Illinois Democrats' pro-choice push could help providers cope with an influx of out-of-state patients by expanding the number of medical professionals who can provide in-clinic abortion services.

Illinois Democrats’ efforts to secure access to reproductive health care are in stark contrast to surrounding states. Republicans in Missouri and Indiana have enacted some of the most restrictive abortion laws in the United States, including mandatory counseling and forced waiting periods to receive abortion care.

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UPDATE, May 28, 5:09 p.m.: The Democratic-majority Illinois house on Tuesday passed the Reproductive Health Act.

Illinois Democrats recently introduced legislation to secure and expand reproductive rights, changes that could have far-reaching effects, as people travel to Illinois to secure abortion care that is difficult to access in neighboring states.

And one part of that legislation could help providers cope with that influx of out-of-state patients by expanding the number of medical professionals who can provide in-clinic abortion services.

The two bills proposed last week in the Illinois General Assembly would repeal decades-old statues intended to criminalize abortion providers and require parental notification for minors to receive abortion care. The measures have large Democratic support in the general assembly where Democrats hold supermajorities in both chambers.

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“It’s pushing back against a deliberate strategy of the anti-abortion movement of stigmatizing and siloing women’s reproductive health care, and these bills are saying we need to treat reproductive health care like any other health care,” Colleen Connell, executive director of the American Civil Liberties Union (ACLU) of Illinois, told Rewire.News.

The Reproductive Health Act (HB 2495), proposed in the Illinois House by state Rep. Kelly Cassidy (D-Chicago), would repeal a 1975 law that includes criminal penalties for doctors who offer abortion care, though it has been largely blocked by the courts. The legislation also seeks to repeal targeted regulations on facilities that provide abortion services, repeal laws that have allowed husbands to block their wives from obtaining abortions, and require all private health insurance companies in the state to provide coverage for abortions. The Reproductive Health Act builds on a law Illinois lawmakers passed two years ago requiring Medicaid and state group health insurance plans to cover abortion, Connell said.

The legislation would repeal the state’s ban on so-called partial-birth abortion, which is unenforceable. Anti-choice activists use “partial birth abortion,” an unscientific term, to describe an uncommon type of dilation and evacuation abortion (D and E) known as an “intact D and E.”

Another key provision of the Reproductive Health Act would allow advanced practice nurses and clinicians to provide in-clinic abortions. Current law only allows for physicians to provide these procedures while advanced practice nurses are limited to providing medication abortion. Allowing nurse practitioners to provide in-clinic abortions will increase the number of providers in the state, potentially meeting an increased demand should patients from surrounding areas continue to seek care in Illinois, said Liz Higgins, associate medical director of Planned Parenthood of Illinois.

“Adding in-clinic abortions for nurse practitioners would be a huge benefit of this bill,” Higgins said, noting that nurse practitioners already provide a range of reproductive health care, including IUD insertion and other gynecological procedures. “Limiting in-clinic abortions for advanced practice nurses is really just harming our patients by limiting access to health care in a timely manner.”

Illinois Democrats’ efforts to secure access to reproductive health care are in stark contrast to surrounding states. Republicans in Missouri and Indiana have enacted some of the most restrictive abortion laws in the United States, including mandatory counseling and forced waiting periods to receive abortion care. It’s not uncommon for providers in Illinois to see women traveling from surrounding states to seek care they couldn’t receive closer to home, said Julie Lynn, spokeswoman for Planned Parenthood of Illinois. In 2017, more than 5,500 women traveled from out of state to terminate a pregnancy in Illinois, according to the Chicago Tribune.

“We’re always thinking about how our patients are going to be impacted as well as people at large because there are states surrounding us with extremely restrictive laws regarding reproductive health care access,” Lynn said. “So if there’s anything we can do in Illinois to lessen that burden on anyone then we want to make sure to do that.”

Missouri is one of five states with a forced 72-hour waiting period between counseling and an abortion procedure. Both Missouri and Indiana ban the use of telemedicine to administer medication abortion and require minors to receive parental consent before terminating a pregnancy.

Illinois had 40 abortion-providing facilities in 2014, according to the Guttmacher Institute. Last year Missouri only had one. Planned Parenthood operates 17 health centers in Illinois, 15 of which provide medication abortion and five that provide in-clinic abortions, Lynn said.

The second bill, SB 1594, which was introduced in Illinois’ state senate last week, would repeal the 1995 Parental Notice of Abortion Act, which requires minors to notify a guardian before receiving abortion care or otherwise appear before a judge and receive a judicial bypass. The law was blocked by the courts from 1995 to 2013, but has been enforced in Illinois for the past five years after the Illinois Supreme Court upheld it .

Although the measure is smaller in scope than the Reproductive Health Act, Higgins said repealing the Parental Notice of Abortion Act is crucial to eliminating barriers to health care for minors.

“A majority of minors are already telling a family member or trusted adult if they are getting an abortion, but unfortunately a handful of patients live in dangerous family situations and aren’t able to tell their parents or a trusted adult,” Higgins said. “Making them go before a judge is putting more barriers in front of these patients, and we want to make sure we’re not making this harder on young people.”

The pro-choice proposals in Illinois follow similar efforts in states like Massachusetts, where lawmakers are working to expand access to medication abortion. New York Democratic lawmakers recently passed a measure to secure abortion rights should conservatives on the Supreme Court overturn Roe v. Wade, while lawmakers in New Mexico are working to repeal the state’s decades-old abortion ban. Rhode Island Democrats are working to pass a measure that would enshrine abortion rights into law despite resistance from anti-choice Democratic leaders in the state.

“It’s extremely important to modernize the law because with the current landscape and makeup of the Supreme Court, no one knows what the future of reproductive rights in this country is going to be,” Lynn said. “Looking at the makeup of the Supreme Court, it’s not in favor of reproductive health so we want to make sure we are doing whatever we can to protect and expand those rights and most importantly acknowledge abortion as health care and take it out of the criminal code.”