HAYS, Kansas — The westernmost abortion provider in Kansas sits in the eastern half of the state — in Wichita. So for someone in Hays or Dodge City, it takes more than two and a half hours to drive to the nearest clinic.
For Kansans who live farther west, the closest place to get an abortion is hundreds of miles away in another state.
A clinic near Denver is the nearest option for people in Colby and Oberlin. For those in Leoti and Syracuse, it’s one in Colorado Springs. The town of Elkhart in southwest Kansas is just about as far from a clinic in Santa Fe, New Mexico, as it is from the one in Wichita.
“There are people in western Kansas who are sort of already living in this post-Roe reality,” said Jack Teter, regional director of governmental affairs for Planned Parenthood in Colorado. “Abortion might be legal in Kansas, but that doesn't mean it’s accessible.”
Even before Kansans decide the future of the state’s abortion rights with Tuesday’s constitutional amendment vote, tens of thousands of western Kansans already live in a world that pro-abortion rights advocates in eastern Kansas fear might be their future. And that far-from-a-clinic reality might offer a glimpse into how the vote could change life in places like Kansas City or Lawrence.
Planned Parenthood of the Rocky Mountains, which operates those locations in Colorado Springs and Denver, already treats patients who travel there from Kansas — 33 of them came last year — even though abortion is legal in both states.
Based on the recent surge of patients coming to Colorado from other states with abortion bans, such as Texas and Oklahoma, he expects that number to increase dramatically if Kansas follows those states’ lead.
“We’re not imagining what could happen,” Teter said. “We’re seeing it happen.”
For example, Planned Parenthood’s Colorado clinics saw roughly 400 patients from Texas in all of 2021. Now they’re getting 400 appointment requests from people in Texas every two weeks.
In total, the Colorado clinics had about 1,500 patients travel from other states last year. Over the past two weeks, however, roughly 500 out-of-state patients have scheduled appointments.
That puts the clinics on pace to receive requests from 13,000 out-of-state patients a year. That would be nearly nine times the number of out-of-state patients they saw last year.
Teter said the wait time to get an appointment with one of Planned Parenthood’s Colorado clinics has historically been two or three days. Now it’s three weeks.
“It’s not sustainable,” Teter said. “It becomes even less sustainable if Kansas votes yes on this ballot measure.”
The domino effect
Kansas abortion providers have recently seen their own flood of patients from other states, such as Oklahoma and Texas. So if abortion becomes illegal in Kansas — even if the amendment passes, lawmakers would still need to pass new restrictions — more of those patients from neighboring areas will turn to Colorado.
The Colorado clinics plan to meet that increasing need, Teter said, whether that means hiring more staff or having staff work longer hours. He said Planned Parenthood will also continue to help pay for gas, hotels and appointment costs for out-of-state patients who can’t afford to travel.
But as more and more states in the middle of the country ban abortion, it creates a domino effect that compounds the barriers people in places like western Kansas already face, according to Elizabeth Nash, state policy analyst with the Guttmacher Institute, a research group that supports abortion rights.
“It's a big ripple effect … every time a state bans abortion,” Nash said. “It increases the distance and it shrinks the number of clinics, which increases delay.”
If Kansas makes abortion illegal, the next closest providers for people in Kansas City and Topeka would be in Nebraska and Iowa.
But Nash doesn’t consider those states long-term abortion refuges. She said both could implement their own bans in the coming months, perhaps even before the time a potential Kansas ban might go into effect.
That means someone in Lawrence could face a longer drive to get an abortion than someone in Colby or Leoti — the nearest clinic to Lawrence would be more than four hours away in Illinois.
For someone in Wichita, the closest option would be a six-and-a-half-hour drive to that same Illinois clinic.
And based on what Nash has seen in other states, that’s what she anticipates will happen in Kansas if the amendment passes.
Alabama approved a similar constitutional amendment in 2018 and passed an abortion ban the following year. In Tennessee, an amendment that passed in 2014 set the stage for the state’s abortion ban that goes into effect in a few weeks.
A potential ban in Kansas, Nash said, would also disproportionately harm Black women — who are three times more likely to die during pregnancy than white women — and people living in poverty. Roughly three of every four Americans who seek an abortion are considered low-income.
“What happens is that in states that have abortion bans,” Nash said, “those who are wealthier and whiter and have more resources go to another state, even if it's three states away.”
‘Not going to buckle’
On a sweltering July Saturday, dozens of abortion rights advocates line the busiest intersection in Hays holding homemade signs. Between the group’s chants, the sounds of encouraging honks — and of engines revving in disapproval — illustrate the sharp divide on this issue.
Hays resident Tracie Baalman sits behind the main line of protestors next to the sidewalk. In one hand, she holds an umbrella to shade herself from the sun. In the other, she grasps a piece of cardboard painted with the words “Keep your laws off my uterus.”
The amendment vote is a life-or-death matter for her, she said, since spinal and blood clotting disorders could make pregnancy fatal.
“If it got to the point where it was me or the baby, I would have to choose myself,” Baalman said. “If abortion was illegal, how could I do that?”
Like everyone else in western Kansas, she would already need to travel hours to the nearest Kansas clinic. If abortion becomes illegal statewide, she’s afraid of what that could mean, especially for women without much money.
“I make less than $400 a month. There's no way I could travel (out of state) to get a legal abortion,” Baalman said. “I couldn’t afford to travel. So I would die.”
Western Kansans advocating against the amendment, however, face an uphill battle.
Western Kansas is a predominantly conservative region — 70% of voters in Ellis County, where Hays is located, chose Donald Trump in 2020. And the influence of the local Catholic church — the region’s two dioceses have endorsed the amendment — is strong both among the descendants of Volga German immigrants in northwest Kansas and Latino communities in southwest Kansas.
And proponents of the constitutional amendment, such as the Value Them Both coalition, contend that it’s needed to restore limits on abortion that were struck down by the Kansas Supreme Court when it ruled in 2019 that the state constitution includes abortion rights.
Without the amendment, the coalition’s website warns Kansas could “become like New York or California” and use tax dollars to fund late-term abortions.
Current Kansas laws, however, do regulate abortions in a number of ways. Abortions are prohibited in Kansas after 22 weeks of pregnancy unless the patient’s health is in danger. Patients must receive an ultrasound and pre-procedure counseling followed by a 24-hour waiting period. No public funding goes to abortions except in cases of rape, incest or life-threatening emergencies.
A recent statewide poll indicates that the amendment vote will be close, with 47% of Kansans saying they plan to vote to remove abortion rights from the state constitution and 43% saying they plan to vote against it.
But the part of the state with the most support for the amendment is western Kansas — 52% of respondents from the region’s congressional district said they plan to vote in favor of it.
Even so, abortion rights advocates in this part of the state vow to do what they can to help rural patients who want to access those services.
Options Domestic and Sexual Violence Services, for example, is the only organization that provides around-the-clock sexual violence care for an 18-county region in northwest Kansas that’s roughly the size of Maryland and New Jersey combined. So, many of its patients face long travel times just to get a medical exam after a sexual assault, let alone an abortion.
Executive director Jennifer Hecker said the amendment would open the door to legislation that criminalizes abortions even in cases of rape and incest.
“That’s unconscionable,” Hecker said. “And that’s the reality that we’re facing.”
She said Options plans to continue helping patients get any health care services they request — including emergency contraception and abortion — regardless of whether or not they have the money to travel.
Even if that means driving a patient more than two hours to Wichita or five hours to Denver.
Options doesn’t keep track of how many patients it connects with emergency contraception or abortion services, she said, because the staff purposefully doesn’t ask patients why they need to go to a pharmacy or clinic. And she’s worried that additional state abortion restrictions could end up forcing women to answer those types of questions as a way of gatekeeping health care.
But regardless of the outcome of the Aug. 2 vote, she said Options doesn’t plan to stop offering to drive patients to health care appointments — no matter which state they’re in — anytime soon.
“There would be pressure to,” Hecker said, “but I'm not going to buckle to it.”
David Condos covers western Kansas for High Plains Public Radio and the Kansas News Service. You can follow him on Twitter @davidcondos. The Kansas News Service is a collaboration of Kansas Public Radio, High Plains Public Radio, KCUR and KMUW focused on health, the social determinants of health and their connection to public policy. Kansas News Service stories and photos may be republished by news media at no cost with proper attribution and a link to ksnewsservice.org.