Although women’s rights advocates are cheering the passage of a reproductive rights act, the new state law doesn’t do anything to improve the situation on Cape Cod, which has been called an “abortion access desert.”
The law signed by Gov. Charlie Baker earlier this month protects out-of-state women seeking abortions from prosecution and was praised by the Outer Cape’s state legislators. It shields doctors from lawsuits for performing abortions on women from states that ban abortion and mandates insurance coverage for reproductive care and increased access to emergency contraception.
“Frankly, it is a great piece of legislation,” state Rep. Sarah Peake of Provincetown said, adding a caveat. “What it doesn’t do,” Peake said, “is broaden abortion services across the Commonwealth. That is a separate issue and a separate struggle.”
State Sen. Julian Cyr of Truro said that, while “the bill is very important from a rights perspective, it’s not an access bill.”
The nearest clinic to the Outer Cape that provides comprehensive abortion care is in Attleboro, 110 miles from Provincetown.
“I find it outrageous that women who live on the Cape have to travel off Cape, sometimes as far away as Boston, to access these services,” Peake said.
Outer Cape Health Services (OCHS), the sole provider of health care on the Outer Cape, does not provide abortion services. Officials have offered conflicting reasons for that policy.
OCHS is a federally qualified health center. Under the Hyde Amendment — first enacted in 1976 — FQHCs are prohibited from using federal funds to provide abortions. But the Hyde Amendment does not prohibit such centers from providing abortion services altogether.
Gerry Desautels, an OCHS spokesman, first told the Independent that the Hyde Amendment prevents the organization’s practitioners from prescribing abortion medication.
When the accuracy of that statement was challenged by a reporter, OCHS issued an amended statement: “Our current focus is to provide and sustain core primary care and behavioral health access to the community which can include referrals to other medical and specialty care providers. On-site abortion services are not being considered at this time.”
Desautels noted that while OCHS providers don’t write prescriptions for abortion medication, OCHS pharmacies will fill those prescriptions written by other providers.
Peake said the solution rests with Washington.
Community health centers, she said, “are gagged, in effect tied up by the Hyde Amendment. It’s an outrage that the U.S. Congress has allowed [the Hyde Amendment] to stand.”
Cyr said there are other issues beyond that amendment.
“They’re having a hard time finding primary care physicians,” he said of OCHS. “To identify and recruit a provider who could administer abortions and all the logistics involved in that — that would be a very heavy lift.”
Peake hopes that a solution to the Cape’s abortion access issues may be jump-started by the urgency over protecting abortion rights after the U.S. Supreme Court’s decision to overturn Roe v. Wade.
“There is momentum for the efforts to curtail these services that will lead in the long run to us broadening access,” Peake said, “which I hope will include a provider, or two, or six, here in Barnstable County.”
The Independent previously reported that the Mass. Dept. of Public Health (DPH) could potentially deny Cape Cod Hospital’s $137-million expansion plan because Cape Cod Healthcare — the hospital’s parent organization — restricts access to abortion care.
The DPH reviews such plans and makes a “determination of need,” which includes access to care. But Cyr said that forcing or pressuring Cape Cod Hospital to review its abortion protocols is not within DPH’s power.
“DPH’s ‘determination of need’ doesn’t have any teeth,” Cyr said. “Even if DPH wanted to [expand abortion access], I don’t think they have that authority.”
Cyr said that expanded abortion access, especially on the Cape, probably won’t come in the form of a bill or mandate.
“There are a lot of conversations about geographic access,” Cyr said. “But it’s something you can’t necessarily legislate. You have to either appropriate dollars for it or you have to work in coalition to make it happen.”
Peake agreed: “Programs like this get established more through meetings, planning, and outreach after which any necessary regulations are changed or statutes are enacted,” she said. “Not by mandates without all of the upfront work taking place. That upfront work is ongoing.”
Peake did not specify what work was currently going on. She said she was not directly involved in it.
Both Cyr and Peake still have hope for the future.
Although the legislative session ended Aug. 1, Peake said that abortion access on the Cape is “something that we can and will revisit next session.
“Just because we may not be taking any more recorded votes in the legislature, that doesn’t mean the legislative work stops,” she said, adding that “where we are now is the conversation, education, information sharing, and community consensus building around this issue.”
“We’re working hard to figure out a menu of solutions,” Cyr said. “And I’m hopeful that in the coming months we can identify a path forward to have abortion care on Cape Cod.”
