After Dobbs, crossing state lines for an abortion means navigating cost, logistics, and legal uncertainty

When the Supreme Court's 2022 Dobbs decision overturned the constitutional right to abortion, it did not eliminate abortion in the United States. It moved it. People who once accessed care locally now travel across state lines, navigating a patchwork of laws that shifts with each legislative session and court ruling. A new study published in JAMA Network Open examines what that journey actually looks like for the people making it.

The geography of access after Dobbs

The study, led by Alia Cornell at Kaiser Permanente, documents the barriers that people in states with abortion bans face when seeking care in other states. The obstacles are not primarily medical. They are logistical, financial, and informational.

Travel itself is the most obvious challenge. Depending on where a person lives, the nearest state where abortion remains legal may be hundreds of miles away. That distance translates into costs for transportation, lodging, childcare, and time off work, costs that fall disproportionately on people with lower incomes, those in rural areas, and those without flexible employment.

But the study also highlights less visible barriers. Many people in ban states do not know what resources are available to help them access care elsewhere. Abortion funds, practical support networks, and telehealth options exist, but awareness of them is uneven. Information gaps are compounded by the legal uncertainty surrounding abortion in many states, where laws are being challenged, rewritten, or reinterpreted in ways that make it difficult for both patients and providers to know what is permitted.

The role of support systems

The study identifies three categories of support that could reduce barriers: policy change at the state or federal level to protect access, visible information and resources that reach people who need them, and charitable and interpersonal social support that provides practical assistance like transportation, lodging, and financial aid.

Abortion funds and practical support organizations have expanded significantly since Dobbs, but their capacity has not kept pace with demand. The study suggests that these organizations need greater visibility and funding to close the gap between available services and the population that needs them.

Legal complexity as a barrier

The legal landscape itself functions as an obstacle. Some states have enacted or proposed laws that target people who travel for abortion care or those who help them. The uncertainty around these laws creates a chilling effect, discouraging some people from seeking care even when it is legally available across a state border.

This legal ambiguity also affects providers in states where abortion remains legal. Clinics near the borders of ban states have seen surges in patient volume from out-of-state travelers, straining capacity and increasing wait times. The study points to the need for systemic solutions rather than relying solely on the willingness of individual providers and organizations to absorb the displaced demand.

Limitations of the evidence

The study captures the landscape as it existed at the time of data collection. The legal environment around abortion continues to change rapidly, with new laws, ballot measures, and court decisions reshaping access in multiple states. Findings may not fully reflect current conditions in any given state.

The study's scope and methodology are detailed in the full publication. It does not quantify the total number of people affected or the aggregate costs of cross-state travel, both of which would require different research designs to estimate.

What the study does provide is a structured account of the barriers that exist and the types of support that could address them. For policymakers, healthcare systems, and advocacy organizations, that mapping is a necessary first step toward interventions that work at the scale of the problem.