Documenting the impact of the Hyde Amendment on women's abortion access

In 1976, Congress passed the federal Hyde Amendment, which prohibits the use of federal Medicaid funding for abortion except for women whose pregnancies are due to rape or incest, or are life endangering. States have the option of using their own funds to cover abortion care in broader circumstances, but only 17 currently do.

Since 2007, Ibis has conducted a number of studies investigating the impact of the Hyde Amendment on women and abortion providers. To date, we have completed three research projects: 1) In-depth interviews with abortion providers at 70 facilities in 15 states about their experiences obtaining Medicaid reimbursement for abortion care; 2) In-depth interviews with more than 70 low-income women in four states about their experiences obtaining and paying for abortion care; and 3) A “mystery caller” survey of Medicaid staff in 17 states assessing the information staff provide to women seeking abortion coverage.

Our research shows that most women who should qualify for Medicaid coverage of their abortion do not have the option to use Medicaid for abortion coverage because of three key challenges:

• Some uninsured women have difficulty enrolling in Medicaid.
• Even when insured, women face barriers in securing Medicaid coverage of abortion.
• It can be difficult for abortion providers to offer Medicaid clients abortion care.

These challenges force women to come up with money they do not have to pay for abortion care out-of-pocket, which can cause women to delay obtaining care while they look for financial resources, or force women to continue unwanted pregnancies.

At the same time that we documented the challenges to working with Medicaid, our research also points to many ways that stakeholders can help women access timely Medicaid coverage of abortion. Looking closely at the strategies put in place by women, advocates, and providers, we find that there are a number of effective policy, advocacy, and practice-based strategies that can help improve women’s access to timely abortion care. We outline these strategies in our Take Action guides aimed at providing women, abortion providers, advocates, and policymakers with a number of actions they can take to help expand access to Medicaid coverage of abortion

Finally, in response to the request of advocates, we have also completed a number of state-specific analyses of our research data. These analyses are designed to support the work of abortion providers and advocates looking to expand access to Medicaid coverage of abortion at the state level.