The head of the Abortion Fund of Ohio had a sinking feeling as she looked at its end-of-year finances last month. The fund had paid out $1.5 million in 2023 to help close to 4,400 patients get abortions — up from 1,175 the year before — and the pace wasn’t sustainable. If the fund didn’t take a pause for a few weeks, she feared it would run out of money and have to close for good.
The nonprofit stopped taking calls on December 19, and made the “very very difficult decision” to suspend operations until Feb. 1, said Taren Holliman, the organization’s program manager. It’s among a handful of abortion funds that have had to temporarily halt operations as demand outstripped donations. Both the Utah Abortion Fund and Indigenous Women Rising paused for a month last summer after exceeding their budgets, and many more are re-evaluating their funding policies and tightening purses.
STAT spoke with officials of five abortion funds who said they’ve seen a fall in donations over the past year, even as the costs of accessing abortion soar in the wake of the Supreme Court’s June 2022 decision overturning Roe v. Wade. “Every single abortion fund” has seen a drop in funding, said Bree Wallace, director of intake at the Tampa Bay Abortion Fund in Florida. “I think we’re all at lower numbers than we’d like to be.”
There are 100 abortion funds working in collaboration across the country as part of the National Network of Abortion Funds. They received a spike in donations right after the court’s Dobbs decision, allowing them to collectively dispense close to $37 million to 102,855 people in the year following. That was an 88% increase in spending compared to the year before. These networks help fund both medical and surgical abortions, which often aren’t covered by insurance, and can also cover the costs of traveling to states where abortions are legal and accessible.
All-Options Hoosier Abortion Fund in Indiana, Tampa Bay Abortion Fund, and Abortion Fund of Ohio all said their donations at least tripled following the decision, while Midwest Access Coalition, based in Illinois, was able to assist twice as many people in 2022 as the year before.
“After Roe fell, we got a lot of ‘rage donations,’” said Wallace. “It was national news and sparkly at that time.” Most donations, said the funds, came from grassroots donors, and individuals who were shocked by the decision. Previously, said Jess Marchbank, director of the All-Options Hoosier Abortion Fund, many “middle of the road liberals” didn’t seem to recognize that abortion access was under threat. “They came out of their complacency,” she added.
The flood of money changed how many funds operated. Whereas the Indiana fund previously had to turn away around half of those who asked for help, Marchbank said it “decided to open the floodgates” and help anyone who applied. The fund often supported 100 people a week, compared with 100 a month previously.
Meanwhile, new state restrictions on abortion upped the costs for those seeking help, with patients having to travel further to end pregnancies. Midwest Access Coalition has expanded to help patients across the country. A third of patients last year were from Texas, said Alison Dreith, director of strategic partnerships, and three of the five locations that patients most commonly traveled to were Minnesota, Kansas, and Washington, D.C.
Appointments that used to be available in 24 hours now take two to three weeks, said Dreith, which can mean more complicated procedures are required, increasing the costs. Before the fall of Roe, the fund spent an average of $350 per patient. Now, it’s over $1,000.
Ohio — where legal challenges and a voter-approved constitutional amendment have kept abortion legal through the 20th week of pregnancy — is now the closest place to obtain an abortion for residents of nearby states with bans, including West Virginia, Kentucky, and Indiana. As a result, the Abortion Fund of Ohio has also struggled to fund the heightened costs of travel. “It can seem impossible,” said Holliman.
After the rush of donations in the latter half of 2022, the pace started to falter. “We got a lot of attention,” said Emma at the Roe Fund in Oklahoma, who declined to give her last name for fear of facing prosecution for her work. “It’s kind of old news now, unfortunately.”
And so, many funds are now being forced to scale back their ambitions. Tampa Bay Abortion Fund was previously able to help people across Florida, said Wallace, but will narrow to only support those from or coming into Tampa. In Ohio, the Abortion Fund is still figuring out its new limits, but Holliman said they won’t be able to help all applicants to the same extent as they have previously, once it reopens in February.
In Indiana, All-Options Hoosier Abortion Fund made the decision last August to provide funding only to those who were at least nine weeks into their pregnancy, though they make exceptions for those with significant other obstacles, such as minors or those who are pregnant as a result of rape. For others who are earlier in their pregnancy, the fund will redirect them to other funds or ways of accessing care.
“It never feels good” to turn people away, said Marchbank, but the fund decided it needed to prioritize those who were running out of time. “We don’t want to put ourselves in a situation when we’re out of money and we can’t help anyone,” she added.
The funds often work together, and when one limits resources, it inevitably affects others. Midwest Access Coalition in Illinois said it’s seen an influx of Ohio requests since the Abortion Fund of Ohio paused operations. “Once one of us goes down, there’s a ripple effect for all of us,” said Dreith.
On top of the legal instability, fall in donations, and growing costs, several funds said they’re also contending with scammers. Trying to weed out those who are seeking a free trip is “one of the biggest hurdles,” said Emma from the Roe Fund in Oklahoma. Dreith said while many scammers seem to be simply looking for free travel, she suspects others might be anti-abortion activists trying to deplete the fund’s resources.
While the Abortion Fund of Ohio remains closed, Holliman said she’s still talking to patients, if only to refer them elsewhere. Telling those who need help that the fund is unavailable is “awful,” she said, but it’s worse not knowing how the organization will be able to operate come next month. “This realm of uncertainty, not knowing exactly what it’s going to look like when we do open back up, that’s an added layer.” Donations are unlikely to return to earlier levels, so the fund is looking to reduce costs, while also preparing for its annual “fund-a-thon” to ramp up grassroots donations.
There are more changes to come, said Dreith, with a presidential election and two Supreme Court decisions ahead, one reviewing whether the Food and Drug Administration properly approved the abortion pill Mifepristone and another on whether Idaho’s abortion law conflicts with federal emergency room care standards. All could have a bearing on abortion access and add to donors’ uncertainty about where and how abortion funds are still operating.
“It’s alarming to be still at the beginning of a new year and hear of so many people running out of money,” said Dreith. “We’re worried about how the whole movement is going to be sustainable, because it’s not.”
This story is part of ongoing coverage of reproductive health care supported by a grant from the Commonwealth Fund.