New York City Now Offers Free Abortion Pills at Sexual Health Clinics

New York City began providing free abortion pills at city-run clinics last week, becoming the first city in the United States to do so.

The clinics could dispense up to 10,000 abortion pills each year, not including those offered at the city’s 11 public hospitals. Unlike the hospitals, however, the clinics do not require insurance, nor do they ask patients about their immigration status.

The city began offering abortion medication at a sexual health clinic in the Bronx and plans to dispense the pills at three other clinics—one each in Brooklyn, Harlem, and Queens—by the end of the year. These clinics historically serve low-income individuals.

Many states have severely limited abortion care access following the Supreme Court’s 2022 decision to overturn Roe v. Wade, the landmark case that granted the constitutional right to abortion.

New York City said medication abortion services would be available to anyone who needs them, from in or out of New York City.

“The Supreme Court, quite frankly, set our nation back in the quality of care that is available to people,” NYC Health Commissioner Ashwin Vasan said in a statement to Verywell. “But New York City will do everything in its power to defend health and human rights. The services we’ve expanded since the catastrophic Dobbs decision reflect our commitment to lead when our national government falters.”

In August, Mayor Eric Adams signed a $1.2 million maternal and reproductive care package, paving the way for medication abortions to be offered for free at Department of Health clinics.

The city also runs an abortion access hub that confidentially connects people seeking abortions to providers.

In light of federal restrictions on abortion care, public health departments have a responsibility to care for people’s reproductive health care, including education about abortion and allowing access to abortion care, Liza Fuentes, DPH, MPH, a senior researcher specializing in reproductive health access at the Guttmacher Institute, told Verywell.

“In a country where there is now no federally protected right to abortion, how are states, municipalities, communities, and departments of health going to step up and ensure access? It’s certainly possible, and this example of New York City is really, I think, a leading example,” Fuentes said.

About 96% of abortions were provided at clinics rather than at hospitals or doctors’ offices in 2021, according to Kaiser Family Foundation. During the COVID-19 pandemic, the Food and Drug Administration (FDA) allowed the pills to be sent by mail and said it would no longer require people to take the first drug in person at a clinic or hospital. The change likely increased the proportion of people who underwent self-managed medication abortions rather than surgical procedures.

Earlier this month, the FDA allowed certified pharmacies to dispense the abortion medication mifepristone to people who have a prescription.

People in New York can get an abortion for any reason up to 24 weeks of pregnancy, or later if the pregnant person’s health is at risk or if the pregnancy will not survive.

Making medication abortion available at no cost is a key part of the program, Fuentes said. Decreasing cost barriers allows people to access care more quickly, reducing their risk of complications. And it allows those who are young, low-income, or otherwise struggling to pull together the money for abortion services to get the care they need.

New York City also offers services connecting people seeking abortions with financial support for travel and lodging.

“People were traveling to New York state for abortion care pre-Roe,” Fuentes said. “The fact that that probably will be happening now, while unfortunate, it’s heartening that the city has stepped up to be able to meet the need.”

About one in nine people who can become pregnant lack health insurance in the U.S. In 2020, 35% of U.S. adults would not be able to pay a medical expense of $400 without borrowing funds. The cost of an abortion procedure can range from $500 to several thousand dollars, not including the cost of travel, child care, and lodging.

It is also well-documented that Black, brown, and indigenous people are also disadvantaged when seeking abortion care, due in part to financial disadvantages and racism in the health system.

“What often happens is that people spend many days, if not weeks, saving up money, trying to find a way to come up with the resources to cover the cost and it delays their abortion care,” Fuentes said. “The fact that something like cost or an abortion restriction is the cause of people being delayed in their care is problematic and unethical.”