Tens of thousands crossed state lines for abortion care in 2024, as bans and restrictions continue to reshape access across the United States.
Patients on the Move as Access Shrinks
In 2024, tens of thousands of Americans traveled across state lines to access abortion care, highlighting the continued fallout from the U.S. Supreme Court’s 2022 Dobbs decision. The ruling, which ended federal protection for abortion rights, has driven patients like Wisconsin’s Gracie Ladd to seek care far from home under distressing and often dangerous circumstances.
Ladd, 20 weeks pregnant with a nonviable fetus and facing health risks, was legally unable to obtain an abortion in her home state due to an antiquated law still in effect at the time. Instead, she and her husband drove over 100 miles to Chicago—a journey made more difficult by physical pain, emotional trauma, and logistical barriers such as arranging child care and taking time off work.
Nationwide Trend Driven by Legal Patchwork
According to new data from the Guttmacher Institute, more than 155,000 people in the U.S. traveled to another state for abortion care in 2024—over double the number from 2019. One in seven abortions involved crossing state lines. The spike is largely attributed to total abortion bans in a dozen states, which together accounted for nearly half of all out-of-state travel.
Texas led the nation, with more than 28,000 residents seeking abortions elsewhere, most often in nearby New Mexico, Kansas, or Colorado. For many, these trips involved full days of travel, navigating not only geography but also increasingly complex legal barriers.
Shifting Centers of Access
Florida served as a regional hub for abortion services in the South—until May 2024, when a six-week ban went into effect. The impact was immediate: the number of people traveling to Florida for care halved, while nearly 8,000 Floridians left the state for abortion services, some traveling as far as Virginia or New York.
In contrast, Illinois has emerged as the most significant access point nationwide. The state welcomed over 35,000 out-of-state patients last year, thanks to strong legal protections, political support, and sustained investment in services. Clinics expanded hours, hired more providers, and committed to seeing anyone who arrived—regardless of lateness or circumstances.
Clinics Adapt with Flexibility and Compassion
Clinics like the Choices Center for Reproductive Health in southern Illinois report that 90% of their patients come from out of state. Staff regularly encounter license plates from Texas, Louisiana, and Tennessee—signaling hours-long journeys often made under duress.
To meet rising demand, clinics have adapted policies to reduce barriers: allowing late arrivals, prioritizing flexible scheduling, and maintaining space in their calendars. “We don’t turn people away for abortion care,” said Jennifer Pepper, Choices’ CEO. “They’ve gone through a lot, and they’ve traveled a great distance to access it, so we take care of them.”
Telehealth Fills Some Gaps—but Not All
Telemedicine has emerged as a vital tool for expanding abortion access. In 2024, 1 in 4 abortions in the U.S. were provided via telehealth, up from 1 in 5 the year before, according to the Society of Family Planning. Shield laws in supportive states have enabled about 12,330 medication abortions per month by year-end—a 40% increase over the start of the year.
Yet access to telehealth is uneven. Funding limitations and legal threats continue to hinder efforts. “Millions live in states where abortion is banned or restricted, and travel isn’t an option for everyone,” said Dr. Angel Foster, co-founder of the Massachusetts Medication Abortion Access Project. “Telehealth ensures care reaches those who need it—regardless of ZIP code or income.”
Financial and Legal Pressures Remain
Despite innovations, access remains fragile. Funding for travel assistance has declined. Organizations like the Chicago Abortion Fund and Choices Center report reduced capacity to cover patient costs—forcing some to delay or forgo care altogether.
Anti-abortion activists have turned their focus toward telemedicine, seeking to curtail its use through litigation and legislative efforts. “Telehealth is a lifeline for people in ban states,” said Dr. Ushma Upadhyay of UCSF. “But that lifeline is under attack.”
As state-level restrictions continue to shift, experts warn that abortion access in the U.S. remains in flux—deeply unequal, legally contested, and increasingly dependent on geography and resources. For thousands of patients, that means continued travel, higher costs, and growing uncertainty.
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