At what cost? How U.S. women pay for abortion services

Most U.S. women pay out of pocket for abortion care, at an average cost of $470. There is little information about how these women—most of whom are low-income—obtain the money. We examined data from a sample of 639 abortion patients at six clinics. Only 23% of patients used it to pay for the procedure, and those with Medicaid were more likely than those with private insurance to do so (45% vs. 24%). Most commonly, women with coverage were not using their insurance because abortion was not covered by their plan (46%) or they did not know if it was (29%); 12% indicated they didn't want to use their insurance (e.g., due to stigma). Forty-one percent of patients indicated it was somewhat or very difficult to pay for the procedure, and half had to rely on financial assistance. Some 31% reported that the man involved in the pregnancy helped pay, and patients were equally likely to indicate they received a discount, relied on an abortion fund or obtained assistance from a family member (10% each). The costs of accessing abortion services extended beyond paying for the procedure and included transportation (69%), lost wages (28%), childcare (12%) and travel (6%). To cover these expenses, a substantial minority, 33%, had to delay or forgo paying bills (30%), food (16%), rent (14%), (other) medical expenses (8%) or childcare (6%). Health care and logistical costs are a burden for women seeking abortion care, and insurance and other assistance are crucial to maintaining access.