Two in Five Abortion Patients Incurred Catastrophic Health Expenditures Prior to Landmark Supreme Court Decision, Study Finds

A study published today by JAMA Network Open found that 42% of abortion incurred catastrophic health expenditures (CHEs) patients prior to the U.S. Supreme Court decision overturning Roe v. Wade. CHE's are defined as healthcare costs exceeding a substantial portion of one's income and resulting in financial hardship.

Of a total 675 patients surveyed in California, Illinois, and New Mexico, 65% who sought an abortion outside the state where they lived incurred CHEs, compared to 32% who received in-state abortion care.

The research was led by Ortal Wasser, a PhD candidate and adjunct faculty member at NYU Silver School of Social Work who researches reproductive health and rights.

"The study's finding of a high rate of abortion-related CHE's, particularly among people who traveled out of state, suggests a need for expanded insurance coverage for abortion care, regardless of state of residence," according to the study titled "Catastrophic Health Expenditures for In-State and Out-of-State Abortion Care."

Most people, the study noted, pay out of pocket for abortion care. "Studies have also documented that, to pay for abortion care, individuals had to take out loans, sell personal belongings, and forego essential household expenditures such as food, bills, and rent."

The paper comes amid reports that the number of people traveling out of their state of residence to access abortion care has risen as a result of the 2022 Supreme Court decision. Thus, the financial burden may have worsened since the survey was conducted at four clinics in abortion-states between January and June of 2019.

A secondary aim of the study seeks to deepen the understanding of researchers and policy makers about the psychological burdens of seeking an abortion, to go along with the financial ones. Findings show that incurring abortion-related catastrophic expenditures is associated with adverse mental health symptoms when patients presented for care.

The study was coauthored with Wasser by Lauren J. Ralph, Shelly Kaller, and M. Antonia Biggs from Advancing New Standards in Reproductive Health, University of California San Francisco.

DOI: 10.1001/jamanetworkopen.2024.44146