State Funding of Abortion Under Medicaid

August 31, 2023

Laws and policies on abortion have been changing rapidly across the United States since the US Supreme Court overturned the federal constitutional right to abortion in late June in Dobbs v. Jackson. As a result, some information here may be out of date. Our team is working diligently to update this resource. Thank you for your patience.

First implemented in 1977, the Hyde Amendment, which currently forbids the use of federal funds for abortions except in cases of life endangerment, rape or incest, has guided public funding for abortions under the joint federal-state Medicaid programs for low-income people. At a minimum, states must cover those abortions that meet the federal exceptions. Although most states meet the requirements, one state is in violation of federal Medicaid law, because it pays for abortions only in cases of life endangerment. Some states use their own funds to pay for all or most medically necessary abortions, although most do so as a result of a specific court order.

Highlights

32 states and the District of Columbia follow the federal standard and provide abortions in cases of life endangerment, rape and incest.
- 4 of these states also provide state funds for abortions in cases of fetal impairment.
- 4 of these states also provide state funds for abortions that are necessary to prevent grave, long-lasting damage to the person's physical health.
1 state provides abortions only in cases of life endangerment, in apparent violation of the federal standard.
17 states have a policy that directs Medicaid to pay for all or most medically necessary abortions.
- 8 of these states provide such funds voluntarily.
- 9 of these states do so pursuant to a court order.

Current Policy Status Table

State Funding of Abortion Under Medicaid
STATE	GENERALLY FOLLOWS THE FEDERAL STANDARD, FUNDS IN CASES OF:		FUNDS ALL OR MOST MEDICALLY NECESSARY ABORTIONS
STATE	Life Endangerment, Rape and Incest	Other Exceptions	FUNDS ALL OR MOST MEDICALLY NECESSARY ABORTIONS
Alabama	X
Alaska			Court order^*
Arizona	X ^†
Arkansas	X
California			Court order
Colorado	X
Connecticut			Court order
Delaware	X
Dist. of Columbia	X
Florida	X
Georgia	X
Hawaii			Voluntarily
Idaho	X
Illinois			Voluntarily
Indiana	X	Physical health
Iowa^‡	X	Fetal impairment
Kansas	X
Kentucky	X
Louisiana	X
Maine			Voluntarily
Maryland			Voluntarily
Massachusetts			Court order
Michigan	X
Minnesota			Court order
Mississippi	X	Fetal impairment
Missouri	X
Montana			Court order
Nebraska	X
Nevada	X
New Hampshire	X
New Jersey			Court order
New Mexico			Court order
New York			Voluntarily
North Carolina	X
North Dakota	X
Ohio	X
Oklahoma	X
Oregon			Voluntarily
Pennsylvania	X
Rhode Island			Voluntarily
South Carolina	X
South Dakota	Ω
Tennessee	X
Texas	X
Utah	X	Physical health
Vermont			Court order
Virginia	X	Fetal impairment
Washington			Voluntarily
West Virginia	X	Physical health, fetal impairment
Wisconsin	X	Physical health
Wyoming	X
TOTAL	32+DC		17
* A law that defines medically necessary is permanently blocked by a court. † Despite the court order, the state Medicaid program does not pay for medically necessary abortions. ‡ The Iowa governor must approve any abortion paid for by the Medicaid program. Ω State only pays for abortions when necessary to protect the patient's life.