Minnesota Beyond Roe: The Leadership Agenda for Abortion Access
Minnesota can be a national leader in reproductive rights, abortion access, and health care access — and when we created this agenda in 2022, as it became clear that Roe v Wade was going to be overturned, we intended it as a long-term roadmap for getting there.
But then the Minnesota judge overseeing the lawsuit we brought to challenge our state’s harmful anti-abortion restrictions ruled many of them unconstitutional. Minnesota voters took to the polls in the 2022 midterms to elect Minnesota’s first-ever pro-reproductive-freedom legislative majority.
And our champions in the Minnesota legislature made historic progress in the 2023 legislative session — enshrining in Minnesota law everyone’s right to make and act on their own decisions about the full range of their reproductive health care options (including abortion), instituting strong protections against legal attacks by out-of-state anti-abortion extremists for everyone who seeks, provides, or helps someone get abortion care in Minnesota, and repealing the vast majority of Minnesota’s restrictions on abortion care.
That means we’ve achieved most of the objectives under the first two agenda items below.
But legal rights and safeguards don’t mean much if affordability and other obstacles stand in the way of equitable access to abortion and other essential reproductive health care.
This is where we will be focusing our unwavering attention and our unrelenting efforts in the 2024 legislative session. Please read on for more detail — and renew your commitment to fully unrestricting Minnesota.
It’s not enough to say we won’t stand for a ban on abortion in our state. That’s the bare minimum, and visionary leadership on this issue demands so much more.
Unfortunately, Minnesota’s laws are littered with restrictions on abortion care that increase the cost of care, intimidate patients and their health care providers, and prevent too many people from getting the care they need when they need it. To lead on reproductive rights and health care access, our first step must be to repeal them.
End state-mandated anti-abortion counseling and the 24-hour waiting period.
The Patients’ Right to Know Act would repeal two insidious and harmful restrictions on abortion access: first, a requirement that doctors deliver state-mandated anti-abortion propaganda to patients seeking abortion care — including demonstrably false information, such as a debunked claim linking abortion to breast cancer — and second, a mandatory 24-hour waiting period for patients to get abortion care after they’ve received this state-mandated “counseling.”
It’s insulting, patronizing, and patently untrue to suggest that people seeking to end a pregnancy and the doctors they trust to provide them with care don’t know what they’re doing and need politicians in the state government to tell them what to think, say, and do. We must pass the Patients’ Right to Know Act.
Stop artificially limiting the pool of abortion providers.
Physicians aren’t the only health care professionals qualified to provide abortion care, but Minnesota law criminalizes abortions performed by all other trained, licensed providers, including advance practice registered nurses. Minnesota also prohibits free-standing birth centers from performing abortions, which restricts options and availability not only for people seeking abortions, but also those who need miscarriage care. And we can do more to ensure that there’s not only a robust pool of existing providers, but also a reliable pipeline of new ones by expanding access to training and other supports for licensed providers.
Even before the fall of Roe, Minnesota abortion providers have been experiencing a surge in demand as people from states with stricter anti-abortion laws travel great distances to seek care here. To offer top-quality care for all who will need it, we must expand the pool of available providers by eliminating Minnesota’s physician-only requirement, ending the ban on abortions performed at free-standing birth centers, and increasing training and support for licensed providers.
Stop traumatizing minors who need abortion care.
If you’re under the age of 18 and pregnant, and do not wish to remain pregnant, Minnesota law is going to make you jump through a whole circus of bureaucratic hoops to get the care and support you need.
The law requires minors seeking abortion care to notify both parents — even if they have no relationship with one or both parents, or if those relationships are abusive (with a slight exception if the authorities have gotten involved). If you’re not able to notify both parents, you have to go through the court system to get your care approved. It’s a crime for providers to provide abortion care to minors who don’t have precisely the right paperwork. And anti-abortion activists have used young people’s court appearances to “out” them publicly for seeking abortion care.
This is no way to treat Minnesota’s youth. The fact is that a majority of minors seeking abortion do consult their parents — and those who do not voluntarily consult a parent typically have good reason not to, like abuse or other serious problems in the home that they do not wish to exacerbate. Minnesota’s laws only add trauma to what can be a very stressful and difficult moment in their lives. We must trust and support our young people — and repeal the parental notification law.
Stop forcing unwanted burial and cremation on abortion patients.
It’s shocking, upsetting, and nearly unbelievable, but it’s true: Minnesota requires all tissue resulting from an abortion or miscarriage to be buried or cremated, regardless of the beliefs, wishes, or preferences of the person who underwent the abortion or experienced the miscarriage.
It should go without saying that Minnesotans represent a diverse spectrum of personal beliefs, and that this may be deeply offensive and hurtful to many people. The only purpose of this law is to try to shame and stigmatize all pregnancy outcomes other than birth. It’s intrusive and harmful, it’s entirely unnecessary from a medical and public health perspective, it adds to the cost of care, and it must be repealed.
Stop trawling through the details of abortion patients’ private lives.
Minnesota law requires abortion providers to collect and report to the state an exhaustive and invasive list of personal details about abortion patients — including how much money they make, the number of miscarriages they’ve experienced, the “specific reason” they’re having an abortion, and how they paid for the abortion. And there’s nothing voluntary about it — providers who do not report this information can be charged with a felony. If that feels like an egregious invasion of privacy by the state, that’s because it is. It must end.
The Supreme Court’s decision to overturn Roe is going to unleash all kinds of chaos, including an onslaught of new attacks on reproductive rights, access to abortion care, and individual liberties and privacy more broadly.
Anti-abortion lawmakers in other states will almost certainly try to reach beyond their own borders and impose restrictions on those who live in states, like ours, that respect pregnant people’s needs and protect their rights under the law.
We must act now to protect patients and providers in Minnesota — and those who come to Minnesota seeking care — from the attacks that the Supreme Court decision will enable and empower.
Pass the PRO Act to ensure that every person’s right to make their own reproductive health care decisions is protected by law.
The Protect Reproductive Options Act (PRO, for short) would codify every individual’s right in Minnesota to make their own decisions about their reproductive health — including the right to end a pregnancy via abortion if they so choose. This right has been guaranteed as a part of our state Constitution for decades. We must pass the PRO Act to strengthen these protections and codify the right to reproductive freedom so that it cannot be taken away even if the composition of our courts changes.
Pass the Reproductive Freedom Defense Act to defend against out-of-state attacks on our rights, liberties, and reproductive health care options.
Minnesotans don’t take kindly under any circumstances to having our values dictated to us or our freedom encroached upon, especially by politicians from other places who have no idea who we are, what we believe, or how we live. The Reproductive Freedom Defense Act would enact strong protections against exactly this sort of meddling for anyone in Minnesota seeking abortion care, as well as the providers who care for them — safeguarding all from prosecution under laws aimed at imposing other states’ restrictions on us. We must pass it as soon as possible.
Protect people who opt to manage their abortions on their own.
Advances in health care and telemedicine have made it possible for people to play a much greater role in safely managing their own care at home via medication, on their own terms, supported by the family, friends, and medical professionals they choose — whether they have chosen to end their pregnancy or are managing a miscarriage. Increasing numbers of people seeking abortion care have chosen this option in recent years, and those numbers are certain to grow in the aftermath of the Supreme Court decision and the additional restrictions that will follow. Anti-abortion activist politicians and prosecutors have responded by criminalizing the procedure and even seeking to imprison people who choose to end a pregnancy this way — and those who support them. We cannot let that happen here.
The right to make our own decisions about our reproductive health care — and to get an abortion if that’s the decision we make — means nothing if access to the care we need is out of our reach.
Along with unnecessary restrictions on the provision of abortion care and legal threats to those who seek and provide it, affordability is one of the most significant barriers preventing people who have made the decision to end a pregnancy from getting the care they need. This is especially true for those already struggling financially, particularly in this harsh economic climate.
As we clear away the restrictions and protect patients and providers from threats, harassment, and intimidation, we must also take action to ensure that abortion care isn’t just a right — but an affordable, accessible option for all.
Guarantee public and private insurance coverage of abortion care — and backstop it with financial assistance for those who can’t get coverage.
Abortion care shouldn’t be treated differently from any other health care services, but some insurance carriers do so regardless. We can take a big and important step toward making abortion care affordable for all who decide they need it by ensuring its coverage in MinnesotaCare as well as Medicaid, encouraging private insurers to cover it, and establishing a financial assistance program for people whose insurance doesn’t include it.
Make sure Minnesotans know the facts about their insurance and financial assistance options.
Sorting through insurers and coverage options can be overwhelming and confusing, especially when it comes to abortion care, which is often singled out for differential treatment. We can cut through the clutter by ensuring that Minnesotans have full and accurate information about both the range of their insurance options and the availability of additional financial assistance.
Support Minnesota’s abortion funds and practical support organizations.
Abortion funds play an essential role in supporting people who need abortion care but cannot afford the many and various costs associated with it. This includes not only the cost of the service itself, but also child care for patients who already have children; travel and transportation for those who live far from a clinic (a number that will rise dramatically in the wake of the Supreme Court decision; according to an estimate by the Guttmacher Institute, Minnesota could see a 371% increase in out-of-state patients); and accommodations for those who can’t return home right away. But many funds operate on shoestring budgets, and the demand for their resources is at an all-time high. Minnesota should make clear its commitment to affordable abortion access for in-state and out-of-state patients alike by providing state funding to Minnesota-based abortion funds and practical support organizations.
Protect and expand state funding for pregnancy support services that counsel patients on the full range of their options.
State funding for pregnancy counseling currently goes to many “crisis pregnancy centers” (also known as fake clinics) that actively counsel patients against abortion care — frequently in misleading and unethical ways, and state law precludes counseling centers that DO refer people to abortion providers from receiving state funds. We must reverse this by expanding funding for real pregnancy support services and requiring that those receiving state funds provide medically accurate, unbiased information and support, free of preconditions and harassment.
Ensure abortion care access for Medicaid recipients by fixing Medicaid reimbursement rates.
Medicaid reimburses abortion providers at a rate that’s far below the actual cost of abortion care. That makes accepting Medicaid patients difficult for many providers and impossible for some — and that reduces access for people who depend on Medicaid to help them cover the cost of their health care. This is an easy fix. We must close the gap in reimbursement rates (including for telehealth services offering medication abortion care) and ensure timely payment to providers so they can accept as many patients as possible without putting their clinics in financial jeopardy.