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What California is doing to protect abortion access

California has acted swiftly to protect abortion rights as the U.S. Supreme Court reversed Roe v. Wade. California is protecting patients and providers through executive action, legislation, a constitutional amendment, and a budget investment of over $200 million to expand access to safe, affordable services.

And California continues to enact new laws and policies to further protect access, patients, and providers here and for those traveling to the state for care.

Protecting patients, providers, and supporters

  • California voters passed Proposition 1, which explicitly enshrines in the state constitution the right to choose to have an abortion.
  • Governor Newsom issued Executive Order N-12-22, which:
    • Prohibits state agencies from cooperating with out-of-state abortion actions such as preventing medical records, patient data and other information from being shared by state agencies in response to inquiries or investigations brought by other states or individuals within those states looking to restrict abortion care access; and
    • Adopts a policy of declining out-of-state extradition requests related to legal abortions in California.
  • In 2022, California enacted several bills into law:
    • AB 1242 seeks to stop law enforcement and California corporations from cooperating with out-of-state entities regarding legal abortions in California.
    • AB 1666 seeks to protect people or entities in California from civil liability for providing, aiding, or receiving abortion care in the state.
    • AB 2091 seeks to keep medical information about abortion private, even in response to an out-of-state subpoena or request.
    • AB 2223 seeks to protect people from criminal and civil liabilities when they lose a pregnancy.
  • In 2023, California enacted several additional bills into law:
    • SB 345 and AB 1707 protect providers and facilities in California from enforcement in California of other states' laws that criminalize or limit access to reproductive health care services.
    • AB 254 protects reproductive and sexual health digital data included in personal health tracking applications.
    • AB 352 ensures individual electronic health records related to reproductive health care services are protected for people traveling to California for care that is illegal in their home state.
    • AB 1720 clarifies that ultrasounds must be offered in licensed facilities or by licensed providers, narrowing opportunities for misleading non-medical uses.
  • The Department of Health Care Services issued All Plan Letter (APL) 22-022 reminding Medi-Cal Managed Care Health Plans that they must:
    • Cover abortion care without imposing access hurdles
    • Allow enrollees to go to any Medi-Cal provider for abortion care
    • Help enrollees find an abortion care provider if a health care provider does not offer abortion care services
    • Pay out-of-network abortion providers no less than the Medi-Cal Fee-For-Service rate
  • The Department of Managed Health Care issued APL 22-027 reminding all California health plans that they must provide timely access to medically necessary basic health care services when plan members are outside of California. This includes abortion care.
  • The Department of Health Care Services established a supplemental payment program for non-hospital community clinics that incur significant costs associated with providing abortion services to Medi-Cal beneficiaries.
  • The Department of Insurance issued Bulletin 2022-7 clarifying that:
    • Abortion care is a basic health care service.
    • Abortion care medication must also be covered as part of an insurer’s outpatient prescription drug benefit.
    • California pharmacies will be certified to dispense abortion medication in early 2023.
    • Starting on January 1, 2023, insurers cannot impose cost-sharing for abortion care and related services or utilization management or review for covering outpatient abortion care services
  • The Department of Justice released a consumer alert with steps people can take to better protect their privacy when accessing abortion care.
  • The Department of Justice created a new consumer complaint form for Californians who have been the victim or target of deceptive, misleading, unfair, or unlawful conduct by fake clinics (aka crisis pregnancy centers).
  • The Board of Pharmacy issued an alert to all licensees reminding them of their obligations under state law.
  • The Department of Managed Health Care issued APL-24-004 reminding commercial health plans regulated by DMHC of their legal obligation to cover over-the-counter FDA-approved contraceptives with no cost-sharing to members.
  • The Department of Justice sent a letter to the corporate offices of the major pharmacy chains reminding them that emergency contraception does not require a prescription or parental consent.
  • The Department of Justice issued a consumer alert informing minors of their ability to access emergency contraception without a prescription or parental consent.
  • The Department of Justice issued an alert to all California pharmacies reminding them of their obligation under California law to provide minors access to emergency contraception.

Expanding access to services

  • California allocated over $200 million in 2022-23 to support people seeking abortion care and abortion providers over several fiscal years. These funds:
    • Help those seeking abortion care with practical support expenses like travel, lodging and other related costs
    • Cover uninsured abortion care to increase access, particularly in underserved communities
    • Support health care facilities and providers
    • Provide training, curriculum, fellowships, and loan forgiveness to build a diverse workforce of reproductive health care professionals
    • Improve physical and digital security at abortion care facilities
  • California has submitted a reproductive health services Section 1115 federal waiver for a $200 million ($15 million General Fund) grant program focused on supporting access to family planning and related services, system transformation, capacity, and sustainability of California’s safety net. This funding builds on the 2022 Budget Act investments for reproductive health services and continues California’s progress to provide comprehensive family planning and related services.
  • The Department of Health Care Services updated its policies to allow providers to seek reimbursement for medication abortions through an extended 77 gestational days for services. In addition, the Department made permanent COVID-19 flexibilities, including the use of telehealth for medication abortion.
  • California enacted several bills into law:
    • SB 245 ends cost-sharing for abortion care services.
    • SB 523 increases access to birth control, regardless of gender or insurance.
    • SB 1142 creates California’s abortion access website where the public can access information on abortion services in the state, including with respect to their legal rights, provider locations, practical support for patients, and combatting misinformation.
    • SB 1245 created a reproductive health pilot in Los Angeles County that will explore innovative ways and collaborations to safeguard abortion care access.
    • SB 1375 expands certain abortion training options for nurse practitioners and certified nurse-midwives.
    • AB 657 speeds up licensing for health care professionals that come to California to perform abortions.
    • AB 1918 created the California Reproductive Health Scholarship Corps to recruit, train, and retain diverse reproductive health care professionals in underserved areas of the state.
    • AB 2134 created the California Reproductive Health Equity Program to provide grants to health care providers who provide uncompensated abortion care to patients.
    • AB 2205 requires reporting by Covered California on funds used to cover abortion care.
    • AB 2586 created the California Reproductive Justice and Freedom Fund to provide grants supporting comprehensive reproductive and sexual health education, including abortion care, in disproportionately impacted communities.
    • AB 2626 stops licensing boards from suspending or revoking licenses solely because a provider performed an abortion.
    • AB 118 adds pharmacists to the definition of reproductive health care professionals, allowing pharmacists greater reproductive health care training opportunities.
    • SB 385 allows properly trained physician assistants to provide abortion care.
  • California established an Institute on Reproductive Health, Law, and Policy at the University of California, Los Angeles School of Law.

Sharing California’s model

  • In February 2023, California launched the Reproductive Freedom Alliance, a non-partisan coalition of Governors committed to protecting and expanding reproductive freedom—the largest such coalition ever convened.
    • With 22 Governors, the Alliance works together to strengthen reproductive freedom in the face of an unprecedented assault on abortion access and other forms of reproductive health care.