Minnesota is a vital abortion oasis to millions in the Midwest. Republicans are scrambling to change that.

In early April, former Minnesota state Sen. Scott Jensen affirmed his long-standing opposition to reproductive rights. In a radio interview, Jensen explained that he believes in banning all abortions, with a minor caveat for instances in which “a mother’s life is in danger” after rape or incest. A few weeks later, after nine bruising ballot rounds at a Minnesota state GOP convention that banned flamethrowers but allowed some unambiguous antisemitism to sneak through, Jensen won his party’s backing to become the next Republican governor of Minnesota, a state that hasn’t had a GOP leader in over a decade.

Along with his equally anti-choice running mate, former Minnesota Viking Matt “abortion is not going to heal a rape victim” Birk, Jensen’s bid to unseat incumbent Minnesota Gov. Tim Walz (D) this fall is a worrying rightward lurch. It outpaces even the extreme anti-abortion views of Tim Pawlenty, the last Republican to occupy Minnesota’s governor’s mansion. More importantly, it comes during an election year under the shadow of the Supreme Court’s looming decision to roll back Roe v. Wade and end the federal right to reproductive health care as we know it — a decision that would codify a regional trend that has already made Minnesota a de facto abortion oasis in a desert of states that provide few, if any accessible options for their own residents. To ban abortion in Minnesota, as the now-GOP endorsed Jensen/Birk campaign has promised to do, would not only deny crucial health care to residents of the state itself, but also to the millions of people in neighboring Wisconsin, Iowa, and the Dakotas, all of which have either total trigger bans or six-week bans ready to go into effect the moment Roe is repealed.

Its infamous, if dubious, reputation as a liberal haven notwithstanding, Minnesota’s status as an abortion oasis stems in no small part from a 1995 court ruling that established abortion as a state constitutional right. That case, Doe v. Gomez, puts Minnesota in the company of just a handful of other states with similar protections — which Jensen, like every other major Republican opponent he beat to become his party’s endorsed candidate, said he’d like to to strip away. (Minnesota’s Republican gubernatorial primary is in August, where Jensen is favored to emerge victorious.)

“I suppose we’re living in a bubble thinking that since we’re in Minnesota, abortion is protected,” Laurie Casey, executive director of the WE Health Clinic in Duluth, tells Mic, adding that “since the [SCOTUS Roe] leak we’re starting to think long-term too, and how it’ll actually affect us.”

As Casey explains, her clinic — which already bills itself as “the only abortion provider in Northern Minnesota, Northern Wisconsin, and the Upper Peninsula of Michigan” — has caught a glimpse of its post-Roe future, even before the Supreme Court has actually ruled. “We’re already seeing some of the effects with people traveling from other states, especially to the Twin Cities area, to have an abortion at those clinics down there,” Casey says. “And so then the people that come from out of state — they’re making it harder sometimes for the people in Minnesota ... to get an abortion because the wait time has increased.”

Casey says some people have made a four-hour drive across state lines to access abortion at the WE Health Clinic. “We are seeing people traveling [to Duluth] from the [Twin Cities] metro area and even the Eau Claire [Wisconsin] area,” she says, “because it’s sometimes up to a four- to six-week wait for them to get an abortion in Minneapolis.”

Even the concept of “regionality” is being examined and adjusted ahead of a Roe-less future. As Megan Peterson, the executive director of the St. Paul-based Gender Justice, tells Mic, Minnesota’s status as an abortion oasis is as much about access as it is proximity. “In the post-Roe abortion access landscape, ‘regions’ are both where people can drive to and where people can fly to,” Peterson explains. “The Minneapolis airport is a Delta hub, and there’s a lot of direct flights in, including from Texas, and we’ve already seen an increase in Texas patients in Minnesota.” She adds: “The Guttmacher Institute estimated last year that we could see a 300% increase [in overall travelers] coming into the state.” To put that in perspective, Minneapolis Department of Public Health data from 2020 showed just over 9,100 people received abortions that year, with approximately 10% coming from out of state for the procedure.

For some patients, the introduction of medication abortion has removed the necessity of travel altogether. That might help lessen the in-person burden on the few clinics that will remain open if Roe falls — but it opens up an entirely separate front for providers to manage as well. As Peterson explains, abortion access “isn’t gonna look the same as it did in the ‘60s because we do have drugs available to us now.”

Those drugs, particularly the 1-2 cocktail of mifepristone and misoprostol, have altered the landscape of reproductive health by offering a non-surgical, less logistically onerous option for ending a pregnancy at home rather than having to travel to a clinic. The WE Health Clinic began offering telehealth appointments for medication abortions, which are most effective for patients early in their pregnancies, last September. But Paulina Briggs, a laboratory supervisor and patient educator there, tells Mic that people from neighboring states have already begun finding workarounds to obtain the pills.

“You have to have a Minnesota mailing address and you have to be in Minnesota when you actually talk to the doctor for the telehealth visit,” Briggs explains. “But because we are a border state with Wisconsin, people that live near Duluth, like in Superior [Wisconsin] — they can drive over the bridge and sit in a parking lot and get the telehealth visit with the doctor.” If a patient doesn’t have a Minnesota address or P.O. box at which to receive the pills by mail, “they can come into the clinic and just pick up their medications,” she adds.

Crucially, it’s not just patients who might travel to Minnesota in greater numbers if Roe falls. North Dakota’s sole abortion provider, the Red River Clinic in Fargo, has reportedly started discussing plans to move just a few miles east to Moorehead, Minnesota, if the state’s trigger ban is activated. If the Red River Clinic doesn’t move, Planned Parenthood has vowed to start offering abortion procedures at its Moorehead site.

“I think some of the protesters will come from other states to target people accessing abortion care in Minnesota.”

For its part, WE Health Care is bracing for a surge of protesters outside their building if and when Minnesota becomes the region’s sole reproductive health care hub. Right now, there are about five to 15 protesters on a given day, but “if Minnesota becomes a destination for people, I think some of the protesters will come from other states to target people accessing abortion care in Minnesota,” Casey says.

Given the state’s outsize role in regional abortion access, it’s little wonder that Walz, the current governor, has placed reproductive rights front and center in the coming gubernatorial election against Jensen. “What happens in Minnesota this November will impact millions of women not just in our state, but in every border state that will lose access to safe and legal abortion if Roe v. Wade is overturned,” Walz told Mic in a statement. “I will never sign a ban on abortion, and I will keep anti-choice judges off our state Supreme Court. As long as I am governor, Minnesota will be a safe haven for reproductive rights.”

Jensen, meanwhile, is a licensed physician who told attendees at the state Republican convention that “I’ve never seen an abortion. I’ve never done an abortion, and I wouldn’t.” (Jensen’s campaign did not respond to a request for comment from Mic.)

For now, abortion rights activists aren’t just working to shore up the protections already on the books. They’re actively trying to expand them even further. Even with Gomez as Minnesota law, reproductive health care in the state is nevertheless curtailed by a number of onerous restrictions and requirements, from mandated reporting to the state to requiring minors seeking to terminate a pregnancy to notify both parents to forcing providers to inform patients about child support laws. There’s still plenty to do to bolster reproductive rights in Minnesota.

To that end, Peterson is hopeful that striking down Roe could mark an inflection point in the broader debate over abortion. “My hope is that part of what is a result of falling off this cliff is that we’re really able to undo what has felt like this intractable framework of what the abortion debate has been,” she says, adding that thus far we’ve been “stuck in this question of, ‘What do you believe or feel about abortion itself?’”

She hopes to instead change the debate to one of bodily autonomy and government overreach. “It’s not about whether abortion is right or wrong or your religious beliefs or feelings or personal circumstances or whatever,” she says. “It’s actually: Should the government be able to force you to stay pregnant? I think that if we can refocus the conversation there about politicians interfering, politicians deciding what’s best for you having power and control over your body, your most important life decision — a lot more people can find a space under that tent.”