Woman lack the resources for adequate contraception

An average self-paying patient was charged $372 for a surgical abortion at 10 weeks and between $438 and $490 for a medical abortion in 2009. Second-trimester surgical abortions are 2 to 3 times more expensive than first-trimester surgical abortions. Most patients pay out of pocket. Only 26% of abortions are billed directly to public or private insurance. Most insured patients are reluctant to file claims because of concerns about confidentiality. Some health plans cover sterilization but not abortion, leaving poor women in the unenviable position of having to choose sterilization if they lack the resources for adequate contraception.

The 1978 Hyde Amendment prohibits federal Medicaid dollars from being spent on abortion, except to preserve a woman's life or in cases of rape or incest. Twenty-two states allocate a portion of their share of Medicaid funding to cover abortion. The Hyde Amendment was applied to Medicare, which covers disabled women, in 1998. Women of color are more likely than white women to be poor, to lack health insurance, and to rely on government healthcare programs. Thus, they are disproportionately harmed by prohibitions on public funding for abortions. In addition, black women and Hispanic women are more likely than white women to have an abortion. Higher rates of abortion are explained, in part, by higher rates of unintended pregnancy, a greater proportion of conceptions that end in abortion, and greater poverty.

The Defense Department, through TRICARE, provides health coverage to military personnel and their families. TRICARE has instituted a permanent ban on abortion coverage, except when the life of the woman is endangered. American Indians and Alaskan natives covered by the Indian Health Service are subject to the Hyde Amendment.[20]The Federal Employees Health Benefits Program pays for abortions only in cases of life endangerment, rape, or incest. Women in federal prisons are allowed to obtain an abortion only when their lives are endangered or when the pregnancy is the result of rape, which may be difficult to prove.


http://www.medscape.com/viewarticle/507404_3