Several legislative policies restrict insurance coverage of abortion, forcing people—many of whom are working to make ends meet—to pay out-of-pocket for a safe, legal, and essential health care service. For example, the Hyde Amendment prohibits the use of federal funds to cover abortion for Medicaid recipients, unless their pregnancies are due to rape or incest or are life endangering. States can use their own funds to cover abortion care for Medicaid recipients and can even require private plans to cover abortion, but most states have declined to implement either or both options. Given that a significant proportion of abortion patients earn low incomes and have some type of health insurance plan, insurance coverage plays a key role in the decision-making process when a person is considering abortion.
For over a decade, Ibis has been examining the extent to which insurance coverage of abortion impacts access and provision of services by:
- Examining the experience of abortion seekers and providers in states that use their own funds to cover abortion
- Understanding the impact of reimbursement for abortion
- Examining the financial impacts of out-of-pocket costs
- Understanding the impact of financial and logistical supports on the abortion experience
- Documenting the abortion experience of populations who may be prohibited from using insurance to cover their abortion
Our research shows that abortion providers face challenges filing claims with Medicaid and that misinformation and burdensome requirements prevent many who could use Medicaid to cover their abortion from doing so. Further, paying out-of-pocket for an abortion can be financially catastrophic to a household. In the cases when abortion is covered, reimbursement rates are low and vary widely across the United States. Ultimately, the harmful impacts of federal and state restrictions on insurance coverage assert the need for policies that create or improve health care safety nets to guarantee abortion care for all individuals, regardless of their income or insurance status.