OSU Study Finds State Medicaid Expansion Helps Covers Abortion Services

A study from Oregon State University found that, after the Medicaid Expansion in Oregon in 2014, more women were able to get abortion services covered through insurance rather than paying out of pocket. 

Researchers analyzed Medicaid claims data and other medical records and found that Medicaid-financed abortions increased by 18% in 2014, then by 7% in both 2015 and 2016. 

The number of abortions in Oregon did not rise. The change was in how they were paid for. 

“According to the literature, there was a 1% decline in the abortion rate in Oregon between 2014 and 2017. During the pre-expansion period women were having to pay for abortions out of pocket, which was taking a lot of money out of their incomes that could have been going to food or clothing or caring for their children,” said Lisa Oakley, who co-authored the study as a postdoctoral researcher at OSU’s College of Public Health and Human Sciences. “What the expansion of coverage did was reduce the financial burden for women in this low-income group.” 

Before 2014, low-income Oregonian women became eligible for Medicaid if they became pregnant. The expansion, which increased care for people earning less than 138% of the federal poverty level, covered an additional 77,000 women of childbearing age regardless of their pregnancy status. Currently, the Oregon-specific poverty limit is an annual income of $26,200 or less for a family of four, or $12,760 for an individual. 

Marie Harvey, lead author of the study and associate dean for research in the College of Public Health and Human Sciences, said that the action helped remove a huge barrier for those seeking reproductive health care.  

Researcher noted that better access to health care overall is a likely factor in the leveling off of Medicaid financed abortions, though more data is needed.  

“Alternatively, Medicaid expansion may eventually result in a measurably decreased need for abortion services if women with low incomes gain access to contraceptive services and experience fewer unintended pregnancies,” the authors wrote. 

The study also looked at abortions performed through medication rather than surgery and found an increase in abortion through medication. This is very safe and less expensive than other types of abortion. However, it can only be done up until the 10th week of pregnancy. Longer wait times for Medicaid coverage in the past took away the choice between the two options, Harvey said.  

Oakley and Harvey completed this research with Susannah Gibbs, a postdoctoral researcher in the College of Public Health and Human Sciences. The Society of Family Planning funded the research, which was published in the journal Women’s Health Issues.  

By: Hannah Ramsey