142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

State-Level Policies on Insurance Coverage of Abortion: Impact of Current and Past Trends

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 9:15 AM - 9:30 AM

Adara Beamesderfer, B.S., MPHc , Women's Health Policy, Kaiser Family Foundation, Washington, DC
Usha Ranji, M.S. , Women's Health Policy, Kaiser Family Foundation, Menlo Park, CA
Alina Salganicoff, PhD , Women's Health Policy, Kaiser Family Foundation, Menlo Park, CA
Bans on private insurance coverage for abortion have received less attention than other well-publicized efforts to limit abortion access, especially over the last three years. This study tracks state actions on abortion coverage, delves into the political environment surrounding state legislation, and explores how these laws interact or interfere with abortion access in the individual markets and new Marketplaces.

Study Design

This qualitative study documents the enactment of state legislation affecting insurance coverage of abortion, resulting in a new timeline and state tabulation of the history of this effort. Additional research tracks related factors, including if legislation passed in response to federal or state action, state policies on ACA implementation, or previous state legislative initiatives.


This analysis finds that while many women will gain coverage as a result of the ACA, there will be wide variation in whether coverage includes abortion, depending on where women live. Initial findings suggest a strong overlap between states not expanding Medicaid and passage of the highest number of restrictive abortion insurance regulations. This results in extremely limited or no access to abortion services, disproportionately affecting low-income and currently uninsured women. 


Access to abortion already varies greatly between states, and legislation banning abortion coverage is another avenue for widening this gap. Women in states with more restrictive legislation could lose access to abortion services altogether. Comparing current trends and the role of previous legislation will provide policymakers and advocates a better understanding of the political environment surrounding enactment of policies affecting abortion access.

Learning Areas:

Public health or related public policy

Learning Objectives:
Identify the interaction between state laws restricting abortion and expanded access to insurance coverage through the Affordable Care Act (ACA). Identify differences between states that have and have not passed legislative bans on insurance coverage of abortion. Describe how bans on insurance coverage of abortion affects women’s access to services and variations between states.

Keyword(s): Abortion, Reproductive Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have co-authored a variety of reports focusing on women's access to health care services while at the Kaiser Family Foundation. Recent reports include "Coverage for Abortion Services and the ACA" and "Health and Access to Care and Coverage for LGBT Individuals in the US". Additionally, I am pursuing a Master in Public Health with a focus in health policy at the George Washington University in Washington, D.C.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3062.0: Abortion at the state level