When Jessy Rosales was a sophomore at the University of California, Riverside, she had a boyfriend and she was taking birth control pills. Then out of nowhere, she started feeling sick.
"I just thought it was the stomach flu," she says. "It turns out I was pregnant."
Rosales was clear that she was not ready to have a baby. She wanted a medication abortion, where she would take one pill at the clinic and a second one at home a day or two later to induce a miscarriage.
"I just wanted the intimacy of dealing with it on my own, in the privacy of my own home," she says. "And being able to cry if I wanted to cry or just being able to curl up in my bed right away."
Public university health centers in California do not perform abortions. But state lawmakers are expected to pass a bill in the coming weeks that would require student health centers at all 34 state campuses to provide medication abortions. If the measure becomes law, it will be the first of its kind in the U.S.
The bill's supporters say they want to remove the obstacles women face accessing medical abortion off campus. For example, Rosales was given three off-campus referrals for abortion providers by her student health center. But the first clinic she called didn't perform abortions after all. The second didn't take her insurance.
By the time she could get an appointment at a third clinic, she was already into the second trimester of pregnancy — too late for a medication abortion, which can only be done up to 10 weeks. Rosales ended up having a surgical procedure.
"The doctor kept telling me to relax ... and I couldn't because it just hurt so bad," she recalls. "I was just afraid and alone."
Rosales graduated last year and is now advocating for the bill (SB 24) as a reproductive justice activist with the Women's Foundation of California. She wants other students to have easier access to the abortion pill than she did.
Opponents of the bill have organized several rallies against it. In August, about 60 protesters in yellow T-shirts gathered outside a church in Sacramento, Calif., their heads bowed as a priest led them in prayer. Then they marched around the state's Capitol, chanting, "Don't kill babies! Don't kill babies!"
While a consortium of women's groups that support abortion rights has promised to pay for all the required ultrasound equipment and upfront training costs of providing the abortion pill on campus, eventually universities would likely need to dip into tax dollars or student fees for ongoing costs.
Abortion opponents such as Michele LaMonica object to that.
"Not on my dime, not on my dime," LaMonica says. "Tax me to help the homeless. Tax me to help social services, but don't tax me to pay for the disposal of human life."
Insurers are already required to cover abortion under California law, and state tax dollars do go toward abortions provided through Medi-Cal, the state version of Medicaid for low-income patients. However, none of the UC campuses and only some of the CSU campuses get reimbursed for health services through Medi-Cal. University officials testified during legislative hearings on the bill last year that it could be an administrative or fiscal burden to establish billing systems to provide the abortion pill on campus. They predicted that some clinical costs, as well as security and liability costs, could fall directly to the universities and get passed on to students.
Up to 519 women at public universities seek a medication abortion every month in California, according to a study published last summer in the Journal of Adolescent Health.
The same research found that off-campus abortion providers were an average of 6 miles away from public university campuses in California.
Former Gov. Jerry Brown cited this stat when he vetoed a version of the same bill (SB 320) last year, saying the legislation was not necessary.
"Six miles away — that's like a $5 Uber ride," said abortion opponent Nick Reynosa, the Northern California regional coordinator for Students for Life of America.
He says the campaign is more about politics than need.
"Over the last decade, many pro-choice activists feel that in red states, there's been a lot of momentum toward more abortion restrictions. This is a way to say, 'No. Here, in blue California, we're going to affirm or expand [the right to an abortion],' " Reynosa says.
The bill's supporters don't deny it. Phoebe Abramowitz was part of the student team that launched the campus campaign for medication abortions at UC Berkeley four years ago.
"Now that we're doing statewide advocacy, we're hoping to set a national precedent that we can, even in these really hostile times to women and queer people, move access to abortion forward," she says. "It's more important now than it even was a year ago."
When Brown vetoed the bill last year, then-gubernatorial candidate Gavin Newsom said he would have supported it. He won the election about a month later, and advocates are optimistic that he will side with them this time around.
The state Legislature has until mid-September to pass the bill, and the governor has a month after that to sign or veto it.
This story is part of NPR's reporting partnership with KQED and Kaiser Health News.
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