Restricting Medicaid abortion coverage forces some women to carry unwanted pregnancies

As we continue to fight for the future of abortion rights, it is critical for us to take a moment to acknowledge that many in the United States currently live without the ability to get abortion care. Prior Supreme Court decisions like Roe v. Wade and Whole Woman’s Health v. Hellerstedt have reaffirmed every person’s right to access abortion services, however, many obstacles — from laws designed to shut down abortion clinics to bans on insurance coverage — stand in the way of exercising that right.  

The right to decide when and whether to be a parent, as well as the ability to access reproductive health care — free of financial hardship — is in practice more of a privilege than a right.

{mosads}Since 2011, states have passed more than 400 restrictions and barriers that limit the ability of many from accessing reproductive health services. In the first six months of 2018 alone, 11 states enacted 22 new restrictions on abortion that force patients to delay care, punish people seeking abortion, and push care out of reach entirely for some.

Over the years these obstacles have had an unequal impact on women, people of color, low-income people, and young people. This disparity could not be more evident than in the case of abortion.While a significant number of women seek abortions each year, large proportions face financial and other barriers to access that make it challenging and sometimes impossible to get care.

People should be able to live, work, and make decisions about their health and future while considering their economic security, and research shows that how people feel about their economic situation is an important factor in how they plan their families.

Laws such as the Hyde Amendment, which prohibits Medicaid insurance coverage for abortion care with limited exceptions, interfere with the ability of those struggling to get by to steer their own life course by placing abortion care financially out of reach. Most women who have an abortion are low-income, and a majority pay out-of-pocket for their care — this unexpected and time-sensitive expense can mean forgoing food, not paying rent, or missing bills.

In fact, over half of the women in one study of abortion patients said the costs amounted to more than one-third of their personal monthly income. Shifting limited financial resources to cover the cost of an abortion may push women into debt and contribute to financial instability.

The evidence shows that restricting Medicaid coverage of abortion forces some women seeking an abortion to carry an unwanted pregnancy to term. Furthermore, the denial of this single health care service can set off a domino effect of poor social and economic outcomes for the woman and her family.

A woman who does not obtain a wanted abortion is more likely to subsequently live in poverty or stay with a violent intimate partner — placing her and her children at continued risk of violence. Research also shows that existing children of women unable to obtain an abortion have lower scores across all domains of child development than children of women who had a wanted abortion. The impact of being denied an abortion is further compounded by the fact that many states have few policies supportive of maternal and children’s health.

Ensuring that women can get insurance coverage for reproductive health care—such as birth control, pregnancy tests, prenatal care, and abortion—is an important part of ensuring that she has equal economic opportunities.

Every person has the right to make her own decisions about her body and her life. Lifting bans on Medicaid coverage for abortion is critical to exercising that right — and to ensuring justice and autonomy for all individuals, without discrimination.

Terri-Ann Thompson Ph.D. is an associate at Ibis Reproductive Health, a non-profit women’s health organization.