Does Medicaid coverage matter? an investigation of how different Medicaid abortion coverage policies impact women and providers

Background: The Hyde Amendment largely prohibits the use of federal funds for abortion. States have the option to use their own funds to cover abortion, but most states do not. Methods: In order to compare how state Medicaid abortion policies impact low-income women and abortion providers we conducted 1) interviews with 98 low-income women who have had abortions in five states, 2) interviews with abortion providers representing 70 practices in 15 states, and 3) a mystery caller evaluation of Medicaid staff in 17 states. Data was collected from states with both broad and restrictive Medicaid abortion coverage policies. Results: Women and providers both have dramatically different experiences with abortion care in states that cover abortion care compared to states that do not. Restrictive coverage policies appear to have a number of negative impacts including: making it harder to access accurate information about coverage, increasing the difficulty of women implementing informed abortion decisions, impeding women's goals and life plans, and forcing women to take measures to raise money for an abortion that put their health and wellbeing at risk. Restrictive coverage policies also increase the difficulty of providing abortion and decrease providers' abilities and willingness to work with Medicaid. State funding of abortion eliminates most of these challenges and facilitates women's access to abortion and providers' abilities to offer care.

Conclusion: Policies that impede access to affordable abortion care have a number of detrimental impacts on both women seeking abortion and health care providers offering care.