On the top floor of a modest two-story brick building near Lake Superior, the executive director of northern Minnesota’s only abortion clinic darts from room to room, checking in patients, taking calls from appointment seekers, and handling billing questions for those struggling to make ends meet pay.
In the waiting room at the WE Health Clinic in Duluth, patients from Wisconsin and Texas sit among Minnesotans — the peak of an expected surge in out-of-state patients following the Supreme Court’s repeal of federal abortion rights.
“It was just really busy,” said Laurie Casey, general manager. “We try to be as flexible as possible, especially when people come from out of state. Many of our patients, even if they are from Minnesota, travel one to three hours each way to get here. So we try to be as accommodating as possible.”
Even before Roe v. Wade was reversed, the WE Health Clinic was the closest abortion provider to some people in northern Wisconsin, northern Minnesota and upper Michigan Peninsula.
Today, the clinic’s staff are 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 Iowa’s Republican governor is asking state courts to severely limit the trial.
The clinic has raised the limit for patients on the one day a week that abortions are typically performed from 16 to 20. Staff attempt to schedule abortions on other days if needed, and may reserve an additional half or full day each week for abortion services.
“We have not yet reached our capacity to serve patients. And we’re working on efficiencies so that when we end up getting a flood of patients, we’ll be ready,” said Dr. Judith Johnson, one of three doctors who perform abortions at the clinic.
Johnson said the increased pressure began months before the Supreme Court’s decision, with requests from people in Texas and Oklahoma as those states introduced extremely restrictive abortion bans.
The additional patient load at the WE Health Clinic includes people who, following the Supreme Court’s decision, had difficulty getting quick appointments at some Minneapolis-area clinics, home to five of the state’s seven abortion clinics. The seventh clinic is in Rochester.
“The number of patients we serve has increased and the places they are coming from are further away,” Johnson said.
And the clinic can’t help everyone who calls.
Cassidy Thompson, a patient advocate and coordinator of the clinic’s volunteer patient support program, recounted a call from a woman in Oklahoma who “cried to me on the phone and said, ‘Can’t you help me? No other clinic can accommodate me right now.’” This patient was hoping for a telemedicine consultation that would allow her to stay in Oklahoma and still have a medical abortion from the clinic.
However, state law requires patients to have a Minnesota mailing address and be physically in Minnesota when speaking with a doctor.
The “entire purpose of (my) career is to provide abortion care. And telling someone we can’t lawfully help them with anything and they’re in a forced pregnancy…is just a complete loss of power,” Thompson said. “If this had been a Minnesota resident, we could have easily aborted her.”
Most Minnesota patients at the clinic are eligible for low-income assistance to help with the cost of an abortion, but it doesn’t cover the full cost of the procedure. Casey estimates that the clinic lost more than $60,000 in the past year providing medical supplies to patients, a deficit that the clinic has had to make up through donations and grants.
“Many doctor’s offices place caps on how many medical assistance patients they can see, but we don’t do that because we really want to care for the people who need it most,” said Paulina Briggs, the lab’s director and a patient educator at the Clinic.
However, patients from other states do not qualify for the Minnesota medical assistance program. The clinic also helps non-state patients with travel expenses; it doesn’t have the resources, Casey said. All of this adds to the financial burden on people traveling across state lines for abortion treatment.
“It’s really sad to think of these people,” Briggs said. “Where they live will determine the type of care they will receive. And the people who need services the most will have the hardest time accessing them.”
Briggs said phones have been “crazy” 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 non-abortion services like birth control, breast and Cervical Cancer Screening.
“The biggest challenge right now is just financial stability, making sure we have the financial resources to keep our clinic going,” Casey said. “It’s really sad that when I started here in 1981, we didn’t have as many restrictive laws. And now we just went backwards.”
Trisha Ahmed is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to cover undercover topics. Follow Trisha Ahmed on Twitter.