Women pay significant out-of-pocket costs for abortion care

Under the Affordable Care Act, millions of women in the United States will have increased access to public and private health insurance. However, any potential gains in women’s access to health insurance will be limited by federal and state restrictions on coverage for abortion care. Even though an estimated 30% of U.S. women will have an abortion by age 45, longstanding restrictions limit the use of federal Medicaid funds for the procedure, and new restrictions limit private insurance coverage for abortion care.

New research from the UCSF Bixby Center reveals that due to these restrictions, many women pay substantial out-of-pocket costs for abortion care. Based on interviews with women visiting 30 abortion clinics nationwide, the researchers found that:

• Twenty-nine percent paid the full cost out-of-pocket.
• Two-thirds (71%) received some financial assistance in covering the cost of an abortion, mainly state Medicaid (34%) and other organizations (29%).
• Even with financial assistance, most women had some out-of- pocket costs for abortion. Out-of-pocket costs for abortion paid by the woman, family, or friends ranged from $0 to $3,700, with an average of $474.
• For more than half of the study participants, total out-of-pocket costs (including abortion and travel) were more than one-third of their monthly income.
• More than half of women (54%) reported that raising money for an abortion delayed obtaining care.

There are significant gaps in the system for providing financial assistance, insurance and Medicaid coverage for abortion care. New state-level laws further restricting insurance coverage for abortion will only exacerbate existing challenges. The researchers call for studies to examine how new restrictions on private insurance coverage for abortion burden women seeking safe reproductive health care.