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On the top floor of a modest two-story brick building near the shore of Lake Superior, the executive director of northern Minnesota’s only abortion clinic moves from room to room, checks in patients, answers to phone calls from people requesting appointments and handles billing questions for those who are struggling to pay.
In the waiting room at the WE Health Clinic in Duluth, patients from Wisconsin and Texas sit among Minnesotans – the tip of an expected surge in out-of-state patients after the government suppressed Federal Abortion Law Supreme Court.
“It was just really busy,” said Laurie Casey, the executive director. “We try to be as flexible as possible, especially with people going out of state. Many of our patients, even if they are from Minnesota, travel between one and three hours each way to come here. So we try to be as accommodating as possible.
Even before the overturning of Roe v. Wade, WE Health Clinic was the closest abortion provider for some people in northern Wisconsin, northern Minnesota and Michigan’s Upper Peninsula.
Today, clinic workers are acutely aware of their state’s status as a legal abortion island in the Upper Midwest. Abortion is now illegal or treated as such in Wisconsin and South Dakota. North Dakota is expected to follow suit in late July, and the Republican governor of Iowa is asking state courts to severely limit the process.
The clinic raised its patient cap from 16 to 20 on the day per week that abortions are typically performed. Its staff tries to schedule abortions on other days if necessary and may book an additional half or full day each week for abortion services.
“We have not yet exceeded our capacity to serve patients. And we’re working on efficiency so we’ll be ready if we end up with a flood of patients,” said Dr Judith Johnson, one of three doctors performing abortions at the clinic.
Johnson said the heightened pressure began months before the Supreme Court’s ruling, with demands from people in Texas and Oklahoma as those states introduced highly restrictive abortion bans.
The additional patient load at the WE Health clinic includes people who struggled to get quick appointments at some clinics in the Minneapolis area, where five of the state’s seven abortion clinics are located, in following the Supreme Court’s decision. The seventh clinic is in Rochester.
“The number of patients we serve has increased and the places they come from have moved away,” Johnson said.
And the clinic is unable to help everyone who calls.
Cassidy Thompson, patient educator and coordinator of the clinic’s volunteer patient escort program, recounted a call from an Oklahoma woman who was “crying to me on the phone saying, ‘Can’t you help me? No other clinic can take me right now. This patient was hoping for a telehealth consultation that would allow her to stay in Oklahoma and still get a medical abortion at the clinic.
However, state law requires patients to have a Minnesota mailing address and be physically in Minnesota when speaking with a doctor.
The “sole purpose of (my) career is to provide abortion care. And telling someone that we legitimately can’t help them with anything, and they’re stuck with a forced pregnancy… is just a complete waste of power,” Thompson said. “If it had been a resident of Minnesota, we could have aborted them, no problem.”
Most Minnesota patients at the clinic qualify for low-income assistance to help them pay for an abortion, but that doesn’t cover the full cost of the procedure. Casey estimated that the clinic lost more than $60,000 last year serving medical assistance patients, a deficit the clinic had to make up through fundraising.
“Many doctors’ offices limit the number of medical assistance patients they can see, but we don’t because we really want to support the people who need it most,” said Paulina Briggs, the lab supervisor and a patient educator at the clinic.
But out-of-state patients are not eligible for Minnesota’s Medical Assistance Program. The clinic also does not assist out-of-state patients with travel expenses; he doesn’t have the resources, Casey said. All of this contributes to the financial pressure of people crossing state lines to get abortions.
“It’s really sad to think about these people,” Briggs said. “Where they live will determine the type of care they receive. And the people who need the services the most will find it the hardest to access them.
Briggs said the phones “have been buzzing” with calls from people – including nurses, physician assistants and a lawyer – wanting to volunteer, help or donate to the clinic, which also offers a range of services non abortion such as birth control and breast and cervical cancer screenings.
“The main challenge right now is just financial stability, making sure we have the financial resources to keep our clinic running,” Casey said. “It’s really sad that when I started here in 1981, we didn’t have so many restrictive laws. And now we just backtracked.
Trisha Ahmed is a member of the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places reporters in local newsrooms to report on underreported issues. Follow Trisha Ahmed on Twitter.