Variation Among States In Insurance Coverage
Due to different federal and state restrictions, Medicaid coverage of abortion depends on where enrollees live.
- Medicaid is a federal-state partnership. Under the Hyde Amendment, federal Medicaid funds cannot be used for abortion except in cases of rape, incest or life endangerment. All state Medicaid programs must cover abortions under these circumstances states have the option to cover other abortions using their own funds.
- Thirty-three states and the District of Columbia follow the federal standard and only cover abortions in their Medicaid program in cases of rape, incest or life endangerment. One additional state, South Dakota, violates federal law by limiting public abortion coverage to cases of life endangerment.5
- As a result of these states policies, half of Medicaid-enrolled women of reproductive ageseven million womenare subject to the Hyde Amendments ban on abortion coverage.6
- The remaining 16 states use their own Medicaid funds to provide coverage that applies to most or all medically necessary abortions.7
Collaborative Strategies For Obtaining Reimbursement
Participants described broad, typically state-level interventions that increased their success in working with Medicaid. These interventions included both collective legal action and multipronged collaborative efforts.
Many participants said they reached out to national legal advocacy organizations when they first experienced problems working with Medicaid. Lawsuits against Medicaid for nonpayment that legal advocacy organizations filed on behalf of abortion providers were described as powerful and inspiring actions, often resulting in payment on current claims. One physician for an abortion clinic described the result of such a lawsuit: The judge told the Medicaid director, You will start paying for these.’ He said, Well OK, we’ll finally start paying up.’
However, some participants expressed ambivalence about participating in legal interventions out of concern that if they won, the victory would be temporary. An abortion clinic administrator said that after winning a lawsuit against Medicaid, she worried about future close scrutiny of the claims from the state. She asked, What if the state comes back in 2 years, and says, Well, you know, you have 10 of these that you signed on this particular woman, who you say was raped, and what proof do you have of that?’
Many participants pointed out that a legal intervention alone was not enough to improve access to funding. As an abortion clinic administrator explained,
Costs Associated With Abortion
Abortion can pose a heavy financial burden for low-income women.
- The cost of an abortion without insurance coverage is substantial: In 2014, the average cost of an abortionwhether surgical or medicalat 10 weeks of pregnancy was slightly more than $500. The median cost at 20 weeks was $1,195.9 In addition, patients often must pay out of pocket for additional nonmedical costs, such as transportation, child care and lodging.
- For a woman whose income is at the higher end of Medicaid eligibility in the states that adhere to the Hyde Amendment requirements, paying for an abortion at 10 weeks of pregnancy would take nearly a third of her monthly family income. An abortion at 20 weeks would take almost 90% of her monthly income.
- Many women and families are unable to handle an emergency expense of $500 or more. When U.S. adults were asked in a 2016 nationally representative survey how they would pay for a $400 emergency expense, more than 40% of respondents said that they would be unable to find the money or that they would only be able to cover the unexpected cost by borrowing money or selling something. One-quarter of adults reported having forgone health care in the previous year because of high cost.11
- Forty-one percent of abortion patients surveyed in six states in 2011 said it was somewhat or very difficult to pay for their care.12
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Bans On Public And Private Health Insurance Coverage In Nc
Anti-choice politicians in North Carolina enacted laws that prohibit both public and private insurers from including abortion coverage in their health plans, preventing many people from using health insurance to cover abortion care. Without insurance coverage, patients who choose an abortion are forced to bear the cost entirely on their own, despite having paid for health insurance. For North Carolinians of lower income, this may put the procedure financially out of reach or force them into unsafe situations .
While All Eyes Are On The Us Supreme Court We Must Remember That Pennsylvanias Constitution Explicitly Guarantees Equality On The Basis Of Sex And Prohibits Laws That Confer Different Burdens Or Benefits On Men And Women
Susan J. Frietsche, senior staff attorney at the Womens Law Project
Whole Womans Health v. Hellerstedt
The recent award-winning short film, Abortion Helpline, This is Lisa tells the gut-wrenching story of low-income women calling Pennsylvanias Womens Medical Fund seeking help to pay for abortion health care.
All my savings that I had are going towards my insulin and making sure my kid is set, said one caller, who had survived one life-threatening pregnancy already and had just lost her job. I have $100 and enough to cover my rent for this coming month.
But the counselor had only $19 left to give out that day, so she asked the caller to try again the next day, when she hoped more money would be available.
Since 1985, Pennsylvania has banned Medicaid insurance coverage for abortion with few exceptions, and low-income women have suffered. Unable to use their insurance for abortion health care, they have had to rely on private abortion funds that often cannot meet all callers needs.
Last Wednesday, Pennsylvania-based abortion providers and reproductive rights lawyers led by the Womens Law Project and Planned Parenthood Federation of America filed their brief in a lawsuitAllegheny Reproductive Health Center v. Pennsylvania Department of Human Servicesasking the states Supreme Court to strike down the Pennsylvania ban on Medicaid funding for abortion as a violation of the Equal Rights Amendment and equal protection provisions of the Pennsylvania Constitution.
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Where Patients Obtain Abortions
In 2017, there were 1,587 facilities providing abortion in the United States, representing a 5% decrease from the 1,671 facilities in 2014. Sixteen percent of facilities in 2017 were abortion clinics , 35% were nonspecialized clinics, 33% were hospitals and 16% were private physicians’ offices. Sixty percent of all abortions were provided at abortion clinics, 35% at nonspecialized clinics, 3% at hospitals and 1% at physicians’ offices.
There were 26 facilities providing abortion in North Carolina in 2017, and 14 of those were clinics. These numbers represent a 13% decline in clinics from 2014, when there were 37 abortion-providing facilities overall, of which 16 were clinics.
In 2017, 89% of U.S. counties had no clinics providing abortions. Some 38% of reproductive-age women lived in those counties and would have had to travel elsewhere to obtain an abortion. Of patients who had an abortion in 2014, one-third had to travel more than 25 miles one way to reach a facility.
In 2017, some 91% of North Carolina counties had no clinics that provided abortions, and 53% of North Carolina women lived in those counties.
How Are Abortions Paid For
If you have health insurance that covers abortion services and live in a state that allows for this coverage and the services, you can have an abortion procedure done and submit a claim for the costs through your insurance company.
The process for submitting abortion procedure claims is broadly similar to insurance claim submissions for other types of procedures, notes Martucci. What happens next the extent to which the insurer will review, verify, and reimburse your claim will vary significantly based on the company, the provider, and your plan.
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What Is Emerson Polling
The Polling Center at Emerson College, which is located in Boston, is a non-partisan organization dedicated to accurately reflect populations through public opinion research. Established 25 years ago in a classroom, Emerson College Polling in 2012 was moved into a polling center. Emerson College Polling conducts and publishes research related to voting trends, polling methodology and public policy.
Michael Hyland of WNCN contributed to this report.
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Find Cheap Health Insurance Quotes In Your Area
Furthermore, depending on the state that you live in, there may be laws that regulate whether abortion services are covered through Obamacare health insurance, Medicaid or under a private health care policy. Although there are coverage differences, every state does allow you some access to abortion, but you may need to pay for the service out-of-pocket.
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What Can I Do To Reduce Taxpayer Funding Of Abortions
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How Much Is An Out
Many women wonder if abortions are free. The answer is that abortions are not free not at Planned Parenthood or any other abortion clinics. In fact, abortion is a billion-dollar industry with an abortion procedure costing each client hundreds to thousands of dollars depending on the type of abortion and gestational age of the pregnancy. There are also many hidden costs you should be aware of before scheduling your abortion appointment.
Disparities In Unintended Pregnancy And Medicaid Coverage
Despite recent declines in unintended pregnancy across all groups, disparities still remain, in part as a result of long-standing systemic oppression and racial inequality. Low-income women and women of color are more likely than other groups to experience unintended pregnancy and abortionand women of color are more likely to rely on Medicaid.
- Women of color are more likely than white women to be low income and enrolled in Medicaid. In 2018, 31% of Black women and 27% of Hispanic women aged 1544 were enrolled in Medicaid, compared with 16% of white women.1
- Low-income women are more likely than more affluent women to have an unintended pregnancy. In 2011, the unintended pregnancy rate among women with an income below the federal poverty level was more than five times the rate among women with an income at or above 200% of the poverty level.3
- In addition to having elevated rates of unintended pregnancy, low-income women had 75% of U.S. abortions in 2014 49% of abortion patients that year had a family income less than 100% of the federal poverty level.4
- Women of color are much more likely than white women to experience unintended pregnancy. In 2011, Black and Hispanic women had an unintended pregnancy rate of 79 and 58 per 1,000 women, respectively, compared with a rate of 33 per 1,000 among white women.3
- Medicaid provides critical access to health care for low-income women. In 2018, 13 million women of reproductive age were enrolled in the program.1
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Do I Pay For Abortions
Yes, at least some. If you live in the United States, regardless of what state you live in, at least some of your tax dollars go to abortions. All Americans directly pay for at least some abortions through federal tax dollars. All Americans also help indirectly fund abortion through tax funding of abortion providers.
If you live in one of the states that cover abortions beyond the provisions of the Hyde Amendment, a much more significant portion of your tax dollars goes directly toward abortions. You also fund more abortions outside of cases such as rape or threat to the mothers life than if you live in one of the other states.
Paying For An Abortion Without Insurance
Planned Parenthood is one of the largest resources for family planning in the United States. Planned Parenthood professionals often charge less for services based on income. The center accepts major health insurance carriers. If you do not have insurance, you may qualify for a discounted fee scale under Title X. Planned Parenthood can also help you sign up for additional programs that can help pay for services such as the Family Planning Benefit Program or Medicaid.
Outside of Planned Parenthood assistance, you may qualify for coverage under your states Medicaid program to pay for services at an abortion clinic. Otherwise, you will likely need to pay out-of-pocket at the abortion clinic itself. There may be options available to you such as community health centers, depending on where you live.
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Abortion Costs In North Carolina
The specific cost of an abortion depends on the type of procedure and the size of the baby, which are based on gestational age. In addition the price rises as pregnancy progresses. Price also varies by provider. Clinics and private practice abortionists typically offer lower costs than hospitals. So lets go into greater detail and understand abortion costs in North Carolina.
Abortion costs in North Carolina
Prices may vary based on multiple factors including what state you live in and how your healthcare handles abortion. So important to find out what your state policies say about abortion. The typical costs of abortion in North Carolina are as follows below:
- Medication Abortion / Abortion Pill : $350-$650
- Suction Aspiration / Vacuum Abortion : $600-$1000
- Dilation and Curettage : $850-$1600
- Dilation and Evacuation : $1500-$2100
To find out how far along you are and the abortion procedure available for you, schedule a free and confidential appointment.
Now that you know abortion costs in North Carolina, if you find yourself considering abortion, your first step is an ultrasound. An ultrasound is important so that you can learn more about your pregnancy, the gestational age.
Do You Need Parental Permission For An Abortion In Nc
Patients under the age of 18 must have a parent accompany them or have a judicial bypass to obtain an abortion in NC. If you are a minor considering an abortion, please read about parental consent and notification laws that might apply in your state. Abortion services may be covered by your insurance.
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About Carolina Abortion Fund
The Carolina Abortion Fund believes that all people should be able to exercise reproductive self-determination, regardless of their income. CAF believes that abortion is healthcare, and healthcare should be well resourced and accessible to all.
Carolina Abortion Fund is a 501c3 nonprofit that was founded in 2011 by a group of clinic defenders who were tired of seeing patients delaying or cancelling their appointments just because they couldnât afford the full cost out of pocket. The Fund began distributing grants to assist people seeking abortion services in April 2012.
Elective Abortion Coverage Is Much More Common In States That Run Their Own Exchanges
Six statesOregon, New York, California, Washington, Illinois, and Mainerequire all state-regulated plans to cover abortion services. Oregon, Illinois, and Maine use HealthCare.gov, while New York, California, and Washington have fully state-run exchanges.
But although 26 states have laws that ban or restrict abortion coverage for plans sold in their health insurance exchanges, only two of those states have fully state-run exchanges. The other 24 all use HealthCare.gov. And its clear that abortion coverage is much more widely available in states that run their own exchanges.
As of 2021, there are 15 fully state-run exchanges , including DCs exchange. The other 36 states use HealthCare.gov.
In a new rule addressing billing procedures for abortion coverage , HHS noted that based on 2020 plan data :
- Across the 38 states that use HealthCare.gov, there were 23 insurers offering a total of 338 plans in nine states that provided coverage for non-Hyde abortion services .
- Across the 13 fully state-run exchanges, there were 71 insurers offering 1,129 plans in 12 states that provided coverage for non-Hyde abortion services .
- Roughly 3.04 million people were enrolled in on-exchange plans that included non-Hyde abortion coverage in 2019 .
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Does Medicaid Cover Abortions
This mainly depends on the US State you currently reside in. Today Medicaids coverage for abortion procedures is more and more limited by federal and state regulations as well as other insurance coverage regulations.
In many states, thousands of distressed women in need of abortion services dont get Medicaid coverage year in year out. Its so bad in some states that even when the pregnancy is deemed a threat to their life they still wont get coverage.
However, some US States go beyond and above these restrictions by the federal government and use State funds to pay for abortions for women enrolled in Medicaid.
