Minnesota Set To Become ‘Abortion Access Island’ In The Midwest, But For Whom?

This article first appeared at ProPublica. ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.

For nearly three decades, long before the fall of Roe v. Wade, the blond brick Building for Women in Duluth, Minnesota, has been a destination for patients traveling from other states to get an abortion. They have come from places where abortions were legal but clinics were scarce and from states where restrictive laws have narrowed windows of opportunity.

For many residents of northern and central Wisconsin, and the Upper Peninsula of Michigan, it was faster to head west toward the Minnesota border than to go southeast to clinics in Milwaukee, Green Bay or Madison. Over the years, thousands of pregnant people climbed the stairs of the Building for Women to get abortions at WE Health Clinic, on the second floor.

Treating travelers from other states is nothing new for WE Health or the other abortion providers around the state, but Minnesota’s role as a so-called abortion access island is. The state’s neighbors have either banned abortion, are poised to do so or have severely restricted the procedure.

Data kept by Minnesota shows that white people make up a larger share of those who travel from another state for an abortion than those who seek abortions in state, raising questions about whether certain groups — particularly people of color — will be able to make the trip.

According to the state’s data, Minnesota residents seeking abortions are a fairly diverse group. From 2018 through 2021, on average, 31% of patients were Black, 9% were Hispanic, 8% were Asian and 2% were American Indian; an additional 6% were recorded as “other.” White patients accounted for 44%.

But among those coming from out of state, people of color made up a much smaller percentage on average of the patient population. White people made up 75% of out-of-state patients.

Experts say some of the disparity results from the fact that the states bordering Minnesota are predominantly white, particularly in the rural areas adjacent to the state. But this also describes Minnesota’s population. So at least some of the difference could be tied to access to transportation or money to travel.

“Minnesota is going to become a haven state, but for what percentage of people that actually need our services?” said Paulina Briggs, WE Health Clinic’s laboratory manager and patient educator. “That’s a huge thing.”

When Roe was overturned in June, the small staff at WE Health Clinic was dismayed but not surprised. In fact, it was prepared to meet the estimated 10% to 25% increase in out-of-state patients.

“We’ve anticipated this for a long time,” Briggs said. “So it’s not like sudden news to us.”

While the clinicians in Duluth may have been prepared for the end of Roe, something much more unexpected happened 2 1/2 weeks later, when a district court judge delivered a surprise ruling that expanded abortion access in the state. Ruling in Doe v. Minnesota, the judge threw out measures that included a mandatory 24-hour waiting period before abortions, two-parent consent for minors and a requirement that physicians discuss medical risks and alternatives to abortion with patients. He also tossed out a requirement that only doctors were allowed to provide abortion care, including by telemedicine, and that after the first trimester, the care had to take place in a hospital.

In contrast to the tearful scenes that played out in many clinics after Roe fell, in Minnesota that Monday morning, abortion providers and their support staff celebrated. Laurie Casey, the executive director of WE Health, was behind her long, crowded desk, doing paperwork when she first got news.

“It’s like, ‘Oh my God, is this real?’” she said. “Something good happened?”

Briggs said: “I think I audibly cheered. Like: ‘Yeah. Hell yeah.’”

Lawyers for the plaintiffs in the Minnesota case, which was filed in 2019, had expected to go to trial at the end of August. Instead, the judge granted abortion supporters a big victory, leaving intact two measures: a requirement that abortion providers collect and report data on their patients to the state, and a law that dictates the rules for disposing of fetal remains.

Minnesota Attorney General Keith Ellison, whose office represented the state in the lawsuit, announced that he would not appeal the court’s decision. Ellison also pledged that he would not prosecute abortion-seekers from other states and wouldn’t cooperate with extradition orders from outside jurisdictions.

Minnesota Gov. Tim Walz signed an executive order making similar promises.

Both officials have made abortion access central tenets of their reelection campaigns.

In these early days of a post-Roe reality, it’s not yet clear who will need these protections, though the data can provide clues.

States track demographic data on abortion differently; according to the Centers for Disease Control and Prevention, more than two dozen publicly report the race and ethnicity of patients. Minnesota is the only access island state in the Midwest that releases those numbers; the state also separates that data into resident and nonresident figures.

Illinois is projected to accept far more out-of-state patients than Minnesota, but its health department does not release statistics about the race and ethnicity of abortion patients. Kansas allows abortion up to 22 weeks, protects the right to abortion in its Constitution and reports one of the highest rates of out-of-state patients in the country, at nearly 50% and second only to Washington, D.C. But Kansas’ state health department does not combine where patients are from with demographic data.

From 2008 to 2021, 13,256 patients who live outside Minnesota received abortion care there, an average of about 950 people a year, according to the state health department. Among that population, the racial and ethnic breakdown of patients has held fairly steady.

A number of factors play into the lack of diversity, said Asha Hassan, a graduate researcher at the Center for Antiracism Research for Health Equity at the University of Minnesota.

“There’s the obvious one that might be coming to mind, which is the effects of the way structural racism and poverty are interwoven,” Hassan said.

Caitlin Knowles Myers, a professor at Middlebury College in Vermont who studies the economics of abortion, added, “Obviously resources like ability to take time off, ability to get and pay for child care, etc., etc. — that obviously prevents poor women from making a trip.”

Then there is the cost of the procedure itself. In Minnesota, residents can use state medical assistance funds to pay for an abortion under certain circumstances; out-of-state residents cannot. According to Our Justice, a nonprofit that provides financial assistance for abortion care and travel to Minnesota, in-clinic abortion services can cost $400 to $2,000, depending on the gestational age of the pregnancy. A locally based telemedicine service and mobile clinic called Just the Pill charges $350 for abortion medication.

Shayla Walker, executive director of Our Justice, said her organization helps people work through the kinds of barriers to travel that pregnant people of color face every day. Undocumented patients, for instance, may not have a driver’s license or other form of identification, meaning that flying from states like Texas or Oklahoma is out of the question.

Of the out-of-state patients who come to Minnesota, residents from neighboring Wisconsin make up the vast majority. And like Minnesota and its neighboring states, Wisconsin is predominantly white: 80.4% of residents identified as such in the 2020 U.S. Census.

From 2008 to 2021, an average of 690 patients from Wisconsin received abortion care in Minnesota each year. The proportion of Wisconsinites has dropped over the years — in 2008, 80% of out-of-state abortion patients reported that they lived in Wisconsin, compared with 63% by 2021. Over that same period, South Dakota residents ticked up from 4% to 16%, and Iowa patients rose from 2% to 6%.

According to Myers, the lack of abortion providers in western and central Wisconsin likely drives the traffic across the border to Minnesota. These parts of the state are largely rural and mostly white. Wisconsin’s more diverse urban centers are concentrated in the southern and eastern parts of the state, much closer to the Illinois border.

“A lot of them are likely to end up heading south to the Chicago area,” Myers said. “The Chicago area also has a lot of providers and likely a lot of capacity. And the question for Minnesota is, if the Chicago area ends up unable to absorb an enormous influx of patients heading their way from all directions, then you would expect to see patients spilling over into Minneapolis.”

Leaders of the Options Fund, which provides financial help to pregnant people in rural central and western Wisconsin who are seeking abortions, said the majority of the money they provide is for care that takes place in Minnesota.

“Certainly it’s not that people of color don’t exist, of course,” said the group’s vice president, who spoke on the condition of anonymity out of concern for her safety. “But I think generally, the more rural we get, the more white it’s going to be.”

Of course, the data from Minnesota is backward-looking, from years when abortion was still legal, though restricted or sometimes difficult to access, in surrounding states. There are certain to be shifts in where patients travel from, most obviously North Dakota, where the state’s lone abortion clinic moved from Fargo to its Minnesota sister city of Moorhead, just across the border. And as reproductive rights supporters across the country respond to the end of Roe, abortion funds have reported huge increases in their donations, which may bring travel and abortion care in Minnesota within the grasp of more low-income pregnant people and people of color.

The first week after the Doe v. Minnesota decision, WE Health Clinic’s patients felt the impact. Casey said she was able to tell a mother that her minor daughter could receive an abortion without the permission of her long-absent father or from a judge. Briggs was able to schedule a next-day abortion, which would have been illegal before the judge’s decision.

At some point, a clinic worker went through intake folders and pulled out all the forms certifying that “state mandated information” had been provided to patients. They were fed into the office shredder.

Tossing out their scripts, canceling the physician phone calls 24 hours in advance, no longer going down to the county courthouse to ask judges to grant their minor patients special permission to have an abortion — all of this will save the WE Health Clinic workers hours every week.

Beyond that, the court ruling — which abortion opponents are seeking to have overturned — has the potential to increase the number of providers, as advanced clinicians like nurse practitioners and some classifications of midwives may now be able to get training, and eventually provide abortion care and telemedicine.

This pivotal moment for abortion care in Minnesota and the country at large comes at a moment of major transition for WE Health as well. Casey is looking at retirement in the coming year, which means much of the work of adapting the clinic to serve patients in a post-Roe world will fall to her staff, including Briggs.

Briggs started working at the clinic six years ago, when she was just 21. She wanted to do this work after receiving her own abortion at WE Health as a college student, an experience she found at once “nonchalant” and “empowering.”

She is troubled by the disparities in who might be able to make it across the borders and climb the stairs of the Building for Women, to receive the kind of life-changing care that she did. Just keeping the doors open does not mean the care will be equitable.

Laura Loomer Is Losing Her Effing Mind After Primary Defeat

A lot of things happened. Here are some of the things. This is TPM’s Morning Memo.

Wowsers, This Is Nuts

The far-right, conspiracy-trafficking, anti-Muslim internet personality Laura Loomer lost to incumbent Rep. Dan Webster in the FL-11 this week, and it wasn’t even particularly close. Webster won 51-44. But Loomer, in fitting Trumpian fashion, is refusing to concede in increasingly unhinged ways.

Loomer declared Thursday in a rambling and vaguely threatening statement: “I actually am the Congresswoman in Florida’s 11th District, and everyone knows it.”

Loomer is alleging without basis all kinds of corruption and voter fraud that led to her defeat, she’s going “scorched earth” against Webster and the Republican Party, and she is excusing her loss with Big Lie style misdirection and misinformation.

Just FedEx It!?!?

It’s becoming clearer as new reporting comes in that the National Archives bent over backwards to accommodate former President Trump and not escalate the dispute over government documents he took to Mar-a-Lago.

At one point last year, the National Archives let Trump send back his correspondence with North Korean leader Kim Jong Un via FedEx!

“Please let me know before you mail it and then pass along the tracking code once it has been sent. I need to make sure I have staff on this end to receive the package,” a National Archives official wrote to a Trump attorney and others in a June 2021 email obtained by CNN.

Redacted Mar-a-Lago Affidavit To Be Unsealed Today

The federal judge who approved the search of Mar-a-Lago has ordered the release later today of a redacted version of the affidavit the FBI used to obtain the search warrant. The Justice Department said it would propose extensive redactions, and the judge appeared to approve those redactions. Do not expect the redacted affidavit to be especially revealing.

Georgia Election Investigation Grinds On

  • The Georgia grand jury investigating Trump’s 2020 election interference is seeking testimony from Mark Meadows on Sept. 27.
  • The grand jury is also calling in Trump lawyer Sidney Powell and cyber researcher James Waldron, Politico reports.

This Is Getting Good

Take a peek at the upcoming deposition schedule in Dominion’s giant defamation case against Fox News for giving widespread play to conspiracy theories about the election tech company:

Friday: Tucker Carlson

Tuesday: Lou Dobbs

Wednesday: Sean Hannity

Quote Of The Day

Joe Biden: “It’s not just Trump, it’s the entire philosophy that underpins the—I’m going to say something, it’s like semi-fascism.”

This Soooo Damning

James O’Keefe’s Project Veritas might be about to get its comeuppance.

Pennsylvania Is Having All The Fun

The spectacle of Fetterman v. Oz for Senate should be plenty, but Pennsylvania governor’s race is no slouch.

Case-in-point headline: Doug Mastriano pranked with fake poll by high school student

The Curious Case Of Alvin Bragg

Mueller probe attorney Andrew Weissmann reassesses the decision by the Manhattan district attorney to wind down his criminal probe of Donald Trump.

New This Morning From TPM

Matt Gaetz’s general election race is gonna be WILD, y’all

The Shifting Sands Of Abortion Politics

Aaron Blake: Buyer’s remorse could be creeping in for GOP on abortion

Landmark Union Expansion

A Michigan Chipotle became the first of the fast food chain’s stores to unionize.

Today’s Deep Dive

(Photo by Justin Sullivan/Getty Images)
PARADISE, CA – NOVEMBER 08: A firefighter looks on as a home is consumed by the Camp Fire on November 8, 2018 in Paradise, California. Fueled by high winds and low humidity, the rapidly spreading wildfire has ripped through the town of Paradise, charring 18,000 acres and destroying dozens of homes in a matter of hours. The fire is currently at zero containment. (Photo by Justin Sullivan/Getty Images)

WSJ: Inside the Investigation That Secured a Guilty Plea for 84 Wildfire Deaths

Morally Bankrupt

Sandy Hook families accuse Alex Jones of hiding assets from them.

Must Read

David Corn: J.D. Vance Appeared With Podcaster Who Once Said “Feminists Need Rape”

Ukraine Update

NYT: Putin Orders a Sharp Expansion of Russia’s Hard-Hit Armed Forces

Reuters: Ukraine narrowly escapes nuclear catastrophe as plant loses power, Zelenskiy says

NYT:

The U.S. State Department and Yale University researchers said Thursday that they had identified at least 21 sites in the Donetsk region of eastern Ukraine that the Russian military or Russian-backed Ukrainian separatists are using to detain, interrogate or deport civilians and prisoners of war in ways that violate international humanitarian law. There were signs pointing to possible mass graves in some areas, they said.

Jared Is Forever

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Rumble In The Panhandle: Gaetz Will Face Off Against Rebekah Jones, DeSantis’ COVID Villain

Voters in Florida’s panhandle will choose this November between two of the most polarizing political figures in the state.

Continue reading “Rumble In The Panhandle: Gaetz Will Face Off Against Rebekah Jones, DeSantis’ COVID Villain”

Biden’s Numbers

We’ve slowly come around to a given that Joe Biden is very unpopular but that in the peculiar politics of 2022 it simply doesn’t matter. A few weeks ago I told a friend that I expected Biden’s approval numbers to surge from just under 40% to about 45% after the mini-BBB (aka, Inflation Reduction Act) passed. After that, I told this person it was less clear. Why? A lot of Biden’s unpopularity was tied Democratic partisans who were pissed off that he wasn’t successful enough as a Democrat. That’s how you can have Biden flatlining while Democrats are doing pretty well on the generic ballot poll and in lots of Senate races. Pass the mini-BBB, pass the CHIPS bill, get some good news on economic outlook and you can expect his support among Democrats to rise fairly quickly. It’s low-hanging fruit.

Continue reading “Biden’s Numbers”

Guilty Pleas In Biden Diary Theft Put Spotlight On Project Veritas

Two guilty pleas in Manhattan federal court on Thursday highlight how far Project Veritas went to obtain stolen items belonging to Ashley Biden — including allegedly paying for a private diary belonging to the President’s daughter.

Continue reading “Guilty Pleas In Biden Diary Theft Put Spotlight On Project Veritas”

Judges Reach Dueling Conclusions In Fight Over Abortions During Medical Emergencies

Over the last 48 hours, federal judges have split on a fundamental question determining when doctors have to perform abortions amid medical emergencies, a dispute that could reach the Supreme Court.  

Continue reading “Judges Reach Dueling Conclusions In Fight Over Abortions During Medical Emergencies”

Why James O’Keefe’s Project Veritas Is Probably Every Kind of F*cked

Have you not liked James O’Keefe’s Project Veritas and been hoping for years to see these sleazy degenerates get into a world of hurt? This may be your lucky day. We’ve known for a while that Project Veritas got hold of the diary and more of Ashley Biden, Joe Biden’s daughter. That story has been rattling around for almost two years and Project Veritas has made great hay out of how the investigation is allegedly an attack on their First Amendment rights. The DOJ just announced two plea deals with the thieves, one of whom, Robert Kurlander, has agreed to testify against the as yet unnamed “organization” noted in the plea deal.

That’s Project Veritas.

We’ll have an accompanying news story shortly. But this is a case where I have some specific insight and perspective as an editor and publisher about how to stay out of trouble or, as Project Veritas seems to have done here, get in a lot of trouble.

So here goes.

Continue reading “Why James O’Keefe’s Project Veritas Is Probably Every Kind of F*cked”