At a time when conservative states are sharply limiting abortion access, California signaled a new frontier in abortion-rights on Friday with the passage of legislation that would require all public universities in the state to provide medication abortion on campus.
The bill, which would use money raised from private donors to equip and train campus health centers, grew out of a student-led movement at the University of California, Berkeley, and it has sparked the introduction of a similar bill in Massachusetts.
Anti-abortion groups say they are likely to challenge the legislation if Gov. Gavin Newsom signs it into law. He has a month to decide. A spokesman declined to say what he will do, but last year during his campaign for governor, Mr. Newsom said he supported a similar effort.
The bill would apply to 34 campuses throughout the state, with nearly 750,000 enrolled students — 11 under the umbrella of the University of California and 23 under the California State University system. A 2018 study estimated that hundreds of students at these schools seek medication abortion each month.
“We can show the rest of the country, especially while there’s these crazy abortion bans sweeping the country,” said Zoe Murray, 23, a recent graduate of University of California Santa Barbara, who sought a medication abortion from the student health center there when she was a sophomore, but had to go off campus. “Going to university is really stressful as is, and a lot of students are struggling financially, or like me, I was struggling with my mental health at the time.”
Under the bill, as of 2023, campus health centers would be required to offer medication abortion — a process that involves taking two types of pills, legally approved to terminate pregnancies that are within 10 weeks of gestation.
Private donations of about $10.3 million, which organizers say has already been raised, would be used to train staff at university health centers and to buy ultrasound machines. State law already requires that insurers cover the cost of abortion.
The two California higher education systems did not take a position on the bill. They raised concerns about whether they would have to bear costs for logistics, liability or security, which they might then pass on to students, and said they were working with legislators to address those.
The abortion pill method, approved by the Food and Drug Administration in 2000, now accounts for about a third of American abortions, and studies have shown it to be safe and effective in most cases. The F.D.A. requires that the first of the two drugs, mifepristone, be dispensed by a certified medical provider after a consultation, but women can then take one or both of the drugs at home.
Most campus health centers now provide gynecological exams and contraception, but refer students seeking abortions to outside clinics. Advocates for the bill argued that sending students off-campus for a process that typically involves medical visits before and after the medication was taken posed hurdles.
“The barriers are about economics and schedules and frankly also about stigma,” said Marj Plumb, campaign director of JustCARE. “It’s the idea that this procedure, which really is simple and really is safe, that there is something wrong that they had to go somewhere else to get this medicine.”
Opponents of the bill include the California Catholic Conference, whose president, Bishop Jaime Soto, last month urged Christians to “pray with me a novena to Our Lady of Guadalupe, patroness of unborn children, asking her powerful intercession to defeat this bill.”
Kristi Hamrick, a spokeswoman for Students for Life of America, said her organization called medication abortions “toilet bowl abortions,” adding that “at the rallies, we often bring toilet seats as a visual.” Her group contends that medication abortions are damaging to women’s health.
“We also are very concerned about the conscience rights of people — students whose fees will be used to underwrite these health centers,” she said.
A similar bill has been introduced in Massachusetts by State Representative Lindsay Sabadosa. “It feels like a very winnable fight,” she said.
The student health program at the University of Illinois Chicago, which has about 33,300 students, currently provides medication abortion.
“We’re their regular doctor, they don’t have to walk through protesters, there’s no stigma,” said Dr. Ariel Leifer, medical director of the university’s Family Medicine Center at University Village. “It works very well, they like doing it in the comfort of their own home, the pain is manageable, it’s private.”
Berkeley students, including Adiba Khan, organized Students United for Reproductive Justice in 2015 and began trying to get the university’s health services to provide medication abortions.
They were unsuccessful, but members of the Women’s Policy Institute, an activist-training program run by the Women’s Foundation of California, contacted the students about working on legislation.
A spokeswoman for Berkeley, Tami Cate, said, “The university did discuss the issue of medication abortion services with students and others, but it had not taken a position on the matter.”
A bill introduced in 2017 passed both chambers in 2018, but was vetoed by Gov. Jerry Brown, a Democrat, who said that because California has abortion clinics located, on average, five to seven miles from campuses, the bill was unnecessary. Mr. Newsom, then the lieutenant governor, said he would have signed the bill.
Activists on both sides of the abortion debate see California’s vote as a new step in national abortion-rights strategy.
Nick Reynosa, the Northern California coordinator of the anti-abortion Students for Life of America, described the bill as “a symbolic gesture to push back against the success of the pro-life movement.”
Ms. Murray said she believes the bill “is going to really change and begin to destigmatize abortion, so we can start to talk about our experiences openly with abortion and with pregnancy on campus.”