Introduction <p>The few studies of patients’ awareness and opinions of abortion restrictions suggest that opinions about such restrictions are influenced by stigma and misconceptions about abortion. We sought to understand the influence of structural stigma on the experience of and support for abortion coverage among Medicaid-eligible abortion patients.</p> Methods <p>Between July 2017 and July 2019, we&#xa0;conducted 50 semi-structured interviews with Medicaid-eligible people&#xa0;who obtained an abortion in the past 2 years.&#xa0;Participants lived in both states that restrict and that allow use of Medicaid for abortion coverage.</p> Results <p>Participant interviews highlighted an experience of abortion and low-income stigma, and an awareness of the discriminatory impact of the Hyde Amendment. However, their perspectives on public insurance coverage of abortion were not negatively impacted by these experiences. All participants were in favor of Medicaid coverage of abortion in circumstances beyond the exceptions of the Hyde Amendment. But support wavered in more stigmatized circumstances, such as fetal anomalies detected beyond 18&#xa0;weeks.</p> Conclusion <p>The Hyde Amendment triggers multiple stigmas for Medicaid-eligible abortion patients. Despite that, most were in favor of abortion coverage. More research is needed to understand how abortion patients mitigate stigmas associated with abortion care and access.</p> Policy Implications <p>Perspectives from low-income abortion patients point to a need to protect and expand funding for abortion, especially for those faced with financial constraints. Public education and values clarification efforts may dispel the misinformation that drives abortion stigma and increase support for policies such as public funding of abortion.</p>

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Opinions on Public Funding of Abortion Among Medicaid-Eligible Abortion Patients in the United States

  • Sachiko Ragosta,
  • Laura Fix,
  • Hannah Forsberg,
  • Terri-Ann Thompson

摘要

Introduction

The few studies of patients’ awareness and opinions of abortion restrictions suggest that opinions about such restrictions are influenced by stigma and misconceptions about abortion. We sought to understand the influence of structural stigma on the experience of and support for abortion coverage among Medicaid-eligible abortion patients.

Methods

Between July 2017 and July 2019, we conducted 50 semi-structured interviews with Medicaid-eligible people who obtained an abortion in the past 2 years. Participants lived in both states that restrict and that allow use of Medicaid for abortion coverage.

Results

Participant interviews highlighted an experience of abortion and low-income stigma, and an awareness of the discriminatory impact of the Hyde Amendment. However, their perspectives on public insurance coverage of abortion were not negatively impacted by these experiences. All participants were in favor of Medicaid coverage of abortion in circumstances beyond the exceptions of the Hyde Amendment. But support wavered in more stigmatized circumstances, such as fetal anomalies detected beyond 18 weeks.

Conclusion

The Hyde Amendment triggers multiple stigmas for Medicaid-eligible abortion patients. Despite that, most were in favor of abortion coverage. More research is needed to understand how abortion patients mitigate stigmas associated with abortion care and access.

Policy Implications

Perspectives from low-income abortion patients point to a need to protect and expand funding for abortion, especially for those faced with financial constraints. Public education and values clarification efforts may dispel the misinformation that drives abortion stigma and increase support for policies such as public funding of abortion.