How Much It Takes to Get an Abortion in the 'PURPLE' State of Florida?

An analysis of non-medical costs of obtaining an abortion for a round trip in Florida.

By Yi (Eve) Lu

October 2022

After the U.S. Supreme Court's decision to overturn Roe v. Wade, most states in the Deep South have criminalized abortion or enacted other gestational limits on the procedure. A new Florida law of a 15-week ban with limited exceptions passed this July is now in effect. That said, Florida still serves as a haven for abortion access for people in the Southeast as its neighboring state Georgia has made abortion illegal as early as six weeks of gestational age while in Alabama abortion has been turned into a completely unlawful action.





Florida's 15-week Ban Now Becomes A Haven

In Florida, the number of abortions undertaken has increased over time, peaking in 2021. In 2021, there were 79,817 abortions performed in Florida according to AHCA[1], and 4,873 of the total cases were reported by residents out of state.

T o t al Abortion Cases Abortion Cases b y P a tie n ts Out of S t a t e 2017 2018 2019 2020 2021 2022 4,700 79,000

*The dashed lines represent the incomplete cases for 2022 which were last updated on Nov 1, 2022 when the story was published.

With the growing influx of out-of-state patients flocking to Florida, the purple state has seen a gradual increase in the total number of patients who seek abortion services over the past few years.

Currently, there are 54 abortion providers in Florida. This is a relatively high number compared to Alabama and Georgia as many facilities in the neighboring states either shut down or stopped providing abortion services due to statewide law restrictions. This indicates that a new rush of patients from out of state is on the way. As one of the quickly emerging abortion destinations after Roe's fall, Florida is facing new pressure to meet the increasing demand.

G E O R GIA ALA B AMA F L ORI D A Augu s t a A tla n t a Columbus S a v annah T ampa Orlando F ort M y e r s Jac k so n ville Miami T allahassee Gaine s ville

However, of all 67 counties in Florida, only 15 of them have access to abortion services, which has left most northern and central parts of the state as a wasteland of women's reproductive rights.



In North Florida, Duval has four abortion facilities located in the Southeastern corner of Jacksonville, one of the most populous cities on the Atlantic coast of Florida, while there are two in the city of Gainesville down in Alachua County.

However, abortions become harder to obtain deeper in Northwestern Florida. There are two facilities in central Tallahassee in Leon, making it the abortion-providing county geographically closest to the border with Georgia and Alabama. The local abortion business may become overwhelmed not only with patients from its nearby counties but from the neighboring states.

In Central Florida, patients living in densely populated counties such as Pinellas or Hillsborough have more choices of different abortion services with up to 11 facilities in total.

Yet in a big city like Orlando with over three hundred thousand residents, patients are actually given fewer options for accessible abortion services.

In South Florida, most facilities are distributed along the Southeastern coast of Florida.

As the most populous county in Florida, Miami-Dade is the most 'abortion-friendly' region in the state with 16 facilities, followed by seven in Broward, the second most populous county in Florida and three in Palm Beach[2].



Florida presents a less desperate situation than other Southern states. However, geographic accessibility doesn't bring along a panacea for all concerns about abortion. Anxiety about secure abortion protection, along with the financial struggles experienced by patients traveling farther to seek abortion care, are awaiting all women.

In Florida, if a woman opts for an abortion, she must receive in-person state-directed counseling that includes information designed to discourage her from the procedure and then undergo a 24-hour waiting period before having an abortion. This means that the law requires at least two trips to the facility, which might incur extra transportation and lodging expenses for long-distance travel on patients.

Northern Floridians Are Traveling Farther

To quantify access to the facility by measuring what people really care about: how far it takes to drive there and how much is paid for gas. Let's start by looking at the distance to the nearest facility for different counties in Florida.

< 15.19 mi. 15.19–35.11 mi. 35.11–67.48 mi. 67.48–135.61 mi. ≥ 135.61 mi. Di s t ance t o the Nea r e s t Abortion P r o vider in Florida b y Oc t ober 2022

Escambia is on the westernmost corner of Florida. In May 2021, the only operating abortion clinic in this county was ordered to close after three patients were hospitalized, which makes Escambia the furthest county from abortion services in the state.

To get to the nearest facility in Tallahassee, patients in Escambia need to travel about 362 miles for a round trip, crossing 13 counties to reach Leon where there are only two abortion facilities.

Possible gas fees and extra lodging costs should be taken into account if patients do not wish to return and make the same 4-hour trip in the 24 hours between the first counseling and the actual procedure as mandated by Florida's law.

100 150 200 250 300 350 15 20 25 30 35 40 45 50 E s c a m b i a Holmes W a s h i n g t o n B a y H a m i l t o n Gulf Highlands S a n t a R o s a O k a l o o s a W a l t o n T op 10 Gas Price f or Florida Cou n ties ($) R ound T rip Di s t ance t o the Nea r e s t Abortion P r o vider (mile)

*The gas prices were calculated based on the average regular gas price released by The AAA Gas Prices in late October 2022.

This long distance travel from Escambia to Tallahassee takes an estimated six to eight hours' drive for a round trip, costing roughly $50 in gas.

Patients traveling from Northern counties such as Santa Rosa, Okaloosa and Walton have to pay more for gasoline supply than those further South because of the longer distances. In Central Florida, accessible facilities are also limited since patients there rely heavily on the abortion business at Pinellas and Hillsborough where there are more choices of facilities which, however, may not always be the closest ones to where patients live.

In addition, to plan the logistics of such a trip, occasionally patients will require a hotel near the facility. For instance, if a woman travels from Escambia to its nearest facility in Leon, the median hotel cost she has to pay is $99 per night. However, the hotel price varies greatly depending on multiple factors including the county's population, whether the facilities are located in the downtown areas, and seasonality —peak or low— will also contribute to a wide range of costs on lodging.

Here are the calculated hotel costs for each abortion facility in Florida. Filter by the median lodging cost to see traveling to which facilities would make the patients pay for the hotels at a different price. Hover over a dot for more details.

Staying Longer Requires More Money

North Florida Ce n t r al Florida South Florida T allahassee Gaine s ville J a c k s o n v il l e T am p a O r la nd o F o r t M y e r s Mia m i F o r t P i e rc e O S C E O L A S A R A S O T A

Around the only abortion facility in Osceola County, the median hotel charge is $65 per night — the cheapest hotel deal near the facilities across the state — while Sarasota County holds the highest hotel costs at a median charge of $223 for a one-night stay.

In short, it is always your ZIP Code that decides how far you drive and how much you pay. If patients wish to have more choices when selecting a safe abortion provider with a cozy and pleasant hotel to stay in afterward, they will have to throw more dollars down than others. For instance, Miami-Dade County, the most populous region in Florida and host to the most publicly accessible abortion businesses, is also home to a robust luxury hotel industry which drives up local lodging prices. There is no price cap for how much a hotel can cost in Miami.

After the Court's decision, patients will have to travel further and stay longer to seek accessible and secure abortion care. Money spent on lodging is only a small part of the much larger non-medical expenditure on the entire process including childcare, meal expenses and even flights. Thousands of dollars might also have to be spent on the procedure itself as a result of abortion care often being excluded from major health insurance plans.

The cost of an abortion can vary notably depending on geographic subregions, diverse facilities, patient's health insurance plans, and abortion types. In 2020, without any insurance coverage, the median self-pay charges of either medical or first-trimester procedural abortion (0-13 Weeks) range from $560 to $575, while later terms of second-trimester abortion (14 to 26 Weeks) can reach up to $895 or higher[3].

However, not every woman who carries an unwanted pregnancy can afford the procedure and all possible non-medical costs. There are over 866,000 [4] nonelderly women living below the poverty line in Florida, and these major charges can bring heavy financial distress for low-income women without sufficient funding support.

To receive health coverage through Florida Medicaid[5], a family of three's monthly income ceiling is $2,552.5 [6], but adhering to the Hyde Amendment requirements[7], publicly funded insurance plans like Florida Medicaid are restricted from covering abortion services, only except in the cases of life endangerment, rape, or incest, which indicates that if a woman is at the higher end of Florida Medicaid eligibility, what her family has to pay for the termination of a later term in pregnancy would take over one third of their monthly income. Therefore, it is very possible for a woman who delays the procedure in order to raise money for its costs also risks other gynecological problems.

In Justice Alito's words, the decision returns the authority to regulate abortion to the people and their elected representatives. However, ending Roe is not just a matter of eliminating the constitutional right and giving more freedom back to the states to let them decide what they want to do in terms of abortion. It is a matter of taking away women's right to receive proper health care and handing it in to those who have the power to make decisions for their own sake. It is a matter of disregarding the structural disparities of gender, race and social class and reinforcing a pseudo-democratic society where no real choices are directed to its citizens.

Ending Roe will never succeed in ending abortion; it will only succeed in ending safe and affordable abortion.


Note:
[1] The numbers released by Florida Agency for Health Care Administration (AHCA) are Year-to-Date. Reports for prior years before 2017 should be requested through AHCA's Public Records Office. The 2019 Report by AHCA is missing in which case the data of that year are compiled from Johnston's Archive.
[2] As of 2022, Miami-Dade County remains the most populous county with 2,757,592 residents, followed by Broward County (1,969,099), Hillsborough County (1,520,529), Palm Beach County (1,518,152), and Orange County (1,481,321), based on the statstics released by The Office of Economic and Demographic Research (EDR).
[3] The median self-pay charges for three abortion types are based on the findings published in Health Affairs. In addition, UCSF Health defines the weeks for three trimesters of pregnancy.
[4] This number is published by Kaiser Family Foundation (KFF), based on analysis of the American Community Survey (ACS) for 2021
[5] Florida Medicaid is the state and Federal program that provides health coverage for selected people with low incomes in Florida
[6] This number is calculated based on an annual household income published by Benefits.gov
[7] The Hyde Amendment is a legislative provision prohibiting the use of federal funds to pay for abortion, except to save the life of the woman, or if the pregnancy arises from rape or incest