California Considers Abortion Pill for Community Colleges

from Andrea BaltodanoCalMatters

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California college students could access medical abortion through campus health centers under a proposal that would expand reproductive health services already required at the state’s public universities.

Assembly Bill 2540 would require colleges with student health centers to offer access to medical abortion starting in 2029, if the Legislature provides funding. The bill builds on Senate Bill 24a 2019 law requiring UC and Cal State University student health centers to provide medical abortion starting in 2023.

Supporters say the bill would close the access gap for community college students who may face barriers to transportation, cost, privacy or insurance when care is only available off campus. But campus health center directors warn that many community colleges may not have the funding, staff or clinical capacity to provide the service.

Authored by Assemblywoman Kathryn Stefani, D-San Francisco, the bill would apply to community colleges with student health centers — roughly 92 campuses nationwide. If the Legislature secures funding, those campuses would have to offer access to medical abortion starting in 2029.

“We are filling a critical gap by ensuring that community college students, one of the most diverse and economically vulnerable populations in our state, have the same access to care as their peers at four-year institutions.” Stephanie told deputies during an Assembly Health Committee hearing in April.

The bill also requires all campuses to promote the service, provide information to students and post availability online. The awareness requirement will cover universities that were not required to advertise medical abortion services under the previous law.

Community colleges fill the health care gap for students

“Health care is a basic need for every person,” said Stephanie Goldman, executive director of the California Community College Faculty Association, a statewide advocacy organization that represents community college faculty and supports AB 2540. “And of course, access to abortion and abortion is a health care issue.”

Goldman said community colleges are increasingly operating on a “whole student” model that goes beyond academics to include access to food, housing support, child care, mental health and health services. Access to reproductive health care can directly affect whether students can stay focused in school, she said.

“It’s helpful for them to know that they have this kind of health care on campus and that it’s available to them if they need it,” Goldman said.

Student leaders who support the bill say community college students often face challenges accessing reproductive health care outside of campus systems, especially in rural areas.

“Where you go to school shouldn’t determine what access you get just because you went to a community college system versus a four-year system,” said Alicia Nagpal, a student at Folsom Lake College who serves as vice president of legislative affairs for the Student Senate for California Community Colleges.

Nagpal said some community college students live hours away from providers, lack transportation or may not know what health services already exist on campus. She cited online-only students, low-income students, and undocumented students as groups that may face additional barriers to obtaining reproductive health care off campus.

Community college health centers vary in size and services

But while supporters frame the bill as a matter of equal access, health center directors say implementing the proposal statewide could be much more complicated than implementing the UC and Cal State models.

According to the Assembly Appropriations Committee analysis, community college health centers “vary widely in structure and capacity, with many operating under staffing models or outsourcing services to community providers and hospitals.”

The California College Health Services Association, which represents student health programs systemwide, opposes the bill. In an April 15 letter to lawmakers, the organization said many community college health centers do not prescribe drugs, nor do they have enough staff or the necessary infrastructure to perform medical abortions on site.

Michelle Barkley, president of the association and a nurse at Cosumnes River College, said many community college health centers function more as public health entry points than full-service clinics.

“Some of our campuses have 5,000 students,” Barkley said. “Their health center is run by a registered nurse.”

Barkley said many campuses currently rely on referrals to outside providers rather than on-site reproductive health services.

Funding can be a challenge

The bill’s projected costs have become a key point of contention between supporters and college health center directors.

The California Community Colleges Chancellor’s Office estimates that implementing the bill could cost between $7 million and $27.9 million in one-time costs to start all 93 community college health centers, plus between $5.6 million and $9.3 million annually to maintain the services. These assessments are not limited to the cost of drugs. The appropriations analysis said costs could include staffing, training, equipment, telehealth services, billing support and other infrastructure needed by campuses to deliver or coordinate care.

Community college medical centers may be partially funded through student health fees, although not all campuses charge them. The analysis says most campuses charge an average health fee of about $23 per academic term. The Office of the Chancellor of California Colleges lists the maximum fee for health services for 2025-26 at $27 per semester and $22 for summer, intersession or quarter terms.

Supporters of the bill argue that the projected costs may overstate the financial burden. According to the committee’s analysis, Stephanie’s office argued that medical abortion services could be made financially sustainable through Medi-Cal reimbursement, private insurance billing, third-party providers and telehealth partnerships.

Nagpal pointed to language that makes the bill dependent on legislative funding, saying community colleges are not expected to implement the requirement without state support.

“If the funding is not secured in community colleges, there is no legal expectation for (community colleges) to provide the service,” Nagpal said.

The bill was stalled in the House Appropriations Committee on May 6 because of its potential cost. On May 14, the committee advanced the bill by an 11-4 vote after amendments.

The amendments changed how the bill would apply to community colleges. Earlier text would have required community colleges with student health centers to offer medical abortion on-site, but the amended bill now says campuses must “offer access” to the service beginning in 2029. The bill still allows care to be provided by campus staff, via telehealth or through contracted outside agencies, but now also includes partnerships with community health providers “as appropriate.”

The changes also expanded what colleges will report to the state, allowing campuses to report services provided by outside health care providers instead of just those performed at campus health centers.

AB 2540 was referred to the Senate Health and Education Committees on June 10. After further amendments, the bill was referred July 2 to the Senate Appropriations Committee, where lawmakers will review its fiscal impact.

The latest amendments further define how community colleges can comply, including through referrals, “warm handovers,” written partnerships with licensed providers, or a statewide provider agreement through the chancellor’s office. They also clarify that government funding can support costs such as telehealth, staffing, training, billing support, coverage and reporting.

Andrea Baltodano is a contributor to the College Journalism Network, a collaboration between CalMatters and student journalists from across California. CalMatters Higher Education Coverage is supported by a grant from the College Futures Foundation.

This article was originally published on CalMatters and is republished under Creative Commons Attribution-NonCommercial-No Derivatives license.