
No, California is not guaranteed to remain an abortion haven
There are few options to fix this problem, even in California, the world's fourth-largest economy. The state barely covered its budget deficit this year, and it has holes to fill as federal funds for public universities, education, transportation and other sectors were slashed in the recently passed budget. Plus, the state needs federal dollars to help rebuild Los Angeles after the devastating wildfires there earlier this year.
Ten million Americans are expected to lose their health insurance because of nearly $1 trillion in Medicaid cuts over the next decade in the One Big Beautiful Bill Act, according to the nonpartisan Congressional Budget Office. Meanwhile, the wealthiest Americans will receive a disproportionate share of the tax cuts funded by those reductions, according to the Center for Budget and Policy Priorities.
'It's an illustration of the limits on what any state can do (on abortion access) if the federal government is hostile,' said Mary Ziegler, a professor of law at UC Davis and leading scholar on abortion rights. 'It's more of a reminder that there isn't really a real sanctuary. California has limited power over a lot of this.'
It is the latest example of how California is in the political crosshairs of what President Donald Trump's former top adviser Steve Bannon famously described as his 'muzzle velocity' philosophy of launching a lot of disruptive policies and spurious attacks simultaneously. California is withering under the incoming fire. The people hurt most by the closure of those clinics will be the poorest Californians, as 80% of the people who used services at those clinics were Medicaid recipients, according to Planned Parenthood Mar Monte, the umbrella organization for the shuttered clinics.
Planned Parenthood doesn't just provide abortion services. The majority of people go to Planned Parenthood clinics for contraceptive services, sexually transmitted infection testing, pregnancy testing and gynecological services. One in 10 (11%) female Medicaid beneficiaries ages 15 to 49 who received family planning services went to a Planned Parenthood clinic in 2021, according to the nonpartisan Kaiser Family Foundation. California has the highest percentage (29%) of Medicaid recipients in the country who go there for health care.
This wasn't the way it was supposed to go. California was supposed to be a haven for abortion rights after the Supreme Court overturned Roe v. Wade. Shortly after the decision, Gov. Gavin Newsom joined the governors of Washington and Oregon to create what he called 'the West Coast offensive. A road map for other states to stand up for women.'
A diverse coalition of abortion rights advocates formed the California Future of Abortion Council. It proposed more than 50 recommendations for policymakers to improve abortion access in the state. In the year after the decision, Newsom and the Democratic-controlled Legislature created more than a dozen new laws and invested more than $200 million to increase access across the state. In November 2022, 67% of California voters supported a ballot measure enshrining abortion rights in the state Constitution. Newsom spent $100,000 from his campaign coffers to plant billboards in seven states with some of the nation's most restrictive laws: 'Need an abortion?' reads one billboard. 'California is here to help.'
'What you do in California sets the standard for everyone else,' Mini Timmaraju, national president of NARAL Pro-Choice America, said at a 2022 fundraiser for Proposition 1 in San Francisco that Hillary Clinton attended. 'I want to take that package of legislation and this proposition and see it copied nationwide.'
Ultimately, all those California laws and all that state funding weren't enough to keep the Mar Monte clinics open. They never could be as long as there isn't the national right to an abortion that Roe provided and as long as women's health clinics are reliant on federal funds to remain open. Planned Parenthood estimates that 200 clinics nationwide could close.
To meet this reality, California needs a new 'West Coast offensive.' It needs to draw up a new 'road map for other states to stand up for women.'
It would be best if clinics were funded privately, insulating them from partisan federal cuts. But that is harder now.
California is the state with the most millionaires and billionaires. Now is the time for wealthy individuals and foundations to stand up and backfill these losses so clinics can continue to provide access to women's health care.
But will those individuals step forward? Or will they be cowed like the wealthy law firms and Ivy League universities that have bowed to Trump's intimidation?
Even if they do step up, is there enough private money in California to keep federally funded women's health clinics open until Democrats regain control of at least one lever of power in Washington and can curb his fascistic policies?
That possibility looks bleak. For starters, it would probably require hundreds of millions of dollars, said Shannon Olivieri Hovis, former NARAL Pro-Choice California director who is now vice president of public affairs at Essential Access Health. 'I think the honest answer is, we don't know yet. We're talking about a huge hole.'
Theresa Cheng, a professor of emergency medicine at UCSF and a member of the school's Bixby Center for Global Reproductive Health, said it will be difficult for the private sector to patch up all the new holes punctured in the social safety net by the Trump administration.
'That's going to be really difficult because the Trump administration has cut so broadly in so many social systems,' said Cheng, who is in touch with private donors through her work with several nonprofit organizations. 'Food insecurity. Homelessness. Immigration. There are a lot of needs out there now.'
Relying on private donations isn't going to help clinics across California's chasm of wealth inequality, Ziegler said.
'If you're depending partly on individual donors, that's going to look very different in Beverly Hills or Marin County than it is in Gilroy or other areas where there are few people to give private donations,' Ziegler said.
Until political change happens in Washington, Cheng urged Californians to 'stay stalwart in protecting reproductive health. So much of this will have to be settled out in the courts. That will at least buy us some more time.'
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