Abortion took center stage during the Democratic National Convention last week, and Illinois was celebrated for welcoming thousands of women needing care since access has vanished across much of the South and Midwest.
But abortions funds that are essential for so many people traveling to states like Illinois — paying for their flights, hotels, child care and their abortions — are running out of money. Providers and advocates say that’s putting access to reproductive medical care in jeopardy.
Megan Jeyifo, for one, said she is exhausted. She runs the Chicago Abortion Fund, one of the largest of its kind in the country.
“Access has always been an issue in this country, and access is not what’s being discussed,” Jeyifo said. “It’s legality, and we know we need so much more beyond legality. While we’re waiting for whoever to be elected and Congress to pass whatever and ‘I’m going to sign this the minute it’s on my desk.’ That is going to take a long time. And what are we doing as a country? What are we doing as a community to address the real needs that people have right now?”
The stakes are high in Illinois — more people are traveling here than to any other state for abortion access, according to the Guttmacher Institute, a research and policy organization that supports abortion rights. This state is held up as a model for protecting reproductive rights under Democratic Gov. JB Pritzker.
Sarah Garza Resnick, president and CEO of Personal PAC, which works to elect pro-abortion political candidates, calls finding the money for equitable access “the next frontier of our fight.”
All of this is raising questions about who could step up to help pay for and even expand access to abortions. In Illinois, some point to Cook County’s public health system, one of the largest in the country with a legacy to treat anyone no matter if they can pay, yet one that has been relatively quiet about abortion.
The tipping point
The Chicago Abortion Fund has existed for some 40 years. In 2019 when abortion was still a federal constitutional right, the fund spent about $160,000 helping people get abortions.
That skyrocketed to about $8 million since the U.S. Supreme Court overturned Roe v Wade in 2022.
Jeyifo is seemingly everywhere drumming up financial support.
“Once you tell the story of the Chicago Abortion Fund receiving 1,700 calls for support in one month and supporting people in 32 different states and spending $600,000 in one month, people do cut checks,” Jeyifo said. “Just not at the scale we need right now.”
The Chicago Abortion Fund is set to receive about $5 million from the state, which helps cover out-of-state patients’ travel and stay here, Jeyifo said.
Jeyifo estimates the fund needs at least $200,000 a month more to cover abortion procedures.
And, as national abortion funds that support providers and patients dry up, more people need help covering their costs and turn to local organizations for that help, like the Chicago Abortion Fund.
Meanwhile, more women are coming to Illinois for abortions. In 2023, just over 37,000 people from other states traveled here to end their pregnancies — a more than threefold increase over three years, according to Guttmacher. Those estimates show around four in 10 people who received an abortion in Illinois came from another state. And that doesn’t account for women who have come here since bans in Florida and Iowa took effect in the last few months, a Guttmacher spokesperson said.
Jeyifo said the fund has been dipping into reserves. And after five years of helping anyone in need, they now say they’re having to limit their aid to patients who live in or are receiving abortions in Illinois or Wisconsin, Iowa, Nebraska and Arkansas, where the Chicago Abortion Fund has partnerships.
Jeyifo said scaling back is “devastating” and hopes it’s temporary.
What this means for patients
Dr. Allison Cowett sits in her office in Chicago’s West Loop neighborhood at Family Planning Associates, one of the largest independent abortion clinics in the country, and helps explain what all of this means.
She’s especially concerned about the roughly 30% of her patients who travel to her clinic from other states. For example, a fund that since Roe fell has paid 100% of the costs for out-of-state patients who are having abortions in the first three months of their pregnancies is ending on Sept. 1.
A first-trimester abortion typically costs around $500. Most of Cowett’s patients are low-income and have government-funded Medicaid health insurance in Illinois, which pays for abortions. The others who travel from other states are mostly covered by abortion funds that are cutting back.
“Will people stop coming when they hear from us on the phone, ‘This is how much money you have to bring?’” said Cowett, the medical director of Family Planning Associates. “It’s heartbreaking.”
She said her staff had these conversations for years with patients before Medicaid and abortion funds covered the cost. They’re preparing to have them again.
Spokespeople for the national abortion funds that are reducing or ending funding did not respond to comment.
Possible solutions
Illinois and Chicago governments have supported abortion through money or other protections, like a special zone around Cowett’s clinic to quiet protesters. Pritzker used his own money to launch Think Big America, an organization aimed at protecting and expanding abortion rights around the U.S.
But Cook County Board President Toni Preckwinkle has shied away from the spotlight on abortion, instead championing other programs that have received national acclaim — and a piece of $1 billion in federal pandemic relief money, such as providing guaranteed income and erasing medical debt for the poorest residents.
The county provides abortions at John H. Stroger Jr. Hospital on the Near West Side — nearly 660 in 2022 the year Roe fell, to about 900 last year and an expected 1,200 by the end of this year, according to a health system spokeswoman. That’s on par with some other local hospitals, though the other hospitals provide more surgical abortions for women later in their pregnancies.
Family Planning Associates, comparably, provides at least 200 abortions a week. A small percentage of abortions happen at hospitals.
Despite being the biggest medical safety net in the region, the county is not part of a state-funded program that refers patients with complicated medical conditions who need abortions to four hospitals in Chicago. A county health system spokeswoman said the county accepts patient referrals from those hospitals.
“I think abortion is still a scary word to a lot of people,” said Democratic Cook County Commissioner Bridget Degnen.
But she and Democratic Commissioner Donna Miller, former chairwoman of the Planned Parenthood of Illinois board, said they want the county to prioritize and publicize abortion access.
“Our mission at the county has long been to support disinvested communities, and wealthy women are not having problems getting abortions,” Degnen said. “This is all squarely in line with the county’s mission.”
She suggested the county expand access and look into funding other abortion providers similar to how the county awards grants to nonprofits.
Miller said she wants to see the county court abortion providers who live in states where they can no longer work. She emphasized wanting the county to get ahead of helping women, not go back to the days when the health system had a ward dedicated to treating women who had botched, illegal abortions before Roe was law.
In a rare interview about reproductive rights, Preckwinkle said she supports abortion, noting that she has a daughter and a granddaughter. But she acknowledged that as the county’s leader, she has not advertised the medical service out of security concerns.
“Protecting our patients and protecting our healthcare providers has to be our first priority, and that takes precedence over promoting the services that we provide,” Preckwinkle said. “I don’t want, frankly, to be in a situation where anybody who comes into our hospital has to cross a line of protesters.”
Dr. Claudia Fegan, chief medical officer at Cook County Health, which includes Stroger, Provident Hospital and clinics throughout Chicago and the suburbs, recalls an abortion provider who worked for the county and had a rat nailed to the tree in her front yard years ago. The clinic these days receives intimidating mail, the health system spokeswoman said.
Fegan said there was a time before Illinois Medicaid paid for abortions where the county was “the only game in town.” Now those patients can choose from more providers, she said.
Still, people who need abortions are referred to the county from other doctors in the area and in nearby states, Fegan said. The county this summer added more appointment times for patients and is working with the Chicago Abortion Fund to coordinate patient referrals.
Kelly Hall, executive director of the Fairness Project, said she’s working on another way to take the financial pressure off of abortion funds: getting voters in various states to support abortion through ballot measures.
In other words, if abortion was once again more accessible in other states, organizations like the Chicago Abortion Fund would not have to pay as much to help women travel across state lines.
But Jeyifo says abortion is still not accessible even for people who live in states that passed ballot measures. Clinics in Michigan, for example, still send patients to Illinois, she said.
Jeyifo wants to see a creative federal fix, like how the government rallied during the COVID-19 pandemic and gave local governments like Cook County money to help their communities recover.
In the meantime, what keeps Jeyifo motivated is thinking back to her own abortion some 25 years ago.
“It was a really awful experience where I did not have financial support or emotional support, and I drive by that clinic every time I’m here,” Jeyifo said while in Milwaukee.
Still, she said, “I know deeply what abortion access meant for my life.”