SACRAMENTO, Calif. — Gov. Gavin Newsom has signed California’s on-campus abortion mandate into law, but it faces one more hurdle: funding.

The law is operative “only if, and to the extent that, a total of at least ten million two hundred ninety thousand dollars in private funds is made available to the fund in a timely manner on or after January 1, 2020.” 

The new law, sometimes called “the College Student Right to Access Act,” requires the University of California and California State University campuses to dispense the abortion pill upon request in their 34 student health centers, starting Jan. 1, 2023.

The abortion-pill procedure is approved by the U.S. Food and Drug Administration to block nutrients and oxygen to embryos and fetuses within the first 10 weeks of pregnancy and then expel the placenta and its contents.

A state Senate floor legislative analysis estimates that the universities will induce 500 abortions a month. 

“S.B. 24 is a terrible piece of legislation,“ John Gerardi, executive director of Right to Life of Central California, told the Register. “Not only will it result in hundreds of additional abortions per month at taxpayer expense, but it is a foolish program that is insufficiently funded, will be insufficiently administered, and those attendant, additional costs will likely be borne by students and taxpayers.” 

A late amendment to the law states: “No General Fund moneys shall be appropriated, or otherwise provided, to support the fund or the commission’s costs to administer this chapter.“ But Gerardi’s concerns are not without merit, as the commission referred to — the California Commission on the Status of Women and Girls (CCSWG) — may assist the student health center to “bill public programs ... to help pay for the costs of providing abortion by medication techniques.”

“In California, Medi-Cal pays for abortions with California taxpayer dollars, and a large percentage of these abortions will be paid by Medi-Cal,” Gerardi said.

The CCSWG, originally established for education and advocacy on behalf of women and girls, is charged with collecting and distributing funds for the abortion program, as well as overseeing it and reporting back to the California Legislature. It recently hired two new staff members, but, in an analysis, the California Department of Finance said the CCSWG is unqualified to fulfill the new functions assigned to it by the abortion bill: “The commission does not have the technical expertise nor existing capacity to develop and administer a program of this size, scope, or content.” Of the six current staff members, the most senior has worked at CCSWG for three years. 

 

University Perspectives

Administrators at California schools who spoke with the Register provided no conclusive details about how their schools were going to fund costs associated with the program.

“The university continues to assess the means by which ongoing costs will be covered,” Sarah McBride, a communications official in the University of California’s office of the president, told the Register.

The California Senate’s appropriations committee quoted the University of California, which offers a broad range of services in its student health centers, in its estimate of the fiscal impact: “We estimate a funding shortfall of $4.6 to $7.8 million across the 11 UC student health centers. Beginning January 1, 2023, no source of funding is provided in S.B. 24. Without funding, the student health centers will incur ongoing costs in the range of $2.2 to $3.2 annually. Unless financing is made available post 2023, by the state or foundation, this cost will fall to students.”

The California State University system has more than double the number of campuses and currently offers only basic services at its health centers. “We appreciate the interest and efforts of the governor and any other legislators related to the health and well-being of CSU students,” Michael Uhlenkamp, senior director of public affairs in the office of CSU’s chancellor, told the Register on behalf of the university. “This is a large departure from the suite of services that are available at health centers, so the challenge will be to ensure that staff is properly trained and has the right equipment to both administer the medication as well as provide appropriate treatment, should a patient have any unforeseen complications.”

When asked if the university could be liable if a student was injured while undergoing an abortion, Uhlenkamp acknowledged that “the CSU and its campuses face additional liability risk related to the procedures, should the law go into effect.”

The California State University has not released an estimate of the new law’s total costs, but the state Senate’s appropriations committee noted its concerns about liability. “The CSU’s existing health malpractice insurance would likely cover the costs (settlements, judgements, defense attorney fees and costs), assuming a possibility that underwriters may increase premiums based on the number of claims. For any incident related to S.B. 24, the CSU would be responsible for the first $5 million of costs. Campus deductibles would range from $35,000 to $900,000, depending on the campus.”

The California State University estimated some of their health center costs for the California Senate’s appropriations committee. “The CSU assumes a cost of $37,556 for ultrasound at each of our campuses (total of $863,788), and additional ongoing maintenance costs,” as well as “$10,067 per campus to provide training (total of $231,541).” And, the university noted, “The CSU does not currently bill insurance, and it would be extremely costly to move to a billing system. ... Insurance-billing is not a viable option for CSU health centers.”

 

Outside Funders

The organization justCare: Campus Action for Reproductive Equity, which exists solely to promote abortion on campuses, stated in a press release that a “consortium of funders, including the Women’s Foundation of California and Tara Health Foundation, has already raised the funds to cover the costs to bring medication abortion to public university student health centers in California.” In a “fact sheet” published in August, justCare asserted that $10.3 million had been raised.

The new law budgets $10,290,000 between Jan. 1, 2020, and Jan. 1, 2023, for “medication abortion readiness,” at each student health center as specified in the law. The CCSWG is to allocate $7.2 million — $200,000 to each of the 34 health centers, as well as each university system as a whole — to fund preparations. The remaining money is to be retained by the CCSWG.

“This bill permits CCSWC to use up to approximately $3 million to administer the medication abortion readiness grant program, which is approximately 30% of total funding for the program,” the California Senate’s health committee commented. “In comparison to what other state departments, commissions and offices budget to administer programs of this size and scope, this seems disproportionate.”

Some of the health-center costs that need to be covered, according to an evaluation by Advancing New Standards in Reproductive Health (ANSRH), a research program at University of California San Francisco, are the purchasing of ultrasound machines and training staff to use them, after-hours hotlines, training staff to do abortions, hiring more staff to do abortions, implementing billing systems, and “values clarification training with staff.“ 

The ANSRH evaluation also listed a number of the universities’ “perceived concerns” with an on-campus abortion program, including health center staff’s opposition to providing abortions.

 

Conscience-Protection Concerns

Opposition to abortion provision also came up during a California Assembly health committee meeting last year. When Connie Leyva, the author of the new law, presented it as a bill, assemblywoman Marie Waldron asked her about health center staff who don’t want to participate in abortions. Leyva reponded, “The folks who work in the health-care center don’t have to work there if they don’t want to. And the answer is, if they don’t want to administer it, they would not be hired to administer it, because it has to be administered by an R.N.”

Yet, this response seems to fly in the face of long-standing California law, which has extensive conscience protections for health-care providers who do not want to participate in abortions. California law states that no “employee or person with staff privileges in a hospital, facility or clinic shall be subject to any penalty or discipline by reason of his or her refusal to participate in an abortion.”

However, the protection for those not yet hired is not as thorough: “No employer shall refuse to employ any person because of the person’s refusal for moral, ethical or religious reasons to participate in an abortion, unless the person would be assigned in the normal course of business of any hospital, facility or clinic to work in those parts of the hospital, facility or clinic where abortion patients are cared for.” If campus health centers start providing abortions, it is unclear whether these centers as a whole will be considered places “where abortion patients are cared for” as “the normal course of business,” and thus be legally permitted to bar medical professionals who refuse to participate in abortions. The extent of the law’s protections and limitations are ill-defined, as it has not been cited in any published appellate-court decision.

 

Alternative Services Unavailable

“With or without this bill, pregnant students still find their true needs on campus largely unaddressed, needs such as education about the full range of their options and resources and support to help them build a better life for themselves and their children,” Nina Rose, a junior at UCLA and club president of Live Action UCLA, told the Register.

When asked about services for pregnant students considering parenting or placing a child for adoption, Uhlenkamp said, “We do not currently provide any of the services you’ve listed, although depending on the campus, it’s likely that there is staff that could provide a referral to someone seeking information.”

But Gerardi and Rose see in the law a narrow view of addressing pregnancy — one that excludes any alternative other than abortion.

“California is telling women that they cannot succeed as a pregnant or parenting student on campus and that the ‘solution’ to the ‘problem’ of pregnancy is abortion,” Gerardi said.

“This bill only furthers the message that pregnant and parenting students are unwelcome on campus and that the only way to succeed in education is by rejecting and killing one’s offspring,” Rose agreed. “I hope that, despite the abysmal messaging of the California Legislature, pregnant and parenting students everywhere will continue to push on in the face of adversity and show the world what strength, bravery and empowerment really is.”

Register correspondent Mary Rose Short writes from Southern California.