The National Abortion Federation and its NAF Hotline Fund will now require patients who receive their funding to take both abortion pills in a state where abortion is legal, according to emails sent Aug. 22 and obtained by The Washington Post. The nonprofit, which is widely backed by billionaire Warren Buffett, helped fund at least 10% of all abortions in the United States in 2020. The new rules could impact thousands of patients per year, according to the providers.
Patients in need of abortion funding can either call the NAF hotline or apply for financial assistance at a clinic licensed to provide support. Under new NAF regulations, which come into effect on August 29, patients whose procedures are funded by the NAF will now have to tell clinic staff that they won’t take their second pill in a state where abortion is illegal.
Clinics need only impose the new NAF restrictions on patients receiving NAF funding, according to an email to abortion providers from the NAF Hotline Fund’s director of operations, Chloe Hanson Hebert. The restrictions will disproportionately impact poor women and women of color, multiple providers said.
These new restrictions go beyond what is explicitly required by abortion bans enacted since deer was overthrown. The various bans in anti-abortion states prohibit providers from performing abortions within state lines, but do not prevent providers elsewhere from prescribing pills to out-of-state patients whose they know they will return home.
The NAF did not respond to a request for comment on this story. But in earlier interviews, NAF officials said they struggled to adapt to the changing legal landscape in order to protect the organization and the patients they serve. This latest policy change highlights the ripple effects of the Dobbs ruling, which has created widespread uncertainty about how state laws will be enforced, even against providers and doctors in states where abortion is legal.
Some abortion providers and advocates say the restrictions are unnecessary and burdensome for patients already facing significant barriers to abortion care following the Supreme Court ruling, which left 1 in 3 women without access to the procedure. NAF restrictions mean that out-of-state patients traveling for medication abortions may have to spend up to two additional nights in a hotel, in addition to additional food and childcare costs. ‘children.
“It’s hard enough to make that trip even if you’re going home the same day,” said an abortion provider in New Mexico who is subject to NAF regulations. Like others interviewed for this article, the provider spoke on condition of anonymity because around 50% of its patients rely on NAF funding.
“Now my patients are unnecessarily regulated even more by a so-called ally.”
The new NAF restrictions, the provider added, “sound like something an anti-abortion lawyer would write.”
Abortion is now prohibited in these states. See where the laws have changed.
With an annual budget of $7 million, the National Abortion Federation partners with hundreds of clinics across the country – including independent clinics and those affiliated with Planned Parenthood – providing staff training and a security support, among other resources. NAF-affiliated staff regularly visit member clinics to “ensure they provide the highest quality care,” according to the NAF website.
In a mid-July interview with The Post, NAF chief operating officer Veronica Jones acknowledged that the Supreme Court ruling has changed the abortion landscape. “Failing to incorporate this new reality into our decision-making would put our entire operation at risk, ultimately leaving hundreds of thousands of people without access to care,” she said, adding that the NAF has helped 3,000 people to access to abortion in the weeks following the Supreme Court. decision.
Medical abortions now account for more than 50% of abortion procedures in the United States, according to NAF estimates and data from the Guttmacher Institute, a research organization that supports abortion rights – with many patients preferring to take pills instead of undergoing surgery.
Although both abortion pills – mifepristone and misoprostol – can be taken at the same time if misoprostol is taken vaginally, this method is far less popular and would make immediate travel risky, providers say, as the patient could start to pass the pregnancy on its way. residence.
With abortion now banned or nearly banned in 15 states, organizations like NAF that provide abortion funding are playing an even bigger role in helping patients access care. To obtain a legal abortion, some patients in anti-abortion states must fundraise to travel — sometimes hundreds of miles — in addition to the price of the procedure itself, which costs an average of $500 in the first trimester.
Under the new regulations, providers must certify that the patient has either taken the pills at the clinic or promised to take them both in a state where abortion is legal until the patient has received care.
“Many patients are [traveling out of state] without telling their community, friends, partners,” said an abortion provider who works in Kansas, where abortion remains legal until 22 weeks of pregnancy. “The poorest and most disenfranchised patients will have to arrange even more childcare, take time off work and change their story of what’s going on.”
Some abortion providers have grown increasingly skeptical of the NAF since the organization threatened to withhold funding from any clinic in Texas that does not fully comply with the state’s strict ban. went into effect last fall, said several abortion providers, some of whom worked in Texas when performing the abortion. was still legal there. The decision, first reported by Jezebel, prevented legal challenges that could have led to an injunction and allowed abortions to continue as normal.
Some abortion providers say they understand the NAF decision.
When she heard about the new policies, Michigan abortion provider Renee Chelian wasn’t surprised: Within weeks of the Supreme Court ruling, her clinics began requiring patients to take both pills before leaving the state. Chelian and her team drafted a form for patients to sign, promising to begin and complete their medical abortion in Michigan.
Chelian said she became more concerned about legal liability after an Ohio pharmacist called to inquire about painkillers her clinic had prescribed for an abortion patient who lived in Ohio, where abortion is now prohibited after six weeks of pregnancy. The pharmacist wanted to know if the patient had had a miscarriage.
“We need to do everything we can to make sure the NAF is protected, our doctors are protected, and our patients are protected,” Chelian said.
“It’s post-deer,” she added. “Nothing is certain anymore.”
Christopher Rowland contributed to this report.