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Abortion Rate Increased And Birth Rate Decreased After Introduction Of Medicaid Abortion Coverage In Illinois.

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Medicaid coverage for abortion care increased abortion rates by 18.2% and decreased birth rates by 2.8% in Illinois. These findings highlight Medicaid

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Area of Science:

  • Public Health
  • Health Services Research
  • Reproductive Health

Background:

  • The Hyde Amendment restricts federal funding for abortions, impacting access for low-income individuals.
  • Limited causal evidence exists on the effects of state-level Medicaid abortion coverage on pregnancy outcomes.
  • Seventeen states utilize state funds to cover abortion care within their Medicaid programs.

Purpose of the Study:

  • To evaluate the impact of a 2018 Illinois policy introducing Medicaid coverage for abortion.
  • To assess the effects of this coverage on abortion and birth rates using pre-Dobbs decision data.

Main Methods:

  • Employed a difference-in-differences design.
  • Utilized 2014-2021 birth and abortion data from the Centers for Disease Control and Prevention.
  • Compared Illinois to 29 non-coverage states.

Main Results:

  • Medicaid coverage increased abortions by 18.2% (2.43 per 1,000 reproductive-age females).
  • Medicaid coverage decreased births by 2.8% (1.66 per 1,000 reproductive-age females).
  • Birth rate reductions were larger among Black and Hispanic populations, high-poverty areas, and proximity to facilities.

Conclusions:

  • Medicaid coverage for abortion significantly impacts abortion and birth rates.
  • The policy demonstrated a notable effect on reproductive health outcomes, particularly in vulnerable populations.
  • Findings underscore the crucial role of Medicaid in ensuring abortion access and influencing maternal and child health.