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In states that allow abortion for rape and incest, finding a doctor may prove impossible

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Clinics and abortion funds in Idaho, Mississippi, North Dakota and Wyoming — four states that have exceptions to rape or incest in their abortion bans — told POLITICO that while the law allows people to terminate their pregnancies in those cases, it will likely be easier to tell patients about cross state lines for an abortion then try to overcome the hurdles associated with legally obtaining an abortion in their own country.

“In theory, [exemptions] sounds great, but practically it seems impossible,” said Tammi Kromenaker, director of the Red River Women’s Clinic in Fargo, ND. “My doctor would never say yes to that. She would just say, ‘Let’s throw all the money and resources at this person. Let’s take them somewhere else where it’s legal.’”

Clinics planning to move operations across state lines may leave patients in their state without providers willing to offer abortions in cases of rape and incest. Willing providers, such as Anthony, may be discouraged for fear of prosecution. And patients may not want to go through with the abortion if their state requires them or their health care provider to report the rape or incest to the police, as is the case in Idaho, Utah and Mississippi.

“There’s still so much fear, stigma and shame,” Kromenaker said. “Sometimes patients say, ‘I thought if I told you, you’d make me report it to the police, and I don’t want that. It’s someone I know.’”

A survey released by the Pew Research Center in May found that 56 percent of Republicans and 83 percent of Democrats think abortion should be legal if the pregnancy is the result of rape. But abortion rights advocates warn that so few people will be able to take advantage of the exceptions that it will be as if they don’t exist.

“Exemptions are just a way for Republicans to say, ‘Now don’t worry, we’re doing this ban, but if you need your ‘good abortion,’ the access will be there for you,” but it’s all bullshit It won’t be there for you,” said Laurie Bertram Roberts, executive director of the Yellowhammer Fund in Alabama and co-director of the Mississippi Reproductive Freedom Fund. “If you think you’re one of the ‘good people’ who only get an abortion need in a ‘good case’ – baby, they came before you too. They’re not going to let you have an abortion either.”

However, some Republicans argue that exceptions remain a lifeline for those in crisis.

Arkansas Gov. Asa Hutchinson, a limited-term Republican in his senior year, told CNN last month that he supports waivers in cases of rape or incest — although the abortion ban he signed in 2019 contains no such exceptions. At the time, he said he hoped the issue would be reconsidered, though he said Friday he would not ask lawmakers to pass waivers in a special session.

“While it’s still the life in the womb, the life of the unborn, conception was under criminal circumstances, either incest or rape,” he said. “And so those are two exceptions that I’ve recognized as being very appropriate in my view.”

While exceptions will only have a limited impact, they will be crucial to the people who can obtain them, although “statistically speaking, very few people will be,” said Iris Alatorre, program manager at the Northwest Abortion Access Fund, which covers Idaho.

Rape and incest exceptions are increasingly dividing lawmakers. Several Republican Senate candidates — including Herschel Walker in Georgia and JD Vance in Ohio — have argued in recent weeks against exceptions to rape and incest, though many of their future colleagues continue to support such carve-outs. Republican Governor Candidates Are Divided on the matter.

And Louisiana Governor John Bel Edwards, a Democrat who supports abortion restrictions, on Tuesday signed a measure passed by the Republican-controlled state legislature that does not allow abortions in cases of rape or incest—despite his personal support for such exemptions.

Anti-abortion groups are similarly divided on how to address rape and incest exceptions. While Susan B. Anthony Pro-Life America believes that “the value of human lives is not determined by the circumstances of one’s conception,” the organization takes no stance on whether or not state legislators should include exceptions to rape and incest in their laws. abortion ban, believing it to be an issue that should be left to each state to decide, said Sue Liebel, the group’s director of state policy.

Students for Life of America, meanwhile, is urging lawmakers to oppose such exceptions.

“We reject shaming children for things they have no control over,” said group spokesman Kristi Hamrick. “It is clear that crimes must be fully prosecuted and women must be helped. But we also grieve for the unborn who also suffer.”

The Hyde amendment — which bans federal funding to pay for abortions except in cases of rape or incest or to save the pregnant person’s life — offers a glimpse of how difficult using exceptions can be afterroeAccording to the Guttmacher Institute, an abortion rights think tank, the federal government paid for 160 abortions for Medicaid recipients in 2015, the latest year for which data is available; meanwhile, 18 states used state Medicaid funds to pay for more than 157,000 abortions.

“Considering how the Medicaid exceptions are not actually implemented doesn’t seem to lend themselves to the idea that the exceptions in the trigger bans or the pre-roe bans would be enforced differently,” said Elizabeth Nash, a state policy expert at the Guttmacher Institute. “They are designed to be extremely narrow and difficult to meet because abortion opponents see exceptions as loopholes.”

At the Red River Women’s Clinic in North Dakota, about one patient a week will reveal that she wants an abortion because she was raped, and the clinic will file a claim with the state’s Medicaid program about once a month to request reimbursement. said Kromenaker.

But it is not enough to remain financially viable.

“In order to keep our doors open – and I’m not saying that not many people are being attacked – for the people who are being attacked, get pregnant, want to disclose it and have an abortion, it would be impossible for us to have a staff to maintain, maintain a facility and all that,” said Kromenaker

Instead, her clinic plans to move five minutes across the river to Moorhead, Minnesota, where abortion remains legal, and Kromenaker hopes patients will follow.

For those unable or unwilling to leave the state, abortion rights advocates anticipate that some private practice OB-GYNs, such as Anthony, may be willing to prescribe abortion pills to people who are pregnant as a result of rape or incest.

Abortion rights advocates are also concerned that those seeking an abortion based on a life or health exception may face similar barriers. State bans on abortion vary — some prohibit abortions except “to preserve the life of the pregnant person,” while others also include exceptions “to avoid a serious risk of substantial and irreversible impairment of important bodily function” — but none. some specifies exactly how much at risk a person’s health or life must be in order to qualify.

“It feels like it’s this conversation that’s going on in this legal, abstract world,” Nash said.

Liebel said she is urging state lawmakers to review their abortion ban and clarify when they meet again.

“I do know that I advise states that if you wipe the slate clean this time and you do it again — and even if you have exceptions or other things — you need to define that better,” Liebel said. “If it’s still too vague, it will go to court.”

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