Lifetime abortion incidence when abortion care is covered by Medicaid: Maryland versus five comparison states
利用2016-2019年六个州的调查数据，研究发现马里兰州医疗补助覆盖堕胎费用与参保女性一生堕胎发生率高出37个百分点相关，表明该政策对低收入女性堕胎可及性影响巨大。
OBJECTIVE: To estimate the association of Medicaid coverage of abortion care with cumulative lifetime abortion incidence among women insured by Medicaid. DATA SOURCES AND STUDY SETTING: We use 2016-2019 (Pre-Dobbs) data from the Survey of Women studies that represent women aged 18-44 living in six U.S. states. One state, Maryland, has a Medicaid program that has long covered the cost of abortion care. The other five states, Alabama, Delaware, Iowa, Ohio, and South Carolina, have Medicaid programs that do not cover the cost of abortion care. Our sample includes 8972 women residing in the study states. STUDY DESIGN: Our outcome, cumulative lifetime abortion incidence, is identified using an indirect survey method, the double list experiment. We use a multivariate regression of cumulative lifetime abortion on variables including whether women were Medicaid-insured and whether they were residing in Maryland versus in one of the other five states. DATA COLLECTION/EXTRACTION METHODS: This study used secondary survey data. PRINCIPAL FINDINGS: We estimate that Medicaid coverage of abortion care in Maryland is associated with a 37.0 percentage-point (95% CI: 12.3-61.4) higher cumulative lifetime abortion incidence among Medicaid-insured women relative to women not insured by Medicaid compared with those differences by insurance status in states whose Medicaid programs do not cover the cost of abortion care. CONCLUSIONS: We found that Medicaid coverage of abortion care is associated with a much higher lifetime incidence of abortion among individuals insured by Medicaid. We infer that Medicaid coverage of abortion care costs may have a very large impact on the accessibility of abortion care for low-income women.