State Medicaid Coverage of Medically Necessary Abortions and Severe Maternal Morbidity and Maternal Mortality

Jarlenski, Marian; Hutcheon, Jennifer A.; Bodnar, Lisa M.; Simhan, Hyagriv N.

doi:10.1097/aog.0000000000001982

Cited by 14 publications

(12 citation statements)

References 17 publications

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“…Since 2009, researchers have continued to study impacts of restricted Medicaid funding for abortion. Methodologically sophisticated studies have documented Medicaid funding restrictions’ impact on maternal morbidity and infant mortality [10, 11]. Other research examined women’s and provider’s experiences with Medicaid coverage and found that, even when Medicaid can pay for abortion, it sometimes does not, leading to delays and financial and emotional impacts on women obtaining abortions [8, 12–15].…”

Section: Introductionmentioning

confidence: 99%

Estimating the proportion of Medicaid-eligible pregnant women in Louisiana who do not get abortions when Medicaid does not cover abortion

Roberts¹,

Johns

Williams

et al. 2019

BMC Women's Health

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Background To estimate the proportion of pregnant women in Louisiana who do not obtain abortions because Medicaid does not cover abortion. Methods Two hundred sixty nine women presenting at first prenatal visits in Southern Louisiana, 2015–2017, completed self-administered iPad surveys and structured interviews. Women reporting having considered abortion were asked whether Medicaid not paying for abortion was a reason they had not had an abortion. Using study data and published estimates of births, abortions, and Medicaid-covered births in Louisiana, we projected the proportion of Medicaid births that would instead be abortions if Medicaid covered abortion in Louisiana. Results 28% considered abortion. Among women with Medicaid, 7.2% [95% CI 4.1–12.3] reported Medicaid not paying as a reason they did not have an abortion. Existing estimates suggest 10% of Louisiana pregnancies end in abortion. If Medicaid covered abortion, this would increase to 14% [95% CI 12, 16]. 29% [95% CI 19, 41] of Medicaid eligible pregnant women who would have an abortion with Medicaid coverage, instead give birth. Conclusions For a substantial proportion of pregnant women in Louisiana, the lack of Medicaid funding remains an insurmountable barrier to obtaining an abortion. Forty years after the Hyde Amendment was passed, lack of Medicaid funding for abortion continues to have substantial impacts on women’s ability to obtain abortions.

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Section: Introductionmentioning

confidence: 99%

Estimating the proportion of Medicaid-eligible pregnant women in Louisiana who do not get abortions when Medicaid does not cover abortion

Roberts¹,

Johns

Williams

et al. 2019

BMC Women's Health

View full text Add to dashboard Cite

show abstract

“…Responding to women’s needs around abortion includes expanding access to health insurance that includes abortion coverage. In the United States, state Medicaid coverage of medically necessary abortion reduced the risk of severe maternal morbidity by an average of 16% [ 101 ].…”

Section: Resultsmentioning

confidence: 99%

The mesoeconomics of abortion: A scoping review and analysis of the economic effects of abortion on health systems

et al. 2020

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Background Despite the high incidence of abortion around the globe, we lack synthesis of the known economic consequences of abortion care and abortion policies at the mesoeconomic level (i.e. health systems and communities). This scoping review examines the mesoeconomic costs, benefits, impacts, and values of abortion care and policies. Methods and findings Searches were conducted in eight electronic databases. We conducted the searches and application of inclusion/exclusion criteria using the PRISMA extension for Scoping Reviews. For inclusion, studies must have examined at least one of the following outcomes: costs, benefits, impacts, and value of abortion care or abortion policies. Quantitative and qualitative data were extracted for descriptive statistics and thematic analysis. Of the 150 included mesoeconomic studies, costs to health systems are the most frequently reported mesoeconomic outcome (n = 116), followed by impacts (n = 40), benefits (n = 17), and values (n = 11). Within health facilities and health systems, the costs of providing abortion services vary greatly, particularly given the range with which researchers identify and cost services. Financial savings can be realized while maintaining or even improving quality of abortion services. Adapting to changing laws and policies is costly for health facilities. American policies on abortion economically impact health systems and facilities both domestically and abroad. Providing post-abortion care requires a disproportionate amount of health facility resources. Conclusions The evidence base has consolidated around abortion costs to health systems and health facilities in high-income countries more than in low- or middle-income countries. Little is known about the economic impacts of abortion on communities or the mesoeconomics of abortion in the Middle East and North Africa. Methodologically, review papers are the most frequent study type, indicating that researchers rely on evidence from a core set of costing papers. Studies generating new primary data on mesoeconomic outcomes are needed to strengthen the evidence base.

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“…In Sub-Saharan Africa, transitioning from unsafe to safe abortion is estimated to result in 18,300 (Nigeria) and 29,000 (Ghana) years of life gained per 100,000 safe abortion procedures. And in the United States, societal benefits from increasing access to abortion services through state Medicaid coverage for medically-necessary abortion services is associated with fewer cases of severe maternal morbidity compared to states without such coverage [95].…”

Section: Macroeconomics Benefits and Valuementioning

confidence: 99%

The macroeconomics of abortion: A scoping review and analysis of the costs and outcomes

Rodgers

Coast²,

Lattof³

et al. 2021

PLoS ONE

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Background Although abortion is a common gynecological procedure around the globe, we lack synthesis of the known macroeconomic costs and outcomes of abortion care and abortion policies. This scoping review synthesizes the literature on the impact of abortion-related care and abortion policies on economic outcomes at the macroeconomic level (that is, for societies and nation states). Methods and findings Searches were conducted in eight electronic databases. We conducted the searches and application of inclusion/exclusion criteria using the PRISMA extension for Scoping Reviews. For inclusion, studies must have examined one of the following macroeconomic outcomes: costs, impacts, benefits, and/or value of abortion care or abortion policies. Quantitative and qualitative data were extracted for descriptive statistics and thematic analysis. Of the 189 data extractions with macroeconomic evidence, costs at the national level are the most frequently reported economic outcome (n = 97), followed by impacts (n = 66), and benefits/value (n = 26). Findings show that post-abortion care services can constitute a substantial portion of national expenditures on health. Public sector coverage of abortion costs is sparse, and individuals bear most of the costs. Evidence also indicates that liberalizing abortion laws can have positive spillover effects for women’s educational attainment and labor supply, and that access to abortion services contributes to improvements in children’s human capital. However, the political economy around abortion legislation remains complicated and controversial. Conclusions Given the highly charged political nature of abortion around the global and the preponderance of rhetoric that can cloud reality in policy dialogues, it is imperative that social science researchers build the evidence base on the macroeconomic outcomes of abortion services and regulations.

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State Medicaid Coverage of Medically Necessary Abortions and Severe Maternal Morbidity and Maternal Mortality

Cited by 14 publications

References 17 publications

Estimating the proportion of Medicaid-eligible pregnant women in Louisiana who do not get abortions when Medicaid does not cover abortion

Estimating the proportion of Medicaid-eligible pregnant women in Louisiana who do not get abortions when Medicaid does not cover abortion

The mesoeconomics of abortion: A scoping review and analysis of the economic effects of abortion on health systems

The macroeconomics of abortion: A scoping review and analysis of the costs and outcomes

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