The types of issues Advocacy Center employees troubleshoot depend on clients’ needs. Although some calls are relatively straightforward, involving little more than scheduling the appointment and ticking off a few required checkboxes, most are complex. Many people don’t know how they’re going to pay for their abortions, an issue that’s exacerbated in states where the Hyde Amendment — a measure banning federal funding for abortion — prevents Medicaid from covering it. In Pennsylvania, for example, Medicaid will only cover an abortion in the cases of rape and incest, which in practice means that survivors of rape and incest must “prove” their trauma to the state before being accessing coverage.
Even in states where the Hyde Amendment has been overturned, there are limitations to what Medicaid will cover. In New Jersey, the program only pays for surgical (not medication) abortions, limiting the agency that Medicaid recipients have over their abortion experiences. And people with private insurance don’t necessarily have it better: Under many plans, abortion coverage is limited or nonexistent. “What is the point of having affordable health care if you can’t use it?” laments Jones.
“Many of the call center workers say the most challenging part of the job is the moments when, due to state laws, they are forced to be a barrier to access for the patients they’re eager to help.”
Fortunately, in cases where clients have limited funds, phone advocates have resources to turn to. Programs like the National Network of Abortion Funds provide significant amounts of financial support. As part of their work, advocates take on the burden of applying for these funds on behalf of their clients, who may feel overwhelmed by the forms they’re required to fill out.
In New Jersey, where abortions are allowed up to 24 weeks, a procedure at that point in the pregnancy can cost upwards of $3,000. “We’ve gotten almost the full $3,000 (for a single patient),” says financial coordinator Olga Montes, explaining that combining the available funds from a collection of different programs can often result in an abortion that’s completely covered.
Many of the call center workers say the most challenging part of the job is the moments when, due to state laws, they are forced to be a barrier to access for the patients they’re eager to help.
When someone schedules a procedure at the Atlanta Women’s Center, for example, a Georgia law called the Woman’s Right to Know Act requires that phone advocates read through a script that emphasizes (and, many argue, overstates) the potential medical and psychological risks of abortion and reminds the caller that, should they carry the pregnancy to term, the person who impregnated them will be held responsible for child support.
As one of the Advocacy Center’s bilingual advocates, Torres-Cruz has gone through this script in both English and Spanish. “It’s worse for me in Spanish,” she says. “I don’t know if it’s because Spanish is my native language, but it just makes me cringe every time that I say the phrase that ‘the man involved is liable.’ It’s horrible in Spanish, it just sounds worse.”
Phone advocates are given the leeway to explain that what they are reading is a state-mandated script, and give their clients a chance to get clarity on the actual risks and side effects of abortion. “Every time that I finish reading that script I always encourage them to ask me questions and not just leave that empty space of awkwardness, so at least I can catch any worries they have or any concerns,” says Torres-Cruz. “Because if they ask me (questions), I can clarify” — and, hopefully, allay any lingering fears clients might have about the safety of their upcoming abortions.
In some cases, the callers don’t need that reassurance: “I actually had a patient, while I was reading (a Woman’s Right to Know), just bust out laughing,” says Lucian. “They make abortion out to be this big scary thing: ‘You’re going to bleed to death, you’re going to have all these complications.’ The caller just started laughing, because she’s like, ‘This is so ridiculous. Pregnancy is way more difficult.’”
As painful as complying with the Woman’s Right To Know Act can be, it can be taken care of over the phone at any time. In contrast, the Pennsylvania Abortion Control Act (PACA) requires that pre-abortion counseling be conducted by a physician 24 hours before an abortion is performed. Though the Women’s Center is also able to conduct those sessions over the phone, the calls require a great deal of scheduling and logistics to meet the 24-hour window. Because the phone call is legally mandated, missing it can throw a well-planned abortion appointment into disarray.
“Who knows, the (client) might not have a phone when it comes time for the phone call,” says Jones. “We have a lot of patients who miss the phone call, so we have to reschedule everything because of that.”
Rescheduling that appointment isn’t an easy task for many people. “They already took off work, they already found childcare, they already have everything set up” to ensure they could make their original appointment, Lucian says. And yet with one missed call, “all that work the patient did to set up that appointment is now out the window.”