A new study out today in Health Affairs shows that state-funded health insurance coverage of abortion is a crucial factor in access, particularly for Black and Hispanic people and people in low-income communities. With federal funding of abortion prohibited in the United States, some states fund coverage of abortion via Medicaid, which is jointly funded by the federal government and states.
"The findings suggest that Medicaid has an essential role to play in guaranteeing reproductive autonomy and access to effective health care," said Michel Boudreaux, associate professor in the University of Maryland School of Public Health’s Department of Health Policy and Management. The study’s lead author, Taehyun Kim, was a doctoral student at the University of Maryland when she conducted the study.
The Hyde Amendment has prohibited federal funding for abortion care since 1978. Today 8.9 million people of reproductive age who use Medicaid live in states that do not cover abortion, according to KFF.
The study evaluated the impact of Illinois’ 2018 policy introducing state-funded Medicaid coverage for abortion, one of 17 states that covered abortion care in its Medicaid program as of March 2024. Researchers analyzed birth and abortion data from the Centers for Disease Control and Prevention between 2014 and 2021, comparing Illinois to 29 states that did not provide Medicaid coverage for abortions in the time period.
When Illinois introduced Medicaid coverage for abortion, the abortion rate increased by 2.4 per 1,000 women (18.2%) and births decreased by 1.7 per 1,000 women (2.8%). Decreases in birth rates were higher among Black and Hispanic people, people in low-income areas, and for people who lived closer to an abortion facility. All data used in this study predates the Supreme Court’s 2022 Dobbs decision taking away the constitutional right to abortion.
“As state policies evolve in a post-Dobbs context, Medicaid abortion coverage will continue to be a vital factor in reproductive access,” said Taehyun Kim, lead author and now a postdoctoral scholar at University of Wisconsin-Madison.
To request an interview with Dr. Boudreaux, please contact sph-comm@umd.edu
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This work was supported by the Ann G. Wiley Dissertation Fellowship at the University of Maryland and by a grant from the Society of Family Planning (Grant No. SFPRF16-ES4). Neither organization had involvement in the analysis and interpretation of the data, or in the decision to submit the article for publication. Co-author Jacqueline Ellison was supported by the National Institute on Minority Health and Health Disparities, National Institutes of Health (Grant No. K01MD020010).