Commentary: Mixing supply-side economics and abortion

Abortion battles are usually fought over heated moral and political arguments.

So it’s worth noting when a health economist applies the laws of supply and demand to abortion in red states like Kansas, and comes up with predictions about where abortion politics are taking us.

In an article published in The New England Journal of Medicine, Theodore Joyce of the City University of New York divides attempts to restrict abortion into demand-side and supply-side measures.

Abortion opponents have historically focused their efforts on the demand side of the economic equation by trying to discourage women from seeking abortions, Joyce says. These measures — mandating waiting times, requiring parental involvement, informing patients about claimed abortion risks — have kept some women from terminating their pregnancies, he says. But overall, they haven’t had much effect on abortion rates.

Possibly out of frustration, abortion opponents have more recently taken aim at the supply side, Joyce says, with efforts to limit the number of providers.

This approach is exemplified by Kansas’s new regulations that set facility standards — minimum amounts of janitorial space, patient dressing areas with restrooms, for example — that abortion clinics found hard to meet.

The rules are on hold while clinics contest them in court.

But targeting supply in this way is much more likely to be successful than trying to reduce demand, Joyce’s research suggests.

Joyce looked at what happened in Texas after an abortion law that has both demand- and supply-side components took effect in 2004. On the demand side, the law requires that women receive abortion information at least 24 hours before their procedure. On the supply side, abortions at 16 weeks or later after gestation are limited to hospitals and surgery centers.

Joyce found that the demand-side measure had no significant effect: Even with the 24-hour waiting period, women at less than 16 weeks kept getting abortions at the same rate as before the law. But the supply-side impact was dramatic.

When the law took effect, no abortion clinics in the state qualified as surgery centers, and Texas hospitals performed few abortions. During the law’s first year, abortions performed at 16 weeks or later dropped by 88 percent.

More Texas women went out of state for late abortions, but even so, there were 2,460 fewer of these abortions.

Virginia and Arizona recently enacted supply-side laws. If such laws spread through the nation’s red states, Joyce foresees women traveling greater and greater distances for abortions.

That may make abortion unaffordable to some, Joyce says.

And that brings things back again to the demand side of abortion economics.