Will State Or Government Insurance Cover My Abortion
The information provided on this site is intended to provide a general overview of Medicaid specifically for abortion coverage. To maintain this page, we gather information from government websites and from the experience of abortion fund activists. This information changes often, sometimes quickly. If in doubt, check with the Medicaid office in your state or call a community health center for specific information.
State or government insurance is called Medicaid. Medicaid covers all or most medically necessary abortion in 16 states in the U.S. If you live in one of the states below, click on the state name to be taken to the stateâs Medicaid/Health and Human Services website for some instructions about how to enroll in Medicaid quickly. If you want to use Medicaid to cover your abortion, you must live in and have your abortion in the same state. Your Medicaid coverage will not follow you if you need to travel out of state.
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How to apply for Apple Health, Washingtonâs Medicaid program.
Here are some things you need to know about applying for Medicaid:
If you do not live in one of these 16 states or if you arenât enrolled in Medicaid, Medicaid will not cover your abortion, except in cases of rape, incest and life endangerment*. However, many clinics offer discounts for people who are enrolled in Medicaid.
Helpful Information
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
States Where The Future Of Abortion Access Is Unclear
Arizona: A 15-week abortion ban signed by Republican Gov. Doug Ducey went into effect in September 2022. However, the state also has a pre-statehood law still on the books that would ban all abortions except for cases where the mother’s life is in jeopardy. After a lower court allowed enforcement of that 1864 law on Sept. 23, the state’s largest provider of the service sued and an appeals court blocked it from being enacted. Arizona’s attorney general has agreed not to try enforce the near total ban while the case plays out in the courts. Also in play is a personhood law that raised fears by providers that they could face charges under that law before a federal judge blocked it in July.
Indiana: Abortion in Indiana is currently legal up to about 22 weeks, with some provisions for medical emergencies. To obtain an abortion, patients must undergo an 18-hour waiting period, medical providers have to tell patients about the risks involved in abortion and must say the fetus can feel pain around 20 weeks, a claim that is disputed in the medical community. However, the state’s Republican-controlled legislature passed a new law after Roe v. Wade was overturned, banning all abortions except in cases of rape, incest, fatal fetal anomaly or life endangerment. The state’s Supreme Court blocked it from being enacted and agreed to take the case, scheduling an oral argument for January.
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Some Gop States Extend Medicaid Coverage For New Moms Amid Abortion Debate
A growing number of GOP-led states are expanding Medicaid coverage to new moms at the same time as they seek to ban or limit access to abortions.
Florida, Tennessee and South Carolina are among the states that are temporarily allowing low-income women to remain enrolled in Medicaid for up to 12 months after childbirth, instead of only the 60 days that federal law requires. They are taking advantage of a measure in the American Rescue Plan Act, which Congress passed in March 2021, that provides federal matching funds for the extended coverage for five years and makes it easier to apply for federal approval to offer it.
They are also among the 12 states that have yet to expand Medicaid to all low-income adults under the Affordable Care Act.
Other states including Democrat-led California, Oregon and Kentucky are also extending Medicaid enrollment for new moms. An estimated 164,000 women in these six states will benefit from the longer coverage period, according to the Centers for Medicare and Medicaid Services.
So far, 11 states have extended postpartum coverage to 12 months, and the agency is working with several other states.
If all states do so, as many as 720,000 women could be guaranteed postpartum health insurance for 12 months. Medicaid, which is generally available to pregnant women with somewhat higher incomes than other adults, covers 42% of births.
States Where Abortion Access Is Currently Protected
Alaska: The Alaska Supreme Court has interpreted the right to privacy in the state constitution as encompassing abortion rights. Recent efforts to advance a constitutional amendment through the Legislature to do away with that interpretation have been unsuccessful.
California: Abortion will remain legal in California prior to the viability of a fetus. Democratic Gov. Gavin Newsom has vowed to make California a sanctuary for women who live in other states where abortion is outlawed or severely restricted.
Colorado: Abortion is legal in Colorado at all stages of pregnancy. There are no term restrictions as to when a pregnancy can be terminated and repeated legislative attempts by Republicans to restrict or abolish the procedure have failed.
Connecticut: The state passed a law in 1990 giving women the legal right to abortion. It affirmed a womans unqualified right to an abortion prior to viability of the fetus, as well as later-term abortions necessary to preserve the life and health of the pregnant woman. The law also repealed state laws predating Roe v. Wade that had made it a felony to have an abortion or to perform one and required that patients under 16 receive counseling about their options.
Hawaii: Hawaii legalized abortion in 1970, when it became the first state in the nation to allow the procedure at a womans request. The state allows abortion until a fetus would be viable outside the womb. After that, its legal if a patients life or health is in danger.
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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 .
Paying For An Abortion
Your ability to pay shouldn’t impact your decision. Your abortion may be free or low cost if you have health insurance. The cost of an abortion may vary depending on your provider.
- HUSKY Health:The Connecticut Medicaid plan covers abortion services for people enrolled in HUSKY, in our state.
- If you have other health insurance plans, including Medicaid plans from other states, your plan may or may not pay for abortion services. Please check with your health insurance provider or Medicaid agency to get answers to your questions about paying for abortion services.
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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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Health Dept Proposes New Requirements For Medicaid Abortion Coverage
This story is excerpted from the MT Lowdown, a weekly newsletter digest containing original reporting and analysis published every Friday.
MTFP obtained a copy of a proposed rule change from the Department of Public Health and Human Services that would add layers of red tape for low-income Montanans seeking Medicaid coverage for abortions and prohibit nurse practitioners and physician assistants from billing Medicaid for those services. By Friday, it was posted publicly along with information about its upcoming Jan. 12 hearing.
You might be scratching your head doesnt something called the Hyde Amendment prohibit the use of federal funds for most abortions? Thats correct. But Montana is one of 16 states that requires its own Medicaid programs i.e., state funds to cover all or most abortions if the procedures are deemed medically necessary. Thats been the policy here ever since a 1995 court ruling in Jeannette R. v Ellery.
Planned Parenthood of Montana CEO and President Martha Fuller said in a Thursday phone interview that the new rule would force people to have abortion later in pregnancy by adding hurdles to a time-sensitive procedure.
Its another attempt to keep people from accessing those services, Fuller said.
In a statement Friday, health department Director Charlie Brereton said the state agency must ensure that abortions paid for by Montana taxpayers under Medicaid are truly medically necessary, in accordance with the law.
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States With ‘fetal Heartbeat’ Laws Or Restrictions Before Viability
Florida: The state’s new 15-week ban went into effect on July 1, 2022. The law makes exceptions if the procedure is necessary to save the mothers life, prevent serious injury or if the fetus has a fatal abnormality. It does not allow for exemptions in cases where pregnancies were caused by rape or incest. Violators could face up to five years in prison. Physicians and other medical professionals could lose their licenses and face administrative fines of $10,000 for each violation. The law is the subject of an ongoing lawsuit from abortion providers but remains in effect.
Georgia: A law passed in 2019 that bans most abortions after about six weeks of pregnancy, when fetal cardiac activity can be detected, took effect on Nov. 15, 2022 following a ruling the state’s Supreme Court which allowed it to be enforced. The law also declares a fetus a person for purposes including income tax deductions and child support. There are exceptions in cases of rape if a police report is filed and incest. There are exceptions if a womans life or health would be threatened. However, clinics in the state are currently not offering abortions.
Limiting Access To Abortion
Several of the states that have extended postpartum coverage or are looking to do so also plan to ban or curtail access to abortion. Some health experts worry that further abortion restrictions could worsen maternal mortality.
A draft Supreme Court opinion leaked last month shows that a majority of justices planned to vote to overturn Roe v. Wades holding of a federal constitutional right to an abortion. If that turns out to be the final opinion, it would be left up to states to determine their abortion policies 22 states have laws that could be used to restrict abortions, according to the Guttmacher Institute, which supports abortion access.
Some states see the Medicaid extension measure as an option to help women after they give birth.
Tennessee Gov. Bill Lee, a Republican, said last month that there is a way to protect unborn children and provide aid to new mothers.
Its also important that we recognize that women in crisis need support and assistance through this process. For example, thats why weve expanded our postpartum coverage for women in TennCare, Lee said in a May news conference, referring to the state Medicaid program.
States likely have a variety of motivations behind extending coverage, said Sarah Gordon, assistant professor at Boston Universitys School of Public Health and co-director of the BUMedicaid Policy Lab. It only requires adding 10 months of enrollment for five years to a relatively low-cost group of residents.
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Ny State Of Health Annual Open Enrollment Period To Remain Open For Duration Of Public Health Emergency Expanded Tax Credits And Financial Assistance Continues Into 2023
The annual Open Enrollment Period for NY State of Health, the Official Health Plan Marketplace , is currently underway for New Yorkers seeking to enroll in a low-cost, quality health insurance plan. NY State of Health is now open for enrollment in Qualified Health Plans throughout every county, with free help from in-person certified enrollment assistors New York State .
NY State of Health offers QHPs from 12 different insurers in 2023, available in four metal tiers: platinum, gold, silver, and bronze, as well as catastrophic coverage. Eligible consumers may also enroll in the Essential Plan, Medicaid or Child Health Plus, which are open all year. All plans through the Marketplace provide free preventive care, such as routine office visits and recommended screenings. They also cover provider visits, hospital stays, emergency care, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services, chronic disease management and pediatric dental and vision.
State Actions That Restrict Access To Medicaid
Medicaid, the largest source of public funding for family planning services, has long been barred by the Hyde Amendment from covering abortion, except in very limited circumstances. But longstanding federal law requires states to cover family planning services in their basic Medicaid programs and allows states to provide Medicaid-financed family planningonly coverage for low-income individuals who do not qualify for full Medicaid. Under both types of coverage, the federal free choice provision guarantees Medicaid enrollees the right to receive family planning services from any willing and qualified provider.1
Notwithstanding this right, some states have excluded providers that offer abortion services from participating in Medicaid, even though these providers are sometimes the largest, or only, local provider of comprehensive family planning services. By seeking to exclude providers that offer abortions outsidethe Medicaid program, these actions jeopardize womens access to essential family planning and preventive health services withinMedicaid. States have pursued three primary strategies to exclude providers, emboldened by supportive actions from the Trump administration.
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Abortion Coverage Under Medicaid
Executive Summary
This Q& A provides an overview of how the federal government and states cover abortion under Medicaid. The Q& As Appendix provides a chart looking at every states coverage, including links to certification forms and state policies.
While federal Medicaid funding for abortion is severely constrained, it is not completely unavailable. Thirty-four states and the District of Columbia follow the federal standard and provide abortions in cases of life endangerment, rape, and incest.
This Q& A explains why federal Medicaid funding is limited, and its exceptions and how they work.
How To Pay For An Abortion
Health care clinics and providers can help you determine if you have insurance coverage and if abortion benefits are included in that coverage. They can also help you find out if you are eligible for a state program or help you find other ways to pay for your abortion.
We suggest you call the clinic youre interested in and:
- Let them know if you are unsure of how to pay or unsure of your insurance status. They can help you understand your coverage, the cost of service, and if help is available.
- Let them know if you have concerns about confidentiality. They can help you keep your information private.
Private Insurance
State law requires all state-regulated plans to cover abortions if they cover maternity services.
If your health coverage is through a Providence Health Plan purchased through the Washington State Health Benefit Exchange or a Providence Large Group Health Plan provided through a Washington State employer, the Department of Health will pay for your abortion services. See our Increasing Access to Reproductive Choice page for specifics on how to obtain this coverage.
State Programs
Washington State provides abortion coverage for people who meet eligibility requirements.
Other Assistance
If you are not eligible for Apple Health and do not have private health insurance, you might qualify for assistance from a clinic or the Northwest Abortion Access Fund. We encourage you to discuss your situation with an abortion provider.
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