If the Supreme Court finalizes its leaked draft ruling overturning Roe v. Wade and Planned Parenthood v. Casey in the coming weeks, New Yorkers will not have to worry about losing their existing abortion rights, which have been codified into law and touted by Gov. Kathy Hochul.

But New York abortion providers and groups that help patients with the finances and logistics of getting the procedure are preparing for the possibility that a lot more people from out of state will soon need their services.

As Hochul said on Twitter Monday night after Politico published the draft opinion: “For anyone who needs access to care, our state will welcome you with open arms.” New Jersey Gov. Phil Murphy pledged the same, saying his state “will not go backwards on reproductive rights.” But the tri-state area isn’t immune to anti-abortion sentiments, with a handful of introduced bills challenging the right in recent years.

New York has served as a safe haven for those unable to terminate their pregnancies closer to home since it became one of the first states to legalize abortion in 1970, three years before the seminal Supreme Court decision made the freedom to get an abortion a constitutional right. In 1992, the Casey ruling reaffirmed the core portions of Roe but opened up avenues for challenging abortions.

As other states have made concerted efforts to chip away at or ban abortion access outright in recent years, New York has again seen an uptick in patients coming from out-of-state, although they still make up a relatively small percentage of the total abortions performed.

Data compiled by the Centers for Disease Control and Prevention shows that the share of abortions obtained by out-of-state residents has steadily increased in New York since record numbers of anti-abortion restrictions began rolling out about a decade ago in other states. The CDC reported in 2012 that out-of-staters accounted for 3% of New York abortions. This proportion tripled to 8.9% by 2019 — with nearly 7,000 non-residents seeking abortions in the Empire State.

That’s more abortions for out-of-state clients than in any other U.S. state besides Illinois. Several other states that serve large numbers of non-resident clients, like Georgia, Florida and Tennessee, are considered certain or likely to ban abortion, according to the Guttmacher Institute. That means that people already making the costly and difficult trip may have to travel even farther afield to seek care.

“We and our partners in the abortion access movement have known long before the draft majority opinion from the Supreme Court that abortion rights are under attack in the U.S.,” Odile Schalit, executive director of the Brigid Alliance, said in an emailed statement. The New York-based nonprofit helps people who must travel long distances for abortion care.

“So far in 2022, the Brigid Alliance has helped more than 450 people travel to their abortion care, and we anticipate a surge in requests for our support in the coming months,” Schalit added.

All told, New York abortion providers performed about 78,600 procedures in 2019 — more than any other state included in the CDC data. That’s 355 abortions for every 1,000 live births in New York that year, a ratio only exceeded by Washington, D.C.

How New York and New Jersey are supporting abortion

Local politicians have signaled their opposition to restrictive abortion laws in other states in the past by helping people come here. In 2019, New York City allocated ​​$250,000 to the New York Abortion Access Fund to help low-income women traveling from other parts of the country to get abortions in New York.

Mississippi’s ban on abortions after 15 week is what predicated the Supreme Court’s leaked ruling, which Chief Justice John Roberts confirmed as authentic on Tuesday. But it’s not the only state that is trying a variety of tactics to take advantage of any change in federal law.

As of last month, 23 states had laws banning or restricting access to abortions that would take effect if Roe v. Wade were overturned, according to the Guttmacher Institute. Some of those states, such as Michigan, could revert to pre-Roe v. Wade laws outlawing abortions that were never updated. Nine states have put laws restricting access in place after the Roe v. Wade decision that have been blocked by the courts as unconstitutional. Those laws could take effect if the Supreme Court strikes down Roe. And four states have passed laws that are designed to take effect if and when Roe v. Wade is overturned.

Still, New York is not the only potential destination for those in need of an abortion. New York is one of 16 states, in addition to Washington, D.C., with laws protecting abortion rights, according to the Guttmacher Institute. In 2019, more than two-thirds of abortions in Washington, D.C., were performed on non-residents, according to CDC data. It also has a higher ratio of abortions to live births than any jurisdiction that reports to the CDC.

In 2019, Gov. Andrew Cuomo heeded advocates’ warnings about threats to Roe v. Wade and signed the Reproductive Health Act. In addition to codifying the federal provisions into state law, it also shifted abortion regulation out of New York’s criminal code to instead regulate it as a health matter.

And it also sought to expand access to abortions after 24 weeks, allowing them in cases where a medical professional determines that the mother’s health is at risk or the fetus is not viable — although getting that procedure in New York can still be challenging. Likewise, Gov. Phil Murphy and the New Jersey legislature enshrined reproductive freedom into state law at the beginning of 2022.

But Republican lawmakers in Albany have also introduced bills in recent years to restrict abortion access, which haven’t made it out of committee. In New Jersey, lawmakers have proposed at least three bills this legislative session — S649, A305 and S1107 — to restrict abortion.

The Abortion Wayfinder Program

Texas offers a window into the potential consequences of extreme restrictions. In September, the state banned most abortions after six weeks of pregnancy, which is before many people even know they’re pregnant.

Whole Women’s Health Alliance, a nonprofit that operates reproductive health clinics, has since had to turn away the vast majority of patients seeking abortions in Texas, leaving some in a state of “total devastation,” Sonja Miller, the interim managing director, said during a panel on abortion access at a conference of the Association of Health Care Journalists in Austin last week.

In response, Whole Women’s Health launched an Abortion Wayfinder Program to help patients who don’t qualify for abortions in their home state book appointments and travel to other states. The organization also opened a clinic in Minnesota in February, in part, to serve patients from Texas.

While people face a range of potential health risks as a result of abortion bans, reversing Roe v. Wade doesn’t mean time traveling back to the way things were in the 1970s, noted Dr. Lisa Harris, who studies the intersection of reproductive health and law at the University of Michigan. Some may picture the now-infamous hangers that have been displayed at demonstrations for abortion rights, but those in their first trimester are more likely now to be able to access abortion pills to end their pregnancies on their own.

Since the Texas law took effect in September, some people near the border have started heading to Mexico to get abortion pills at pharmacies.

“That’s the best-case scenario,” Harris said at the panel. “Not everyone has the same access to safe medication.”

Even when people do have access to pills or out-of-state abortions, medical professionals worry that people may put themselves at risk by delaying abortions longer than they would otherwise or avoiding needed after-care. At the panel, Dr. Crystal Berry-Roberts, an OB/GYN in Austin, said a patient showed up at her hospital bleeding heavily and at first lied about having gotten a late-stage abortion in another state.

“I’ve seen this cause harm,” Berry-Roberts said. “I took an oath to do no harm.”

The story was updated with the news involving Chief Justice Roberts, a statement from the Brigid Alliance and additional stats on abortion.

Jaclyn Jeffrey-Wilensky contributed to reporting.