The Supreme Court on Friday overturned Roe v. Wade, ending the constitutional right to abortion. Twenty-six states are likely to ban abortion care as a result. [1]
In addition to the legal barriers, pregnant people face financial barriers to obtaining abortions. An abortion costs close to $800 on average, and depending on where you live, insurance may not cover it. [2]
For the most part, states regulate whether private health insurance companies can cover abortion services. Because of that, where you live governs whether abortion is covered. Here’s a guide to whether an abortion is covered, depending on your state and the type of insurance coverage you have.
If you have private insurance
Private group health insurance plans are regulated by states, except for self-funded insurance plans, which are regulated by the federal government. A self-funded insurance plan is one provided by a company that pays for health expenses by collecting premiums directly from employees. Fully insured companies pay a premium to an insurance company, which administers health expenses for the company. Because self-funded plans are governed by the federal Employee Retirement Income Security Act, not state laws, companies who self-insure tend to have more autonomy in whether they cover abortion. However, it’s not clear what self-insuring companies will do in states that ban abortion outright in the wake of the Supreme Court decision.
In light of the Supreme Court’s decision on Dobbs v. Jackson, states hostile to abortion may issue new restrictions on the procedure, says Michelle Banker, director of reporductive rights and health litigation for the National Women’s Law Center, a non-profit advocating for women’s and LGBTQ rights. For example, a Texas law awards $10,000 to anyone who successfully sues someone who “aids and abets” people seeking an abortion after six weeks of pregnancy.
“Those laws may be weaponized against health plans, plan sponsors, and employers that cover abortion,” Banker says.
These eight states ban private insurance plans from covering abortion even in cases of rape or incest: [3]
Kansas
Kentucky
Michigan
Missouri
Nebraska
North Dakota
Oklahoma
Texas
On the other hand, six states require almost all private insurance plans to cover abortion:
California
Illinois
Maine
New York
Oregon
Washington
If you have Medicaid
When it comes to abortion, Medicaid follows a federal guideline called the Hyde Amendment, which prohibit federal funds from being used to cover abortions except in cases of life endangerment, rape, or incest. But 16 states use their own funds to cover all or most abortions: [4]
Alaska
California
Connecticut
Hawaii
Illinois
Maine
Maryland
Massachusetts
Minnesota
Montana
New Jersey
New Mexico
New York
Oregon
Vermont
Washington
If you have a marketplace plan
Twenty-five states have banned insurance companies from including abortion coverage in insurance plans sold in the marketplaces created by the Affordable Care Act: [5]
Alabama
Arizona
Arkansas
Florida
Georgia
Idaho
Indiana
Kansas
Kentucky
Louisiana
Michigan
Mississippi
Missouri
Nebraska
North Carolina
North Dakota
Ohio
Oklahoma
Pennsylvania
South Carolina
South Dakota
Tennessee
Texas
Utah
Wisconsin
In Louisiana and Texas, insurance plans on the marketplace may not cover abortion even in life-threatening situations.
How to find out if your health insurance covers abortion
An abortion provider should be able to find out whether your insurance covers abortion.
“The best thing to do is to call the clinic, tell them what insurance you have, and the clinics will take care of it for you,” says Ushma Upadhyay, an associate professor of obstetrics, gynecology, and reproductive science at the University of California, San Francisco.
You can also check your policy documents directly to see whether abortion is covered. In light of the Supreme Court decision, it may be worth checking whether the plan covers travel to another state to get an abortion. Without insurance coverage, people often pay out of pocket for abortions. While there are funds that donate money to people seeking abortions in many states, they often have limited budgets.
“They rarely cover the entire cost of the abortion,” Upadhyay says.
Some employers have pledged to help pay for travel for employees seeking abortions out of state. It may be worth talking to human resources about these options, but this will likely be a last resort for many people because of the privacy issues involved.
What will happen to insurance coverage of abortion now?
The legal situation is changing rapidly, and not every situation will be immediately cut-and-dry. Many states have laws that could outlaw or severely limit abortion in the wake of the Supreme Court decision. It’s not clear how these laws will govern insurance coverage, especially across state lines.
“There are going to be open legal questions in what will be a rapidly changing legal environment,” Banker says.
She encouraged employers who provide health insurance coverage for abortion to do everything they can to assist their employees, including covering travel, lodging, and paid leave related to abortion, though she warned, “There may be some tricky and thorny legal issues.”
Abortion will become more expensive and difficult for people, who will be forced to have abortions later in their pregnancies and travel farther to get them, Upadhyay says.
“The costs of abortion are going to go up,” she says, “regardless of who’s paying for it.”
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