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Minnesota abortion providers are preparing for an influx of out-of-state patients if an upcoming U.S. Supreme Court decision triggers state laws that limit services around the region.

The high court last week heard arguments in the Mississippi case Dobbs v. Jackson Women’s Health Organization — a case that could redefine the right to abortion in large swaths of the country and block abortion access in several states in the Midwest.

And the court appeared ready to uphold a Mississippi law prohibiting abortions after 15 weeks of pregnancy, except in the case of a medical emergency or severe fetal abnormality.

Mississippi’s law serves as a test case about states’ authority to pass laws that restrict abortion before fetal viability, which starts around 24 weeks of pregnancy. The 1973 Roe v. Wade decision, which was decided 7-2, determined that a woman has a right to end a pregnancy within those first 24 weeks, before a fetus could survive outside the womb.

But the court, which now is composed of six conservative justices and three liberal ones, could upend the legal precedent and allow states to impose whatever restrictions they see fit. A decision is expected sometime next summer.

AN ISLAND IN THE REGION

Minnesota’s Supreme Court in a 1995 case upheld the right to an abortion under the state’s constitution, so the U.S Supreme Court’s decision wouldn’t affect the state’s restrictions. But Minnesota clinics could see an influx of people from neighboring states coming across the border for abortion services if the court upholds the Mississippi law.

Minnesota’s neighbors to the west — North Dakota and South Dakota — have “trigger” laws that would immediately outlaw abortion within 30 days if Roe v. Wade is struck down. Meanwhile, Wisconsin and Michigan still have laws on the books deeming abortion illegal. And the states could enforce those provisions depending on the high court’s decision.

To the south, Iowa GOP lawmakers are organizing a campaign to pass a constitutional amendment that says abortion is not protected by the state’s constitution.

“Should Roe v. Wade go away, abortion could become illegal in those states pretty quickly,” said Erin Maye Quade, advocacy and engagement director of the St. Paul-based Gender Justice organization. “That would make Minnesota the only state in the Upper Midwest where abortion would remain legal and accessible. … That is not tenable, it’s not safe for pregnant people in the region, and Minnesotans are already struggling to get care here.”

North Dakota’s sole abortion clinic in Fargo has mulled a move across the border to Moorhead, should lawmakers there outlaw abortion in the wake of the court’s decision, Tammi Kromenaker, director of the Red River Women’s Clinic in Fargo, told the Forum of Fargo-Moorhead.

Planned Parenthood’s regional directors representing Iowa, Minnesota, Nebraska, North Dakota and South Dakota said they were readying for additional traveling patients in Minnesota clinics. And they noted that the restrictions could put abortion services out of reach for those who couldn’t find child care, get time off of work or afford to travel.

“In general, we are preparing in Minnesota to care for patients who may need to travel across state lines if the Supreme Court overturns Roe v. Wade later this year,” a regional Planned Parenthood spokesperson said. “Restricting abortion access will result in forced pregnancy for many people and will worsen existing race- and income-based health disparities by driving up maternal and infant mortality rates.”

CASE STIRS MORE TALK

On both sides of the issue, advocates said the case stirred enthusiasm ahead of the 2022 legislative session and campaign cycle.

“For 100 years, the unborn were respected in Minnesota, and they’ve only been marginalized in the last several decades,” Minnesota Citizens Concerned for Life executive director Scott Fischbach said, referring back to the 1973 Roe v. Wade decision. “It’s going to take time to restore protection. But slowly, surely, it’s being restored. So we’re going to keep at it.”

Fischbach said abortion opponents in the state are watching the court’s ruling with excitement, as they think it could help build up additional restrictions around the procedures in Minnesota. He pointed to existing restrictions that he said had driven down abortion rates in recent years.

Under current law, Minnesota requires a 24-hour waiting period between the first contact with a provider and an abortion procedure, lays out a script that physicians have to read before the procedure and mandates that both parents of a minor to have to sign off before an abortion.

The state has seen a relatively steady decline in induced abortions since 1980 and the total number of procedures reported to the state in 2020 was less than half that reported four decades ago. In 2020, the Minnesota Department of Health reported that 807, or roughly 9 percent of the total 9,108 abortions in the state, were induced in residents of Iowa, Michigan, North Dakota, South Dakota or Wisconsin.

Fueled by a Texas law banning abortions at six weeks of pregnancy, a group of Democratic-Farmer-Labor lawmakers for the first time this year started a reproductive freedom legislative caucus in the Legislature. The group said it would protect existing reproductive rights in upcoming legislative sessions.

“Minnesotans should be able to make our own reproductive health care decisions without interference from politicians. This caucus will stand up for, defend, and work to expand reproductive rights in Minnesota,” Minnesota House Speaker Melissa Hortman said when the caucus formed in September.

Support for abortion restrictions or protections doesn’t break along party lines, but legislative leaders have said they’re divided on the issue with the GOP-led Senate supporting additional restrictions, while the Democratic-Farmer-Labor-led House of Representatives has opposed them. First-term DFL Gov. Tim Walz said he would block additional restrictions if any reached his desk.

“In Minnesota, certainly as long as I’m governor we will be where we’re at and we’ll provide health care to individuals and we’ll let women make their decisions,” Walz recently told Forum Communications editors and reporters.