Approximately one-fourth of women who would obtain a Medicaid-funded abortion if given the option are instead forced to carry their pregnancy to term when state laws restrict Medicaid funding for abortion, because they lack the money to pay for the procedure themselves. According to a new report, "Restrictions on Medicaid Funding for Abortions: A Literature Review," by the Guttmacher Institute and Ibis Reproductive Health, Medicaid funding restrictions also delay some women’s abortion by 2–3 weeks, primarily because of difficulties women encounter in raising funds to pay for the procedure.

Currently, 32 states and the District of Columbia allow Medicaid funds to be used for an abortion only in cases of rape and incest, or if the woman’s life is endangered, in accordance with the federal Hyde Amendment; only 17 states have policies to use their own funds to pay for all or most medically necessary abortions. Lacking insurance coverage, some poor women need a considerable amount of time to come up with the money to pay for an abortion, and may have to pull resources from other family necessities, like food or rent, if they are able to find the funds at all. As the cost of the procedure increases with gestation, many poor women become trapped in a vicious cycle of scrambling to raise enough money before the cost—and risk—increase further, while others are left with no recourse but to carry an unwanted pregnancy to term.

"The research literature clearly shows that restricting Medicaid funding for abortion forces many poor women—already at greatest risk of unintended pregnancy—to carry an unwanted pregnancy to term," says Stanley Henshaw, Guttmacher Institute senior fellow and the study’s lead author. "Antiabortion advocates are using these restrictions in a misguided attempt to reduce the nation’s abortion rate. Instead, we should be focusing on reducing the underlying cause of abortion—unintended pregnancy—by ensuring better access to and use of contraceptives."

The Hyde Amendment allows federal funding for abortion only in cases of rape, incest or life endangerment. In addition, Congress has enacted legislation essentially banning coverage of abortion for women whose medical insurance is provided by the federal government, including federal employees, military personnel, women in federal prisons and low-income residents of the District of Columbia, which does not have a state funding option. The issue of federal funding goes to the heart of who has access to abortion in the United States and under what circumstances.

"In his recent budget proposal, President Obama had the option of calling on Congress to end the funding restrictions imposed by the federal Hyde Amendment. We are disappointed that he did not do so," says Heather Boonstra, a Guttmacher senior public policy associate. "It is time for Congress to repeal the Hyde Amendment and restore Medicaid coverage for abortion so that every woman, regardless of her economic circumstances, has the right to decide when and whether to have a child."

Click here for the full report "Restrictions on Medicaid Funding for Abortions: A Literature Review," by Stanley K. Henshaw, Theodore J. Joyce, Amanda Dennis, Lawrence B. Finer and Kelly Blanchard.

For more information on Medicaid funding for abortion, click here: State Policies in Brief: State Funding of Abortion Under Medicaid.