Restrictions on Medicaid Funding for Abortions: A Literature Review


Stanley K. Henshaw
Theodore J. Joyce
Amanda Dennis
Lawrence B. Finer
Kelly Blanchard
The time is now. Will you stand up for reproductive health and rights?

Key Points

Key Points
  • The Hyde Amendment bans the use of federal Medicaid funds for abortions except in cases

of life endangerment, rape or incest. In addition, as of 2008, 32 states and the District of
Columbia had prohibited the use of their state Medicaid funds for abortions except in the
limited cases allowed under the Amendment.
•     A literature search identified 38 studies of the impact of these laws on a range of outcomes.
•     Approximately one-fourth of women who would have Medicaid-funded abortions instead give
birth when this funding is unavailable.
•     Medicaid restrictions lead to a reduction in the proportion of teenage pregnancies that end in
abortion, but the long-term effect on the birthrate is less clear.
•     Such restrictions appear to delay some women having abortions by 2–3 weeks and Medicaideligible
women having first-trimester abortions by a few days on average; the net impact on
second-trimester procedures is unclear.
•     Studies have found little evidence that lack of Medicaid funding has resulted in illegal
abortions, although one death was directly related to the restrictions and two were
indirectly related.
•     Studies of the impact of Medicaid restrictions on other outcomes—sexual behavior, prematurity,
low birth weight, fatal injuries to children, late or no prenatal care, suicide and number
of abortion providers—suffer from methodological limitations and are inconclusive, although
there is some evidence of adverse effects on child health.
•     The additional public cost of prenatal care, delivery services and welfare totals 4–5 times the
amount saved by not paying for Medicaid abortions.
•     Many studies were limited by the weakness of data sources and inability to control for unmeasured
factors that influence trends in abortion rates and birthrates. Although short-term
impacts of Medicaid restrictions have been demonstrated, the long-term impact is less clear
and difficult to measure