Policy Brief: Potential Impact of an Abortion Ban in Michigan on Driving Distance for Services

Potential Impact of an Abortion Ban in Michigan on Driving Distance for Services

On June 24, 2022, the United States Supreme Court reversed the landmark Roe v. Wade ruling that legalized abortion nationwide. As a result, jurisdiction over the regulation of abortion has been returned to the states. About half of states are expected to enact bans or place gestational age limits on the procedure.¹

As of October 2022, abortion is legal in Michigan, pending legal review of a 1931 abortion ban that would criminalize abortion at any gestational age and criminalize clinicians providing abortion care.^2–3 If the ban is ultimately enforced, Michigan residents trying to access abortion care face options that primarily include traveling to another state, seeking a medication abortion via telehealth, or continuing their pregnancy. In the surrounding region, abortion is legal in Illinois, Minnesota, Pennsylvania, and Canada, and access has been restricted or banned in Indiana, Ohio, and Wisconsin.⁴

Prior studies of restrictive abortion policies in other states have shown that increases in travel distance to abortion care are associated with decreased abortion rates, increased costs, delays in care, and added mental health burden.^5–6

For this analysis, a team at the University of Michigan assessed the minimum distance that Michigan residents would travel for out-of-state care if the 1931 abortion ban were upheld.

What does this mean for health policy discussions?

If abortion becomes illegal in Michigan, residents seeking abortion care out-of-state will travel much farther than today to access services, increasing from an average driving distance of 55 miles in-state to an average of 271 miles out-of-state. A round trip that currently takes 2 hours could take nearly 7 hours to access services out-of-state.

Michigan residents seeking abortion care out-of-state will also incur additional travel-related expenses such as the cost of transportation (gas, parking, a taxi or a rental car, or bus, plane, or train fare), lodging, meals, childcare, and missed work. Many people may also need a travel companion for support, which will increase costs as well.

These added costs may exacerbate existing disparities in health care access, especially for people with a lower socioeconomic status. An abortion itself can cost an average of $500 to $900 or more.⁹ The Federal Reserve Board estimates that one-third of adults did not have enough in their savings accounts to pay for a $400 emergency expense in 2021, meaning that for many individuals, the costs of care and travel could be prohibitively expensive.¹⁰

If seeking abortion care out-of-state is prohibitively expensive, some people may decide to forgo an abortion and continue with their pregnancy instead. Prior research has shown this can lead to long-term financial impacts, as there are large and persistent negative effects on a childbearing person’s emotional and financial well-being when they want to access abortion care but are not able to.^11–12 There is also a direct relationship between abortion access and an increase in women’s participation in the workforce.¹³

Finally, states where abortion remains legal will likely see an influx of out-of-state patients, potentially placing a strain on their abortion clinics and increasing appointment wait times for all patients. Depending on the increase in wait times, some patients may not be able to access medication abortion (available through the first 10 weeks of pregnancy) and would need surgical abortion care. As the logistics of accessing the procedure become more complex, people may reach care later in their pregnancies, which in turn will increase the cost and complexity of an abortion.