As the Supreme Court moves closer to potentially overturning Roe v. Wade, Democrat-led states have begun investing money to increase access to abortion - both for their own constituents and for people traveling from states where the procedure may soon become illegal. But critics say the efforts lack transparency. 

Oregon legislators quietly agreed to create a $15 million "reproductive health equity fund" for abortion providers in March, well before a draft of a majority opinion reversing Roe was leaked earlier this month. In response to the leaked draft, New York's governor announced this week that her state will spend $35 million to expand capacity and beef up security at clinics. A New York assembly member has introduced a bill to spend an additional $50 million shoring up access, and in the Washington, D.C., region, Montgomery County Maryland's top official said recently he will commit $1 million for organizations that provide reproductive services, including abortion. This week, California's governor also proposed adding $57 million to a $68 million plan he unveiled in January to support reproductive health clinics and to cover the cost of abortions for people who can't afford them.

The financial supports are part of a larger effort to prepare for what many anticipate will be a seismic shift in abortion access, with swaths of states in the central and southern parts of the country planning to ban or severely restrict abortion if Roe is reversed.

"We've followed the writing on the wall, but that doesn't mean that it's any less devastating to see the majority opinion come out," said An Do, the executive director of Planned Parenthood Advocates of Oregon, referring to the leaked draft. "Never before have we had a constitutional right taken away from us. There are going to be the individuals who are going to have to drive four or five hours to get to a provider, and that will impact people in our state."

Oregon has long been one of the most liberal states when it comes to reproductive health. People there can buy birth control without a prescription. Private health insurers are required to cover abortions. And the state covers abortion costs for uninsured people and those on Medicaid.

As Texas, Oklahoma and neighboring Idaho moved to restrict access, activists and abortion providers in Oregon told legislators they needed help for what they expect will be a sharp uptick in patients.

Oregon abortion clinics already treat a number of people from outside the state. In 2019, more than 9% of the 8,688 abortions in Oregon were on out-of-state residents, according to the Centers for Disease Control and Prevention. If Roe is overturned, as many as 26 states will ban or restrict abortion, and Oregon could see a 234% increase in patients, according to the Guttmacher Institute, an abortion rights research group.

The Supreme Court decision could also leave Oregonians without easy access to a clinic. For residents of Eastern Oregon, the closest clinic is 45 minutes away in Boise, Idaho, but earlier this year, the Idaho legislature adopted a ban on abortions after six weeks of pregnancy. A judge has temporarily blocked that ban. Idaho also has a trigger law that would outlaw abortions after the Court overturns Roe. If that takes effect, the closest clinic for East Oregonians will be in Bend, five hours away.

Oregon House Speaker Dan Rayfield, a Democrat, said he and others wanted to increase access for Oregonians who depend on Idaho. (In 2019, 78 abortions were performed in Idaho on people from out of state, according to the CDC.)

"Just because you have something on the books in Oregon law that protects reproductive health, access to abortion, the laws don't necessarily always equate to access," Rayfield said.

The problem, critics say, is no one knows exactly how Oregon will spend the money. The state won't release the funds until this summer, and the appropriation didn't have its own bill. Instead, lawmakers tucked the $15 million into section 368 of a 100-page budget bill that added nearly $2.7 billion in spending to a budget they passed in 2021. The line item doesn't use the word "abortion," and Oregonians might not have known the fund was up for a vote, Democratic state Rep. Andrea Valderrama said.

"We were very concerned about having a stand-alone legislation that said to the public, 'We're going to fund abortion,'" Valderrama said. "We wanted to make sure that it was successful, and the best way we knew how to do that was by embedding it into the budget."

Lois Anderson, the executive director of Oregon Right to Life, said approving the bill without a hearing set a disturbing precedent.

"If you apply that to the whole system, why have public input at all?" Anderson said. "Just pass the stuff you're going to pass and tell the public you don't care what they think."

Critics logged similar complaints in New York, where Gov. Kathy Hochul waited a month after the budgeting process had concluded before directing two state offices to spend $35 million in emergency funds. Hochul said the Department of Health will allocate $25 million, while the Division of Criminal Justice Services will administer the remaining $10 million sometime before the Supreme Court releases its decision.

"Regardless of one's position on the underlying issue, the idea the Governor can just magically appropriate funds without legislative approval is ridiculous," Republican state Assemblyman Michael Lawler tweeted.

In Oregon, the budget bill directs the Oregon Health Authority to give the $15 million to Seeding Justice, a nonprofit that administered and raised money for the pandemic Oregon Worker Relief Fund. A spokesperson for Seeding Justice declined to comment, but Anderson fears handing the process to a nonprofit will leave Oregonians in the dark about how the state is spending taxpayer dollars.

"We're very concerned about this idea of offering vulnerable women money to come to Oregon to have abortions, which seems to be the purpose of the fund," Anderson said. "We don't know for sure, but we should at least have the opportunity to hold people accountable for the decisions they're making."

Anderson also noted that Eastern Oregonians don't know if the money will help build an abortion clinic there. In April, the Malheur Enterprise reported that Planned Parenthood had begun renting medical office space in Ontario, a small town near the Idaho border. Planned Parenthood declined to say how they will use the space, but Anderson said a clinic might draw an influx of visitors from Boise - one of the nation's fastest growing metro regions.

"There's a lot of consideration to their community values and their quality of life, and they should be able to speak out, and the information should be available, and the process should be transparent so that the people in the communities understand what's going on and can express their opinions," Anderson said.

Policymakers and abortion rights advocates say they expect the fund will pay for a variety of initiatives. Do, the Planned Parenthood executive, said she hopes the money will also go toward recruiting and retaining providers, abortion navigators and other reproductive health workers. It also might pay for technology or facility upgrades for clinics experiencing large upticks, or it could go toward helping patients pay for travel, lodging or child care. Workers at the Northwest Abortion Access Fund, a nonprofit that helped 321 people travel for abortions in 2021, said they expect to receive some of the money, but they have not confirmed yet if or how they will.