Access to abortion in the wake of Massachusetts health care reform
Massachusetts’ health care reform law, passed in 2006, aims to expand access to insurance coverage and high-quality health care for residents. Data suggest that reform has been successful at increasing the rate of those insured, though little is known about how near universal insurance coverage has affected access to specific health services, such as abortion. Given that 97% of reproductive-aged women in Massachusetts are insured, and that almost all public and subsidized insurance programs in Massachusetts include abortion as a benefit, it is assumed that abortion coverage is within reach for most low-income women.
This study aimed to document the impact of two state policies that likely influence low-income women’s access to abortion coverage: the state health care reform law and broad state coverage of abortion. From December 2011 to July 2012, we conducted 27 in-depth interviews with low-income women about their experiences obtaining and paying for abortion care while uninsured or on public or subsidized health insurance plans. Findings indicate that while health care reform and broad state coverage of abortion has increased accessibility of the service for many women, abortion access barriers remain. Experiences accessing abortion care under health care reform in Massachusetts can provide critical information on the likely successes and challenges that will accompany national implementation of the Affordable Care Act.