On Election Night, Chelsea Williams-Diggs went to bed around 10 p.m. Even though it was too early to know the results of the presidential election, a race “critical” to her had already been called: Florida’s Amendment 4.
“That’s what I was mostly biting my nails on,” she said. “It was so frustrating that it was called so early, even though 57% of Floridians voted ‘yes.’”
Amendment 4 was Florida’s abortion referendum: a ballot question posed to voters that, if enacted, would have protected abortion access and dismantled the state’s current near-total ban. It needed 60% of the vote to succeed — but with only 57% of voters saying yes, it did not meet that threshold.
At the same time, in Williams-Diggs’ own state, New York, Proposition 1 passed, enshrining abortion protections in the state constitution. But for her, the executive director of New York Abortion Access Fund (NYAAF), the Florida amendment’s failure would have a much more immediate effect on her life and work.
As one of the five employees who disperses financial assistance to abortion seekers through NYAAF, Williams-Diggs has witnessed firsthand the consequences of Florida’s strict anti-abortion laws.
“It was a really big blow to our broader movement and to how we understand New York’s ecosystem as well,” she told THE CITY last week. “After Florida enacted their six-week ban, which was in May of this past year, NYAAF immediately saw a spike — a huge increase in Floridians traveling to New York to access abortion care.”
According to her data, the increase was around 460%.
Floridians are the biggest group of out-of-state abortion seekers traveling to New York for care, according to independent data from both NYAAF and Planned Parenthood of Greater New York. If Amendment 4 had passed, Sunshine State residents would have been able to receive care up to the point of fetal viability, generally around 24 to 26 weeks, in their home state.
Now, an unsustainable status quo remains: many abortion seekers from Florida must board a plane in order to get care, and providers in New York must secure the substantial resources and funding needed to continue to offer abortions — all while preparing for potential national threats to the procedure’s legality.
“Best case scenario is nothing gets worse,” said Williams-Diggs, but added: “It’s still pretty freaking bad.”
Coordinating Care, From Miami to Manhattan
Abortion funds like NYAAF help people pay for their abortions — not just the procedure itself, but everything the person needs in order to make it happen. When someone is traveling out of state, those costs can be high: hotel rooms, last-minute flights and the appointment, which generally costs hundreds of dollars.
In Florida, where out-of-state travel for abortion care is common, funds like the Tampa Bay Abortion Fund have been giving out an average of $800 per caller just for travel. The appointment then averages around $430, putting the average cost of assistance at over $1,200 per person.
According to Senti Sojwal, communications director at Planned Parenthood of Greater New York, Floridians make up the largest group of out-of-state abortion seekers that seek care at New York Planned Parenthood clinics.
“From April to May, PPGNY saw an increase from 15% to 26% of out of state patients coming from Florida,” Sojwal said in a statement to THE CITY. The initial bump correlates with Florida’s six week ban that went into effect on May 1. “This number has increased steadily since the spring — in October of this year, 46% of out of state patients came from Florida.”
But New York City is an expensive place. Because of that, many coordinators in Florida try to steer patients to other, less pricey locations where they can get safe, legal care.
“There’s just so many factors we take into consideration — getting the appointment, how much does the appointment cost, getting the flight, how much does the flight cost,” said McKenna Kelley, a board member of the Tampa fund. “Cost is what gets us most of the time, especially for hotels.”
Instead, Kelley’s fund usually ends up sending people to Illinois, Maryland, and Washington, D.C. Washington has no restrictions on abortion care, so the fund usually directs people there who call later in their pregnancies.
But many people traveling to New York for care may do it for common-sense reasons: strong social ties.
“Many have friends or family in New York,” said Williams-Diggs.
Kelley thinks that there are many people who may not even know that before six weeks, they can still get an abortion in their home state.
“I think there are some people who just assume that abortion is not legal in Florida and they never even make it to an abortion fund, and are just trying to figure it out on their own,” she said.
No matter where a patient ends up for care, Kelley always recommends reaching out to local advocates first.
“We’ve done all the research,” Kelley said. “Our director of case management — we joke that she’s basically like a travel agent at this point. She will get you wherever you need to go as quickly as possible, and she will make it as seamless as possible.”
This kind of granular, location-specific information can be vital: According to Kelley, a lot of their callers “have never been on a plane before.”
For Floridians going north, she noted, there are also practical concerns: things like winter coats and boots that southern abortion-seekers might not usually think to bring.
“We had someone last year that we sent up north and she went in flip flops, because she didn’t know,” said Kelley. Last year, they did a coat drive just in case callers didn’t have one for their trip.
Despite the high costs and cold weather, many Floridians are making the journey anyway.
Laura Goodhue, who leads Florida’s Planned Parenthood advocacy arm, says she’s not surprised given the abortion access landscape in the state. “I can tell you that it’s awful, and I’m sure that people are gonna go somewhere they can get a flight, or they can drive, or they know someone, or where there’s care,” she said.
Goodhue thinks that, geographically, New York City makes sense as a destination from Florida — it’s also somewhere where there’s a decent chance you can get a direct flight from cities like Tampa, Orlando, or Miami.
Plus, she points out, Florida is a large state: “We just have a lot of people that are pregnancy age,” said Goodhue.
City Hall, for its part, has actively encouraged Floridians and other abortion seekers in the South to come up. In March 2023 after Mayor Eric Adams created thes Abortion Access Hub, the city funded billboards across the region to publicize the new hotline. USA Today reported that the campaign was potentially the first instance of a local government advertising itself as an “abortion destination.”
Unsustainable Demand
In New York, people can get abortions at hospitals, Planned Parenthood offices, and independent clinics — and all of these options face their own challenges to provide care.
“It’s been really hard,” said Robin Chappelle Golston, president and CEO of Planned Parenthood Empire State Acts, the advocacy arm of the organization. “As we’re seeing bans across the country, and we do have folks coming in from other states to receive care, it’s even more important for there to be a true investment.”
In the wake of the election, Planned Parenthood Empire States Acts is presenting Gov. Kathy Hochul with a “substantial budget ask package” to increase funding for reproductive health care in the state, Chappelle Golston told THE CITY. While New York currently uses state funding to help cover abortion through state Medicaid — which, as federal funding for abortion is forbidden under the Hyde Amendment, is the only option — Chappelle Golston says that it’s not enough.
As with other medical procedures, the reimbursements that Planned Parenthood clinics get vary based on what type of service they’re providing. According to Chappelle Golston, for abortion administered via pills, the clinic gets reimbursed less than it would for a typical family planning visit — which, as abortion pills have started to become a more popular choice, significantly affects the clinic’s overhead.
“We’re losing money on every patient that we treat,” Chappelle Golston said.
In addition to coping with normal operating costs, Planned Parenthood offices also have to pay for increased security and “frivolous lawsuits.”
“It’s just things that other providers don’t have to deal with,” Chappelle Golston said.
The organization also faces funding threats from the federal level: Elon Musk and Vivek Ramaswamy wrote that they intend to cut funding for Planned Parenthood as part of their new Department of Government Efficiency, similar to the measures aimed at “defunding” the organization that Trump supported in his first term.
In September, Planned Parenthood locations in New York stopped providing abortions after 20 weeks, citing financial issues, THE CITY previously reported. It also closed multiple locations and stopped providing deep sedation, which is used not only for abortions but as a pain management option for other procedures like IUD insertion.
In New York, abortions are available up until 24 weeks of pregnancy and, after that, in cases where the life or health of the pregnant person is at risk. Abortions later in pregnancy, which make up around 1% of all abortions nationwide, are some of the most difficult and expensive to obtain. They’re largely provided by independent clinics — as are second trimester abortions — which are closing at “alarming” rates in New York and across the U.S.
Williams-Diggs says that NYAAF is “lucky” to be able to provide financial assistance for everyone who calls looking for help paying for their abortion, unlike other abortion funds across the country that have had to limit their budgets due to lack of donations. Donations to abortion funds saw a huge increase after the Supreme Court struck down Roe v. Wade in 2022, but have fallen since — despite abortion restrictions continuing to pop up across the country, like Florida’s six-week ban enacted this May.
“When we think about the amount of money but also just the energy and capacity to support the amount of people who are accessing care in this ecosystem, it’s exhausting,” said Williams-Diggs. “It’s just not sustainable.”
An ‘Access State’
One thing that advocates stress: In New York, abortion is legal.
But in order to preserve New York’s status as an “access state,” as Chappelle Golston refers to it, she and other advocates are fighting for stronger legislative protections.
Alongside more funding for insurance reimbursement in the budget, PPGNY and other organizations like the NYCLU are advocating for bills that would give people more control over their electronic health records, and strengthen the state’s “shield” laws, which protect telehealth providers who send abortion pills to people in states where abortion is illegal.
“There’s obviously a chilling effect that everyone’s kind of anticipating what’s going to happen, but like all the other abortion providers out there we’re going to continue to provide care as long as we can,” said Chappelle Golston.
New York’s own abortion referendum, Prop. 1, also shored up abortion rights in the state. It could even help in the event of a national abortion ban, which abortion advocates aren’t ruling out despite president-elect Trump’s claim that he would veto such a ban. In the event of a national ban, the issue would likely become mired in a huge legal fight, said Sarah Wheeler, a law professor at the NYU Reproductive Justice Clinic.
“It’s too simplistic to just say federal law always trumps state law,” she said, “even though that absolutely is the background constitutional rule.”
Though a federal ban would theoretically supersede a state constitutional amendment, there could be serious legal challenges to a national ban. In this case, such challenges could hinge on concerns about federalism: the balance of power between state and federal governments.
Since abortion protections are now enshrined in the New York constitution, it shows the overwhelming preference of New Yorkers that abortion be legal — and it establishes the procedure as a fundamental right in the state. What’s more, Wheeler sees the fact that seven out of 10 states voted to pass similar abortion referenda as another demonstration of how this preference by state governments conflicts with a potential national ban.
Far from hypothetical legal battle and legislation, advocates are coping with real-world problems: Finding money for flights, hotels and procedures. Every advocate THE CITY spoke to urged people to remember that there is assistance available to them right now, whether they are in Miami or Manhattan.
“I want people in New York and across the country to know that there are resources available for them,” said Williams-Diggs. “There are people who work around the clock to make abortion access a reality even in circumstances where it feels like it’s not possible.”