State Funding of Abortion Under Medicaid

Background

Background

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.

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Highlights

  • 33 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.
  • 16 states have a policy that directs Medicaid to pay for all or most medically necessary abortions.
    • 7 of these states provide such funds voluntarily.
    • 9 of these states do so pursuant to a court order.

 

State Funding of Abortion Under Medicaid

STATE

GENERALLY FOLLOWS THE FEDERAL STANDARD, FUNDS IN CASES OF:

FUNDS ALL OR MOST MEDICALLY NECESSARY ABORTIONS

Life Endangerment, Rape and Incest

Other Exceptions

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

X

 

 

South Carolina

X

 

 

South Dakota

 

 

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

33+DC

 

16

*    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.