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"This is what abortion bans do—they don't stop people from needing abortions, they just make access harder and more expensive."
Midwestern abortion funds on Thursday presented the latest evidence that state-level abortion bans have effects that reach far beyond state borders, with wait times increasing in states friendlier to reproductive healthcare and abortion funds reporting strained resources, making it harder for people throughout the region to obtain care.
The Chicago Abortion Fund reported that, according to a coalition of groups that raise funds for patients in the Midwest, hundreds of Iowans traveled across state lines to get abortion care since the state's six-week abortion ban went into effect last July.
One hundred and thirty state residents have traveled to Minnesota in the last six months to obtain abortions, while 84 have gone to Nebraska and 47 have traveled to Illinois.
Clinics in Nebraska, Wisconsin, Minnesota, and Kansas are reporting longer wait times, with some patients required to wait up to five weeks for their appointments—forcing some Iowans to travel even further, delaying care for both local and out-of-state patients, and likely leaving some patients with no choice but to carry unwanted pregnancies.
"With Omaha sitting right on the Iowa border, we've seen a dramatic increase in the number of Iowans seeking care in Nebraska," said Shelley Mann, executive director of Nebraska Abortion Resources. "Our clinics are already stretched thin, and Iowans are often forced to travel even farther due to limited appointment availability in our state. This is what abortion bans do—they don't stop people from needing abortions, they just make access harder and more expensive."
"This is what abortion funds do: We step up, we organize, and we make sure people get the care they want, need, and deserve."
While clinics across the region are seeing an influx of out-of-state patients, abortion funds are seeing an increase in the support needed by Iowa residents living under the state's abortion ban.
The Chicago Abortion Fund saw a 222% increase in the number of Iowans needing help covering the cost of their procedure, travel expenses, and other practical costs in just one year.
The fund poured $7,139 into practical support for patients in August 2024, the first full month under the ban, compared to $2,536 in June 2024.
The Iowa Abortion Access Fund also reported a 21% increase in Iowans needing help paying for abortion care compared to 2021, before Roe v. Wade was overturned.
Shayla Walker, executive director of Our Justice, an abortion fund in Minnesota, said that since Iowa's abortion ban went into effect, the organization has "been averaging 18 patients a month from Iowa at a total cost of $54,800—before the ban, we averaged around six at a fraction of the cost."
"The reality is abortion bans don't stop people from needing abortions," said Walker, but instead widen "the gap in access and mortality rates among Black, queer, disabled folks, and minimum wage workers."
With the six-week ban in place, Iowa now has only two clinics that provide abortion care—a Planned Parenthood clinic in Ames and the Emma Goldman Clinic in Iowa City. Five clinics provided care before July 2024.
The Guttmacher Institute, which researches abortion care, found in a report published this month that 76% of abortions in Iowa in 2023 were provided with medication rather than surgical procedures.
With the loss of brick-and-mortar clinics across the state, Isabel DoCampo, a senior research associate at the Guttmacher Institute, toldIowa Public Radio Thursday that a rising number of Iowans could seek medication abortions from online-only providers.
"It could be that we see further changes in clinic counts in Iowa, which could place greater importance on telemedicine provision throughout the state as a result of this ban," DoCampo told the outlet.
Megan Jeyifo, executive director of the Chicago Abortion Fund, said the group will continue to be "nimble and relentless in responding to every new barrier, every policy shift, and every crisis moment."
"In just the last year, we've handled over 16,000 support requests and distributed $5 million in direct assistance, the most in our 40-year history," Jeyifo said. "This is what abortion funds do: We step up, we organize, and we make sure people get the care they want, need, and deserve."
"Abortion funds have always been here, working together across state lines to get people to care," Jeyifo added, "because access to abortion is not just about laws, it's about the people who need care right now. No matter the barriers, we will find a way."
"It's like there's only one person who is actually able to sidestep the demoralization and frustration," said one observer.
After addressing more than 3,400 Nebraska residents in Omaha Friday evening, U.S. Sen. Bernie Sanders on Saturday made his second stop on his National Tour to Fight Oligarchy—telling Iowa City, Iowa residents that "Trumpism will not be defeated by politicians inside the D.C. Beltway."
"For better or worse, that is not going to happen," said the Vermont Independent senator, whose broadly popular policy proposals have long been dismissed by Democratic leaders as unrealistic and radical while President Donald Trump has increasingly captured the attention of the working class Americans who would benefit most from Sanders' ideas.
"It will only be defeated by millions of Americans in Iowa, in Vermont, in Nebraska, in every state in this country, who come together in a strong grassroots movement and say no to oligarchy, no to authoritarianism, no to kleptocracy, no to massive cuts to programs that low-income and working Americans desperately need, no to huge tax breaks for the wealthiest people in this country," said Sanders.
The senator announced his tour earlier this month as Elon Musk, the head of the Trump-created Department of Government Efficiency( DOGE) who poured $277 million on the president's campaign, swept through numerous agencies, with DOGE staffers setting up illegal servers, seizing control of data, shutting federal employees out of offices, and working to shut down operations across the government.
Since Trump took office for his second term just over a month ago, roughly 30,000 federal employees have been fired or laid off—part of Musk's push to cut $2 trillion in federal spending in order to fill the $4.6 trillion hole that Trump's extension of the 2017 tax cuts would blow in the deficit.
Republican lawmakers have also pushed to include cuts to Medicaid, and Trump this week signaled he would back Medicare cuts after repeatedly insisting he would not slash the popular healthcare program used by more than 65 million Americans, in order to save money while handing out tax cuts to the same corporations and ultrawealthy households that benefited from the 2017 tax law.
"Today in America we are rapidly moving toward an oligarchic form of society where a handful of multibillionaires not only have extraordinary wealth, but unprecedented economic, media, and political power," said Sanders in Iowa City, which like Omaha is represented by a Republican U.S. House member who narrowly won reelection last November and has faced pressure to reject the GOP budget plan. "Brothers and sisters, that is not the democracy that men and women fought and died to defend."
Sanders began his tour in Omaha and Iowa City to pressure the Republican House members there—Reps. Don Bacon (R-Neb.) and Mariannette Miller-Meeks (R-Iowa) out of supporting the GOP's proposed cuts.
"Together, we can stop Republicans from cutting Medicaid and giving tax breaks to billionaires," said Sanders ahead of the Iowa City event.
Sanders drew loud applause when he noted that the increasingly oligarchic political system extends past just Trump, Musk, and Republican lawmakers.
"The role of billionaires in politics, it's not just Musk, it's others," he said. "It's not just Republican billionaires, it is Democratic billionaires. It is the corruption of the two-party system."
Progressive activists and journalists in recent weeks have expressed growing frustration with Democratic leaders as they have publicly appeared to throw up their hands and deny they have any power to fight Trump's attacks on immigrants, transgender children, and other marginalized people.
House Minority Leader Hakeem Jeffries (D-N.Y.) has garnered scorn for meeting with Silicon Valley executives to "mend fences" with the powerful tech sector—where numerous CEOs have signaled support for Trump during his second term.
Ken Martin, the newly elected chair of the Democratic National Committee, said last month that the party should continue to take money from "good billionaires."
Some Democratic senators have voted for Trump's Cabinet nominees even as members of the caucus have accused Musk of orchestrating a coup on Trump's behalf, and leaders including Jeffries have reportedly become "very frustrated" with progressive advocacy groups like Indivisible and MoveOn for organizing grassroots efforts to pressure the Democrats to act as a true opposition party.
Meanwhile, Sanders this weekend has captured the attention of thousands of people in Republican districts along with hundreds of thousands of people who have watched his anti-oligarchy tour online.
"The energy around what Bernie is doing is insane," said Matt Stoller, a researcher at the American Economic Liberties Project. "It's like there's only one person who is actually able to sidestep the demoralization and frustration."
Jeremy Slevin, a senior adviser to Sanders, reported that in Iowa City, the senator gave "not one, not two, but three different speeches to overflow crowds," with 2,000 people lining up to see him speak "on a freezing cold day in a Republican district."
Pointing to the enthusiasm shown in Nebraska and Iowa, Sanders supporters questioned the idea, reportedly embraced by Democratic consultants and politicians, that "Americans don't understand the word oligarchy."
"Bernie Sanders launched an anti-oligarchy tour, and it's the only thing that has popularly resonated within the Democratic Party base," said Stoller. "That's fascinating and notable."
Rights advocates were energized by the "gold standard" poll results, but called on progressives to continue working to turn out voters.
Political observers expressed shock Saturday evening as the Des Moines Register released its final poll before Election Day showing Democratic Vice President Kamala Harris leading Republican presidential nominee Donald Trump by three points.
Harris was supported by 47% of respondents compared to 44% who backed Trump.
The newspaper's poll, conducted by pollster J. Ann Selzer, is widely regarded as the "gold standard" survey of voters in the state and has been recognized as "predicting" numerous election results in Iowa and giving a potential preview of how candidates could fare in other Midwestern states with similar demographics.
Progressive advocates cautioned against placing too much faith in a single poll—even a widely respected one—and urged Harris supporters to continue canvassing, phone-banking, and taking action to defeat Trump and the far-right MAGA movement.
But the unexpected result in a state that hasn't been considered a swing state in this election, and was widely assumed to be a Trump-supporting state, led political observers to look closely at the poll, which showed significant shifts toward Harris among women.
Women aged 65 and older supported Harris over Trump, 63% to 28%, in the poll. Women who identify as political independents also backed her, 57% to 29%.
Overall, women in the state are backing Harris in the poll by a margin of 20 points, according to the survey.
Lyz Lenz, a journalist based in Iowa, said she believed the poll could be linked to one major change in Iowa since the last presidential election: the six-week abortion ban that took effect in July, banning abortion care after fetal cardiac activity can be detected. Similar abortion bans have been blamed for at least four deaths of pregnant women in Texas and Georgia.
"It's the abortion ban," said Lenz. "Women are furious."
Daniel Nichanian, editor-in-chief and founder of the digital magazine Bolts, said the result could preview losses for state Supreme Court justices who have upheld abortion bans in a number of states, including Iowa.
In 10 states this year, voters will make their voices heard on ballot initiatives regarding the right to abortion care. In traditionally red states including Kansas and Kentucky since Roe was overturned, people have voted to protect the right to obtain an abortion.
"It's the Dobbs election," said Helaine Olen of the American Economic Liberties Project. "The Iowa poll is just the latest proof."
Selzer herself told the BBC that many respondents talked about abortion rights.
"The people who say they're supporting Kamala Harris, the issue they say they're thinking about most is democracy, about half of them saying that's the most important thing," she said. "But then half of that, about 25% roughly, say abortion. And Iowa has one of the strictest abortion laws in place... and that may well have played a part in this."
Sean Trende, senior elections analyst for RealClearPolitics, said it would be "foolish to dismiss [Selzer's] poll," but cautioned election watchers against abandoning "all of [their] prior views about the state of the race."
Dan Pfeiffer, a former adviser to President Barack Obama and co-host of "Pod Save America," said one possible interpretation among several is that "Harris isn't really winning Iowa but the poll is capturing late-stage momentum that bodes well for Wisconsin, Michigan, [and] Pennsylvania."
Advocacy group Indivisible on Sunday morning advised supporters to "send this Iowa poll to all your group chats. Then, sign up to talk to some voters. With your help, we're going to win this thing in two days."