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Abortion seekers, particularly those who must travel out of state are at higher risk of incurring catastrophic health expenditures (CHEs) to pay for medical care and other travel-related expenses

New pre-Dobbs research finds that many individuals seeking facility-based abortion care incur abortion-related catastrophic health expenditures (CHEs). The out-of-pocket costs that many people seeking abortion must pay to cover their medical and travel expenses can pose a significant financial and psychological burden, especially for individuals who travel from out of state, potentially impacting their ability to pay for basic living needs.

Findings: Catastrophic Health Expenditures for Abortion Seekers

As many as 42% of participants overall and 65% of people traveling from out of state incurred abortion-related CHEs.
People who traveled from out of state incurred higher total mean out-of-pocket costs ($1367) compared to participants accessing care in-state ($411).
Experiencing more abortion-related CHE was associated with reporting more symptoms of anxiety and depression when presenting for care

Implications: How Does State Residence Impact Catastrophic Health Expenditures?

This study sheds light on the large number of people seeking facility-based abortion care pre-Dobbs who incurred out-of-pocket expenses for their medical care and other expenses that likely hindered their ability to meet basic needs such as food and housing. Findings show how out-of-state patients were more likely to experience catastrophic health expenditures (CHEs) due to lack of insurance coverage and the need to pay for transportation, accommodation, and child care expenses. Experiencing CHE was associated with adverse mental health outcomes. Findings point to a need to broaden insurance coverage so as to ensure equitable health care access for abortion-seeking individuals and to alleviate the financial and psychological burden of care seeking.

The researchers write:

“Policy efforts should prioritize expanding insurance coverage for abortion care so as to ensure equitable and timely access to abortion care so as to alleviate the financial and psychological burden faced by individuals seeking abortion care.”

The article, Catastrophic Health Expenditures for In-State and Out-of-State Abortion Care, is available in JAMA.