The impact of state Medicaid coverage of abortion on people accessing care in three states.

Autor: Heil SKR; American Institutes for Research®, Health Program, Crystal City, Virginia, USA., Caglayan K; American Institutes for Research®, Health Program, Crystal City, Virginia, USA., Castillo G; American Institutes for Research®, Health Program, Crystal City, Virginia, USA., Valenzuela-Mendez C; American Institutes for Research®, Health Program, Crystal City, Virginia, USA., Lankford CM; American Institutes for Research®, Health Program, Crystal City, Virginia, USA., Sgro G; American Institutes for Research®, Health Program, Crystal City, Virginia, USA., Yang M; American Institutes for Research®, Health Program, Crystal City, Virginia, USA., Downing L; American Institutes for Research®, Health Program, Crystal City, Virginia, USA., Bhalla M; American Institutes for Research®, Health Program, Crystal City, Virginia, USA., Davis SM; American Institutes for Research®, Health Program, Crystal City, Virginia, USA.
Jazyk: angličtina
Zdroj: Perspectives on sexual and reproductive health [Perspect Sex Reprod Health] 2024 Sep; Vol. 56 (3), pp. 255-268. Date of Electronic Publication: 2024 Jul 29.
DOI: 10.1111/psrh.12275
Abstrakt: Context: Medicaid is a major funder of reproductive health services, including family planning and pregnancy-related care, especially for people with limited income and people of color. Federal Medicaid funds cannot be used for abortion however 16 states allow state Medicaid funds to pay for abortion. In recent years, Illinois and Maine implemented, and West Virginia discontinued, state Medicaid coverage of abortion.
Methodology: With retrospective procedure- and patient-level data obtained from clinics in these three states, we used an interrupted time series design, multivariable regression models, and descriptive statistics to assess changes in procedure volume and patients' share of total procedure price (patient price).
Results: In Maine and Illinois, implementing state Medicaid coverage of abortion contributed to an immediate overall increase in abortion access (as seen by a rise in monthly procedure volume at the time of the policy's implementation), a decrease in patient price (by 36% in Maine and 44% in Illinois) after policy implementation as compared to pre-implementation, and overall improved access among people of color. Conversely, when West Virginia discontinued coverage, access to care decreased, patient price increased by 130%, and the share of abortion procedures among people of color decreased.
Conclusions: In the fragmented abortion access landscape of the post-Roe era, our study provides new evidence that financial assistance offered through state Medicaid policies that cover abortion may be most helpful to those facing traditional structural inequities to access, while discontinuation of Medicaid coverage of abortion further burdens those already economically marginalized.
(© 2024 American Institutes for Research. Perspectives on Sexual and Reproductive Health published by Wiley Periodicals LLC on behalf of University of Ottawa.)
Databáze: MEDLINE
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