Nevada achieved a major victory for reproductive freedom this year when a court ruled that the state’s Medicaid program must cover the cost of abortion — a move that will expand access to abortion for hundreds of thousands of low-income residents who rely on the program. Medicaid, which covers a wide range of health services, has been banned from paying for nearly all abortions in the state, despite the fact that abortion is legal in Nevada. This puts necessary reproductive health care out of reach for Nevadans who cannot afford to pay the full price out of pocket, making their right to an abortion a right in name only.

It’s also illegal. Under the Equal Rights Amendment — the constitutional amendment overwhelmingly approved by Nevada voters in 2022 — all residents, regardless of race, creed, sex, and more, cannot be denied equality under the law. Silver State Hope Fund and the American Civil Liberties Union sued, arguing that by specifically excluding abortion from the list of approved Medicaid services, the government was discriminating on the basis of sex. A state court agreed, ordering Nevada to start covering abortions through Medicaid, just as 18 other states already do.

Now, many Nevadans — regardless of how much money they make — will have the opportunity to make their own reproductive health decisions and receive the care they need. While this ruling is a huge win for Nevadans, much more is needed to ensure abortion access for all. It’s time our lawmakers catch up to Nevadans and make legal, accessible, and affordable abortion care a top priority, including financial resources for local funds.

Since the Supreme Court struck down Roe v. Wade two years ago, we’ve seen horror stories come out of states with abortion bans, from patients being forced to carry pregnancies to term against their will to hospitals refusing to provide stabilizing emergency care, including abortion, for fear of being prosecuted.

Even though abortion remained legal in Nevada, we’ve still felt the impact. As abortion bans cropped up in states across the country, including in neighboring states such as Idaho, Utah and Arizona, demand for abortion services in Nevada has skyrocketed, straining our health systems and increasing wait times.

However, it wasn’t just the overturning of Roe that put abortion out of reach for so many in our state. Nevada’s ban on Medicaid coverage for abortion had long effectively barred low-income people from accessing abortion. The Supreme Court’s decision has been a disaster, but it didn’t start the problem. There’s so much more our state can do to bolster our reproductive care infrastructure and catch up state policy with the views of Nevadans. That’s why it was so important that Nevadans made our views clear in 2022 by approving the Equal Rights Amendment — without it, the Medicaid ban on abortion would likely still be in effect.

I’m a third-generation Nevadan fighting for our reproductive rights, just like my grandmother did before the landmark Roe ruling. When my daughter heard that Roe was struck down, she felt angry, sad and hopeless. I felt those things, too, but I also thought of all the people in our state who would be hurting because of this sea change. I knew this was a time for action, so I told her, “Today we can cry, but tomorrow we fight.”

I soon took the reins of the Silver State Hope Fund, a donor-supported fund that works to cover the cost of abortion for Nevadans who need financial help. It’s important work, as most of our clients don’t even have $100 of disposable income to put toward the many costs associated with reproductive health, such as travel and lodging, child care and medical fees. Ensuring that people have the resources they need to access abortion is the only way we can live up to Nevada’s values of freedom, safety and prosperity.

Choosing to get an abortion is often one of the most consequential decisions a person can make, and for someone’s entire life trajectory to be altered because they don’t have a few hundred extra dollars is heartbreaking and simply against the ideals of equality and progress. Paying for abortions saves lives, and while we at Silver State Hope Fund do what we can, we can’t fill the void of an entire state health plan. Nevada Medicaid coverage for abortion is such a big deal because now we have a shot at ensuring abortion is actually accessible to all.

Erin Bilbray is the executive director of Silver State Hope Fund, a nonprofit that provides funding for people to obtain abortions. She lives in Las Vegas and unsuccessfully ran for the Congressional District 3 seat in 2014 as a Democrat.

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