The Medicaid cutoff and abortion services for the poor

Since 1977, the Hyde Amendment's restrictions on federal funding of abortions have prevented poor women from obtaining abortions through the federal Medicaid program. This article describes research undertaken to determine the impact of these restrictions on low-income women. Patients who had Medicaid-funded abortions at a clinic in St. Louis, Missouri, in 1977 (when Medicaid funding of abortions was available) were compared with Medicaid-eligible patients who had abortions at the same clinic in 1982 (when public funding of abortions was allowed only if the woman's life would be endangered by continuation of the pregnancy). Their experiences were also compared with those of higher income women attending the same clinic in both years. Finally, some of the 1982 patients were interviewed in 1983 to determine how they went about raising the money that they needed to pay for their abortions. In 1977, Medicaid-eligible patients experienced no delay in obtaining abortions compared with other women, even when demographic differences are considered. However, in 1982, they were significantly delayed; on average, the Medicaid-eligible women who were delayed had abortions 2-3 weeks later than the others. Fifty percent of patients eligible for Medicaid in 1982 had abortions at 10 weeks of gestation or later, compared with 37 percent in 1977. Medicaid-eligible women who were interviewed in depth had abortions about a week later than the other women. Increased delays occurred both between their first suspicion of pregnancy and their pregnancy test and between their decision to have an abortion and the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)