Lessons from California: Expanding Access to Medication Abortion on College Campuses

Lessons from California: Expanding Access to Medication Abortion on College Campuses

This blog was co-authored by legal intern Mason Bettencourt

Medication abortion is a safe and legal abortion method with an approximately 97 percent success rate. Women have been using medication abortion with increasing frequency in the United States. Generally provided to individuals in the first ten weeks of their pregnancy. Medication abortions make up about a third of all non-hospital abortions and almost half of abortions before nine weeks’ gestation. Although medication abortion is a safe and common medical intervention for terminating a pregnancy, many states are placing restrictions on how individuals can obtain medication abortions. 

FDA-approved regimen for medication abortion is safe and legal

In the United States, the FDA-approved regimen for medication abortion is taking a combination of the medications mifepristone and misoprostol. The patient takes mifepristone orally in the presence of the provider, and then the patient takes misoprostol on their own. Some patients prefer this abortion method because, among other things, it avoids procedures that some may perceive as invasive and allows them to undergo the second part of the process at home. Protecting and expanding access to medication abortion is important because it offers patients the choice to get the type of service and care they need and request. 

Abortion Medicaid coverage is still excluded in most states

Despite the effectiveness and safety of abortions, carving abortions out from other sexual and reproductive health care coverage is common and nothing new. Today, abortion is excluded from Medicaid coverage in most states and from private health insurance coverage in some states. Mifepristone is subject to FDA regulations requiring that, rather than receiving a prescription for Mifeprex at a retail pharmacy, the patient must receive the medication at a clinic, medical office, or hospital from a health provider who has pre-registered with the drug manufacturer and arranged to order and stock the pill in their health care facility.

College students in CA and the United States have no access medication abortion and face barriers

Access to medication abortion is an especially unique challenge for college students in the United States. Abortion is health care, yet no colleges or universities provide abortions or coverage for abortion care at their student health centers (SHCs). Even in California, a state with almost no abortion restrictions, college students face substantial challenges both on- and off-campus in accessing medication abortion care. Common barriers to access for college students include limited financial resources, mobility and distance challenges in getting to a provider, as well as appointment and referral scheduling that are unconducive to college student schedules. Despite the capacity of California’s public universities to provide medication abortion for students at their respective SHCs, no SHC in the state covers medication abortion. 

California college students propose bill SB 24 requiring Student Healthcare Centers (SHCs) in the state to provide medication abortion

Frustrated by the lack of access to medication abortion at their SHC and at SHCs across the state, students at UC Berkeley began organizing and advocating for change with other like-minded groups in 2017. Their efforts culminated in Senate Bill (SB) 320, which would have required SHCs at all public colleges in California to provide medication abortion for students. Then-Governor Jerry Brown vetoed SB 320 in 2018. The following year, the bill was reintroduced as SB 24, the College Student Right to Access Act, which likewise requires SHCs at public universities in California to provide medication abortions for students. If SB 24 becomes law, California will become the first state in the nation to require SHCs at its public universities to provide medication abortions.

Students access to medication abortion should be part of the sexual and reproductive care received at colleges across California and the nation

SB 24 serves as just one possible example of how California is joining other states like New York, Maine, and Illinois are countering the rollback of abortion and reproductive rights. Regardless of the ultimate fate of SB 24, all college students, in California and elsewhere, should be able to access medication abortion from college campuses with the same ease they can access other reproductive health care services. Carving out medication abortion from the sexual and reproductive health care services provided in colleges burdens students’ ability to get the care they need. Maintaining barriers to medication abortion access will no doubt disproportionately harm students who already experience health disparities, including low-income students and students of color. With growing numbers of college students unable to afford everyday necessities, ensuring access to medication abortion for students should remain a top priority.


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