Use of Medicaid Coverage for Abortion Is Associated With Improved Abortion Access [OP03-3C]

INTRODUCTION: Low income women disproportionately face barriers to abortion access. It remains unknown whether Medicaid coverage for abortion improves abortion access measures. METHODS: We performed a secondary analysis of the 2014 Guttmacher Abortion Patient Survey. Respondents were included if they selected “Medicaid” as their primary insurance. The exposure was self-report of using Medicaid to pay for the abortion. NARAL state legislative classifications and patient demographics were used as covariates. Chi-square testing and t-tests for unequal variance were used for categorical and continuous variables, respectively. Multivariate regression was performed for the primary outcome of >7 days wait time between decision for abortion and abortion appointment. All statistical analysis was performed in StataSE v15. This study was IRB exempt. RESULTS: Of 2,549 respondents on Medicaid, 1,482 had Medicaid coverage for their abortions and 1,067 did not. Patients with Medicaid coverage had their abortions at an earlier gestational age (8.61 vs. 8.94 weeks, P=.02). Patients using Medicaid for abortion had shorter mean wait times (3.84 vs. 4.37 days, P=.01), traveled less time (32.15 vs. 48.63 minutes, P<.0001) and shorter distances (28.62 vs. 42.91 miles, P=.0003) for their abortions, and were less likely to cross state lines (0.81% vs 7.97%, P < .0001). Patients with Medicaid coverage for abortion were less likely to wait >7 days (83.14% vs. 86.97%, P=.008), which remained true in multivariate regression with OR 0.71 (CI 0.51-0.99). CONCLUSION: Utilization of Medicaid coverage for abortion is associated with increased abortion access, as evidenced by decreased wait times, earlier gestational ages, and decreased travel measures.