(k)s from the moment you start your first job as well as opening college accounts for your offspring months before that dependent is even born. With Americans carrying on average of more than $8,000 of credit card debt and another $37, 000 in student loan debt, advice like “be sure you have an emergency fund” makes perfect sense in order to avoid bankruptcy in case of a surprise job layoff, major life change like divorce or illness, or loss of a key resource like your home or car.

But one event no one prepares for is the very real possibility of needing an abortion, despite the fact that 45 percent of all pregnancies in the U.S. are unplanned. With a federal government that vows to expand opportunities for religious nonprofits and even some privately held companies to forgo offering birth control options in their health care plans, as well as strip funding from organizations that offer contraception for lower-income or uninsured populations, that number is only expected to grow. While not everyone faced with an unexpected pregnancy will choose to get an abortion, it is an unavoidable fact that for many people giving birth is a too much of a financial, physical or emotional burden at this point in their lives, making abortion a safe – and constitutionally guaranteed – option. According to a five-year study conducted by Advancing New Standards In Reproductive Health (ANSIRH), a reproductive-health research group, those who are unable to obtain an abortion due to financial barriers face severe economic, medical and social repercussions. They are not only four times more likely to live below the federal poverty line, they are more likely to have serious pregnancy complications, to remain in abusive relationships and to see a negative impact on the lives of their other children (if they have them) too.

Unfortunately, not having the money to pay for an abortion – and the expenses surrounding it, such as time off work, travel, lodging, childcare and more – is what causes many people to delay the procedure, which, ironically, can then drive up the costs. That cycle can rapidly escalate to the point where an abortion becomes financially out of reach. While a first-trimester procedure is usually around $500, a clinic often charges additional hundreds of dollars per week as gestational age progresses further, usually passing $2,000 once a pregnancy reaches near 22 weeks. This especially affects those seeking to terminate a wanted pregnancy where the fetus is found to have medical complications – something usually not found until the second trimester or later.

But having even $500 on hand for an emergency simply isn’t the norm. According to the U.S. Federal Reserve’s 2017 report on economic well-being, four out of 10 Americans would be unable to cover a $400 emergency expense, or would need to sell items to meet the need, and in 2017 more than 25 percent of American adults skipped necessary medical care because the cost was too high. And even if a person has insurance, that may be little help. In 11 states even private insurance plans provided by employers are forbidden from covering abortion except in very limited cases like life endangerment or a physical threat to the pregnant person – only two of those states consider sexual assault to be a reason for insurance to cover an abortion, and nine of those states offer abortion coverage only through a separate rider with its own additional payment.

It’s even more difficult if you have a public insurance plan, as 26 states limit any insurance plan that uses tax dollars – not only Medicaid coverage, but also plans bought on the public insurance exchange – from covering any elective abortion procedures, limiting reimbursement to cases of rape, incest, severe health risks or life endangerment.

Luckily, there are groups that can assist those who find themselves in a dire financial bind when they want to end a pregnancy but don’t have the funds. There are state-and city-based abortion funds across the country, many of them working under the umbrella of the National Network of Abortion Funds. Abortion funds work either directly with a patient to help bridge a financial gap, or directly with an abortion clinic that has a patient with economic needs. But funding needs continue to increase throughout the country due not just to lack of insurance coverage for abortion but also the additional costs besides the procedure itself, such as gas for traveling long distances because there are no local providers, or a hotel room in order to be in town for the 24 to 72 hours a state may require you to wait between seeing a doctor and terminating a pregnancy. Demand for funding further increases when there’s a sudden reduction in access, as when Planned Parenthood’s Nashville clinic stopped offering abortions last month due to a shortage of providers, forcing patients to travel hundreds of miles to the nearest clinic.

Since 2010, state legislatures have enacted more than 400 restrictions on abortion, from outlawing common second-trimester procedures to regulating the corridor width for any medical facility providing abortions to mandating that women have, and in some cases, view, an ultrasound before terminating a pregnancy. In that same period states like Louisiana, Texas and Arizona have lost more than half of their clinics, with six states now having just one provider left to offer care. For people in low clinic-density states and states that ban abortion after a certain number of weeks, terminating a pregnancy often means leaving their home state altogether. This will only get worse as state legislators across the country pass additional restrictions, even knowing they will likely be challenged in court – with Trump filling the federal bench with more conservative judges, abortion opponents are betting they’ll find a more sympathetic audience for their claims. This, of course, is on top of the fact that, with the confirmation of Justice Brett Kavanaugh, there’s a real possibility that Roe v. Wade will be overturned and allow nearly half of the states to make abortion illegal or pretty much inaccessible.

A pregnancy is a life-altering experience, and if you think you might want an abortion if faced with that situation, it’s a good idea to plan ahead if you can. Putting enough money in a personal abortion fund not just for an abortion (if it’s not covered by insurance), but for time off, travel and other expenses obviously can be overwhelming, so like preparing for any emergency, take small steps. Set aside a little now by opening a separate account just for this and scheduling an automatic transfer for $10, or some other small amount you can afford, each month. If you get a bonus or some money as a gift, toss it in there, too. Every bit helps if you do find yourself facing an unwanted or non-viable pregnancy, and time is of the essence. And if you end up not needing the money in your emergency fund, it can always be used somewhere else, or even given to a real abortion fund to assist others in need.

Accessing an abortion is already extremely difficult for many throughout the United States. Given the political landscape, extremely difficult could quickly become nearly impossible. Just like before Roe, abortion will probably always available for those who have the money to jump through the hoops. If you want to make sure that is you, you better start saving now.

Contact us at editors@time.com.

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