Gas, food, and a hotel: Americans seeking an abortion out of state already shell out up to $10,000 for the procedure. Experts warn that cost could rise.

• Roe v. Wade getting overturned will force Americans to travel across state lines to access abortions, experts say.
• Checkered access to abortions will increase the cost of travel, among other expenses.

Getting an abortion will likely get a lot more expensive for many Americans.

The procedure itself is already costly, experts say. But after Politico last week published a draft Supreme Court opinion signaling a reversal of Roe v. Wade, which legalized abortion, experts told Insider that expenses for those seeking the procedure are likely to rise exponentially if the landmark case is overturned.

For instance, in states where abortion will become mostly — or entirely — illegal if Roe v. Wade is struck down, travel costs will be prohibitively expensive for many seeking the procedure in other states where the procedure is allowed.

That itemized list can include airfare, gas, car rentals, childcare, petcare, food, and hotels. And that's not to mention the money one loses by taking time off work, which is the reality for many low-income people who live paycheck to paycheck.

"You might be salaried and I might be salaried, and you can take time off," said Anna Rupani, executive director of Fund Texas Choice (FTC), a nonprofit organization that pays for low-income Texans' associated abortion costs. "A lot of our clients are living paycheck to paycheck, they're not in salaried positions… they're experiencing wage loss."

Doctors who specialize in reproductive healthcare don't normally track the cost of an abortion that takes place outside the medical system, said Dr. Jamila Perritt, president and CEO of Physicians for Reproductive Health.

But doctors are increasingly familiar with the personal costs patients pay in pursuit of the procedure — especially if the act of getting one is criminalized or carries a punishment.

If getting an abortion is criminalized, someone who goes through with the procedure can lose their job, Perritt said. They can also lose access to their existing family members.

"For folks who are arrested, prosecuted, jailed for managing their own abortion, they're more likely to lose custody of their children or to have their families dissolved," Perritt said. "We know that the cost is great for individuals and family, if they are accused of managing their abortion and thrust into the criminal legal system."

'The costs can add up very quickly, and there's no alternative'

Abortion will remain legal in the United States until the court hands down a final verdict, which could come as early as June. But the leaked draft opinion was enough to put reproductive rights activists and doctors who perform abortions on high alert.

Historically, abortion restrictions forced patients to find alternative means of getting one.

When the Texas state legislature, for example, introduced SB 8, which effectively prohibits anyone from obtaining an abortion after six weeks of pregnancy — a point at which most people do not even know that they're pregnant — clinics told Insider they were receiving an influx of patients seeking abortion from Texas. And undocumented immigrants in Texas had to weigh the cost of getting an abortion against potential deportation.

On average, a first-trimester abortion that's done using the aspiration method, which is the most common type, costs about $508, according to Veronica Jones of the National Abortion Federation. Medication abortions can cost about $535 on average, Jones said.

And the price can increase depending on the length of the pregnancy. Median costs were $560 for a medication abortion, $575 for a first-trimester procedural abortion, and $895 for a second-trimester abortion in 2020, according to a recent study led by Ushma D. Upadhyay at UCSF.

And insurance is rarely any help, Katrina Kimport, a medical sociologist at the University of California, San Francisco, told Insider.

"There's a lot of fine print around what is covered," Kimport said. "Many insurers, such as Medicaid in many states, will just prohibit coverage."

Kimport also said that the cost of an abortion is often more expensive than what most Americans have in savings.

For patients seeking services out of state that don't already have working relationships with insurers, the costs can get even heftier, Kimport said. In that case, patients would have to file for reimbursement, which typically doesn't go through, Kimport said.

If a state restricts access to abortion, patients who need one have to think about how to get to a state that is offering abortion, in addition to the actual cost of the abortion itself.

That can mean they might have to take the amount of a plane ticket under consideration.

"I've spoken with people who have spent maybe $10,000 in terms of their travel," Kimport said, counting flights, hotels, childcare, and car rentals among the common expenses. "The costs can add up very quickly, and there's no alternative. You can't wait to be strategic about a low price on a flight if you need an abortion."

When Texas passed SB 8, abortion seekers went out of state to obtain reproductive healthcare. For several reasons, most people, Jones told Insider, opted to drive out of state.

If they're taking kids along with them because of an inability to secure childcare, for example, it might be easier to drive rather than fly, Jones said. And Texas has networks of sprawling highways that allow for convenient access to other states by car.

But that doesn't mean most people in other states would opt to drive if Roe were repealed, Jones said, noting that funding a trip to a friendly state that may be hundreds of miles away can also increase costs.

Expenses are already skyrocketing in states where abortion is mostly illegal

Fund Texas Choice doesn't pay for the actual procedure, but it covers the cost of transportation, hotel stays, and food to and from abortion appointments.

Rupani told Insider that in the last year the organization's costs have tripled and its client base has doubled. That's because SB 8 made in-state abortions illegal for a vast majority of people, signaling some of the financial woes organizations may well face as more states ban the procedure.

Before SB 8 went into effect last September, FTC served 330 clients — and they help more than 650 now, Rupani said, indicating that people need additional financial help as abortion access restrictions expand.

Rupani said some clients may request $400 for gas, while others need food or simply the cost of a taxi.

Flights and hotels, she said, can run up the bill to roughly $4,000.

"And 62% of our clients are parenting," she said. "So childcare is added in."

And a lot of FTC's clients are living paycheck to paycheck, Rupani said, meaning if they're taking time off to get an abortion, they're not getting paid. And crossing state lines poses even more of a challenge for undocumented individuals, who face the risk of deportation or arrest.

"People don't realize how much those factors play into the expenses," she said.