Abortion is a basic, safe health care service that should be affordable and accessible for all people. One in four people capable of getting pregnant will have an abortion in their lifetime. Despite the undeniable need, a patchwork of state abortion bans and federal restrictions mean that where you live often determines your ability to reliably access abortion care. This is particularly true for Medicaid enrollees, as the Hyde Amendment, a budget rider that prohibits most federal funding for abortion coverage, functions as a de facto abortion ban for many of the 13.5 million women of reproductive age enrolled in Medicaid in states that do not use their own funding to cover abortions.*
Multiple studies indicate that the inability to afford abortion care places pregnant individuals further into poverty and harms their health as well as the wellbeing of their current and future children.
Many people lack the means and access to decide whether to continue a pregnancy. Limits on federal funding for abortions cause significant harm to people with low incomes, in particular Black, Indigenous, and other people of color, LGTBQI+ individuals, disabled people, young people, and residents of rural areas. The harm of these structural barriers to accessing abortion care have been worsened by the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization in June of 2022, which eliminated the constitutional right to abortion. Now more than ever, a person’s ability to access abortion often depends on their income and zip code – and Medicaid enrollees are often the least equipped to deal with the unexpected costs associated with seeking an abortion in the current landscape. Comprehensive insurance coverage of abortion is one of the most crucial factors in rebuilding an equitable abortion access landscape.
Abortion is health care. Period. Beyond improving affordable access to care, insurance coverage is crucial to normalizing abortion as the basic health care service that it is. The National Health Law Program works at every level to protect access to the full range of essential reproductive health services, including abortion, in Medicaid, the Affordable Care Act (ACA) Marketplaces, and private insurance.
*The National Health Law Program occasionally uses the terms “women” or “woman” as well as other gendered language where the research data or laws cited use those specific terms. NHeLP recognizes that people of all genders, gender identities, and expressions require access to abortion and we have tried to otherwise limit our use of gendered language where possible.
