As the conservative-majority U.S. Supreme Court allowed Texas’s near-complete abortion ban to proceed, abortion-rights advocates and Democratic lawmakers warned of who would bear the brunt of what is now the country’s most restrictive abortion law: people of color, people with low incomes and other marginalized groups.

The law prohibits abortion once cardiac activity can be detected in the embryo — as early as six weeks into pregnancy, when many people are unaware they’re even pregnant. The law would prevent more than eight in 10 abortion seekers from getting care, by one analysis.

“Essentially, it’s a total abortion ban,” Jamila Perritt, a Washington, D.C.-area OB-GYN who provides abortion care and serves as president and CEO of Physicians for Reproductive Health, told MarketWatch. “But it runs along race and income lines, and so it’s very clearly discriminatory and inequitable.”

Anti-abortion groups applauded the law, which took effect Wednesday and empowers private citizens to sue anyone who “aids or abets” a banned abortion, including healthcare providers and friends and family members who help an abortion seeker.

“This is the most significant accomplishment for the pro-life movement in Texas since Roe v. Wade,” Texas Right to Life legislative director John Seago told the Associated Press. Susan B. Anthony List president Marjorie Dannenfelser said the Supreme Court ruling “allows Texas to protect unborn babies with beating hearts while litigation continues.” 

(Many healthcare providers criticize the widely used “fetal heartbeat” concept as misleading, as an embryo at six weeks is not yet a fetus and does not have a developed heart.)

Who will be most impacted?

Abortion seekers in Texas and abortion-rights supporters across the country expressed alarm, with many pointing out that the law — like other restrictive state abortion policies — stood to disproportionately impact people of color, people with low incomes and other historically marginalized groups. (Cisgender women are not the only people who seek abortions.)

“This law will dramatically reduce access to reproductive care for women in Texas, particularly for women with low incomes and women of color,” Vice President Kamala Harris said in a statement Wednesday. 

Related: Biden slams Supreme Court ruling on Texas abortion law, vows ‘whole-of-government’ response

The law, which can still be challenged in courts, “would particularly affect Black patients and those living on low incomes or who live far from a facility that provides abortion because they often experience delays obtaining care,” according to a July research brief by the University of Texas at Austin’s Texas Policy Evaluation Project.

“The main reasons Texans are delayed include: the need to come up with enough money to pay for their visits because abortion is not covered by Medicaid and most private insurance plans in Texas; difficulties coordinating appointments around their job, school and childcare; and challenges scheduling the state-mandated ultrasound and separate abortion visits with the same physician as required by Texas law,” the authors wrote.

Two 2020 analyses of earlier Texas abortion restrictions conducted by researchers from the same organization found that lower-income people, Latino residents and people who lived far away from abortion clinics were disproportionately impacted.

See also: Texas abortion law: Women will have to travel 496 miles on average round trip to get an abortion out-of-state

Nearly 27% of abortions reported in Texas in 2018 were in Black patients, almost 39% were in Hispanic patients, 27% were in white patients and 7% were in patients from other racial and ethnic groups, according to a U.S. Centers for Disease Control and Prevention report. In the broader data reported by 30 states and the District of Columbia, Black patients made up 34% of abortions, Hispanic patients 20%, white patients 39% and patients from other groups 8%.

Research suggests that higher rates of unintended pregnancy among people of color may be related to disparities in consistent contraception access and use, which are often rooted in structural inequities like poverty and racism. About 42% of unintended pregnancies in the U.S. in 2011 ended in abortion, one 2016 study found

“It is contraception [access], it is access to care in and of itself, it is the way that racism is embedded into every system in this country — including our healthcare system — that results in inequitable health outcomes for our communities,” Perritt said.

Michelle Anderson, a policy associate at the Dallas-based Afiya Center, a Black-led reproductive justice organization that advocates for Black women and girls, and whose many services include practical support for abortions, added that “for a lot of Black women, it’s just not their time.” 

“They don’t want to create that generational poverty; they don’t want to bring other children into the world and not be able to take care of them,” Anderson told MarketWatch. “We should not be shamed. The government should not be telling us we don’t have a choice but to have children.”

The new law would also have a disproportionate effect on young people and LGBTQ people, who already face unique barriers to abortion access, Perritt said. Other heavily impacted groups may include disabled people of color, people experiencing homelessness, and people who lost a two-income household during the pandemic, Anderson noted. 

Immigrants, particularly those who are undocumented, will face disproportionate impact from the law, advocates add. 

“The checkpoints set up by Immigration and Customs Enforcement (ICE) that surround the Rio Grande Valley, the southern border region of Texas, prevent people without documentation from crossing to another state to seek abortion care,” Nancy Cárdenas Peña, the Texas state policy and advocacy director of the National Latina Institute for Reproductive Justice, wrote in a Refinery29 column.

And Sung Yeon Choimorrow, the executive director of the National Asian Pacific American Women’s Forum (NAPAWF), said in a statement Thursday that “the Texas law creates fear and confusion by intimidating people out of getting the abortion care they need” during a time of heightened harassment and hate crimes against Asian Americans and Pacific Islanders, further stigmatizing abortion and making it less accessible for those who can’t travel out of state.

“This is especially dreadful for undocumented community members who may not have health insurance or depend on in-language support,” Choimorrow said. 

Those with less resources are going to have a direct hit’

Among other consequences, being denied a wanted abortion may result in worse economic outcomes, put people at risk of staying in contact with an abusive partner, and be connected with serious health problems.

But people with money and connections have always been able to access abortion care, even before Roe v. Wade enshrined abortion rights in the Constitution, Perritt said.

And so regardless of the Texas law, she said, people with resources will be able to take time off work without losing pay, find child care for the kids they have, and travel out of state for abortion care — while “those with less resources are going to have a direct hit, and they’re going to be forced to carry pregnancies to term.”

Related: When charity is fueled by anger: How the Supreme Court Texas abortion ruling could spur a wave of ‘rage giving’

Clinics have remained open in adherence to the law as donations pour in to nonprofits and President Biden promised a “whole-of-government” response. Meanwhile, Perritt said, “abortion funds are doing what they’ve always done”: providing abortion seekers with logistical support such as transportation, lodging and funding for the procedure itself. 

That means they’re also at risk, she added: “This ‘aiding and abetting’ means them too.”

See also: Texas abortion law: $10,000 penalty could incentivize ‘bounty hunters’ to make ‘tens of thousands of dollars’

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