Prop Plane Pilots Are Airlifting Patients Out of Abortion Deserts

The patient’s first two appointments were canceled. When Oklahoma’s governor signed the nation’s strictest abortion ban into law on May 26, her third appointment was moved from a Planned Parenthood in Oklahoma City to the closest clinic with an appointment roughly a 10-hour round trip drive away, in Kansas. (The local chapter, Planned Parenthood Great Plains, covers four states — Missouri, Kansas, Oklahoma and Arkansas — and books patients across all four.) “It was a goddamn mess,” says Alison Dreith, director of strategic partnerships at Midwest Access Coalition, a Chicago-based abortion fund.

A companion managed to book a rental car and get the patient to the third appointment, where she expected to have a medication abortion. “When she got to Kansas,” Dreith says, “She was too far along for them to do a medication abortion. They rescheduled her because they didn’t have appointments that day for a surgical… which pissed me the fuck off because you had this person come all the way from Oklahoma, and now you’re turning them around?”

Midwest Access Coalition was ready to reimburse the patient for a second rental car so she could make the return trip to Kansas, but then her companion bailed. The patient, old enough in the state’s eyes to be forced to carry her unwanted pregnancy to term, was not old enough to rent a car. “She could not get a rental car, so she was freaking out,” Dreith recalls.That’s when Drieth turned to Mike, a volunteer with Midwest Access Coalition who’d been quietly preparing for a moment like this one for several months.

A soft-spoken Midwesterner, Mike (whom Rolling Stone has agreed to only identify by his first name to protect his identity) has been an amateur pilot for more than a decade. It’s an expensive pastime; pilots like himself, he says “sometimes do what we call the $100 hamburger, where we’ll fly from our home airport to a nearby airport that has a restaurant” just to have lunch. After Donald Trump’s election in 2016, Mike started thinking about how he could put his pilot’s license to better use. Last fall, around the time Texas’ abortion snitch law went into effect, he floated the idea of airlifting patients out of abortion deserts to his colleagues at MAC. “I’ve been in this work for about 15 years,” Drieth says, “and it’s one of the few really innovative solutions I’ve heard of.”

Small propeller planes offer several advantages to a patient seeking abortion care in post-Roe America: They can pick you up at any of the regional airports found in virtually every county in America, ferry you across state lines, and return you home within a few hours. In an era in which zealous state legislatures are contemplating laws that would criminalize helping patients travel to recieve abortion care, flying private has another advantage: no flight manifests. “There’s no TSA security,” Mike says. “Nobody’s asking you who you are, why you’re there at the airport. It’s as private as you can get, about as safe as you can get without having to sit down on an airplane with a whole bunch of people.”

Last year, Mike reached out to Air Care Alliance, an umbrella organization for nonprofits run by volunteer pilots who lend their equipment and experiences to, for example, airlift supplies or assist evacuations during natural disasters. They connected Mike with another pilot who was interested in the same work. In April, they incorporated as Elevated Access, a coalition of volunteer pilots who are making themselves and their planes available to help transport patients in need of abortion or gender-affirming care to states where they can get those services.

Elevated Access’s website went live on a Friday. That Monday, a draft of the Supreme Court’s decision overturning Roe leaked. In the weeks since, more than 200 pilots have applied to volunteer with Elevated Access. The group is now vetting each one, a process that includes inspecting their flying credentials, their social media accounts, and conducting interviews with two references. “We also ask for some personal statements about their beliefs around abortion and gender-affirming care,” Mike says. Once a volunteer pilot makes it through the vetting process — 67 of them have so far — he or she may be contacted when a patient in need of transportation approaches a nearby abortion fund for help.

The chaos unleashed by the court’s decision last week is likely to increase demand for their services as patients in states where abortion is now banned are scrambling to find appointments in neighboring states and transport to those appointments over longer distances. Drieth is seeing it happen: two weeks ago, a client in Iowa was left in the lurch when the state supreme court abruptly struck down abortion protections: “The Lyft was enroute to pick her up when she called me and said Planned Parenthood just called and canceled her appointment.” Drieth was able to find a new appointment for her in Minnesota, but she doesn’t know if the client, who has since stopped communicating, will end up using it.

Flying private would make sense for that client, if she resurfaces, but it doesn’t make sense in every instance. If, for example, someone in metropolitan Austin needs to fly to an appointment in a city like Denver, it’s much quicker and less expensive to fly commercial. Elevated Access is likely to be most useful for patients located in rural areas — like, for instance, Cameron County, Texas, 680 miles from the closest clinic in New Mexico — or anti-abortion states surrounded by other anti-abortion states, like Louisiana, where the median to the nearst clinic is 539 miles away. Or between two major cities with no direct flights, like Oklahoma City and Kansas City.

“This isn’t a nonprofit that’s set up to use every day,” Drieth says. “It is for those cases where I have done everything in my power to get them reasonable accommodations for their travel, whether it be a volunteer driver, a commercial airplane, a bus ticket, a train ticket, an Uber, Lyft, whatever — I’ve looked into all those resources and either the cost is too great, or the duration of time someone would have to travel is so egregious.”

The second trip to Kansas was shorter than the first: the flight time was roughly three hours total, instead of the ten it would have taken to drive. The fuel cost for the four-seat, single-engine propeller plane was somewhere between $500 and $600, as opposed to more than $1,000 Drieth calculated it would have cost for a two-leg commercial flight and the overnight lodging that would have been necessary because of the airline’s flight schedule. (The fuel cost for an Elevated Access flight is borne entirely by the pilot at this time. The group has filed paperwork to be recognized as a 501c3 by the FAA, which would allow their pilots to deduct the cost or be reimbursed. It is waiting on approval.)

None of this is ideal. For all the advantages of light aircraft travel, it still takes a huge amount of courage to board a small propeller plane with a virtual stranger and fly across state lines to receive routine medical care. But it is a practical solution to a problem — a problem that in any reasonable society wouldn’t exist at all. A problem that would have been unimaginable even just six years ago.

“Unfortunately, in practical support for abortion care, in this moment, we are all giving up a little bit of control,” Drieth says. “We’re all relying on each other. People are so desperate to get the care that they need and want and deserve that they’ll, you know, do a lot of things to access that care.”

Mike appreciates that. Even as he is working hard to scale Elevated Access up to meet demand in a post-Roe America, he hopes his organization becomes obsolete as quickly as possible. “Long term vision is: we don’t exist,” he says.

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