ArticleBMJ public health2025
Changes in abortion access after implementation of Medicaid coverage in Illinois: a retrospective analysis.
Article in BMJ public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
abstractIntroduction: In 2018, Illinois implemented House Bill 40 (HB-40), allowing state funds to provide Medicaid coverage for abortion. This study aimed to quantitatively measure changes in access among Illinois residents after the law's implementation, with a focus on changes experienced by Medicaid versus non-Medicaid patients. Methods: We conducted a retrospective analysis using 67 462 abortion visits across 18 health centres comparing service delivery patterns 1 year before and 3 years after HB-40 implementation. We used a t-test and difference-in-differences regression to assess the policy's effect on mean gestational age at the time of abortion among Medicaid patients and non-Medicaid patients. We used χ Results: From 2017 to 2020, the overall volume of abortions increased by 27% and the share of abortions paid for with Medicaid increased from 15% to 49%. Compared with non-Medicaid patients, Medicaid patients experienced a significant decrease in average gestational age at the time of abortion post-HB-40 (incidence rate ratio (IRR)=0.93, 95% CI 0.91 to 0.95, p<0.001). The proportion of Medicaid patients ≤11 weeks gestation increased post-HB-40 (76% to 83%; p<0.001) but did not change among non-Medicaid patients (89% to 90%; p=0.62). By 2020, the 13%-point gap that existed between the two groups in 2017 (76% and 89%) was reduced to 4 (86% and 90%). The proportion of medication abortions increased substantially for Medicaid patients post-HB-40 (27% to 46%; p<0.001) and increased slightly for non-Medicaid patients (51% to 53%; p=0.001), resulting in decreased gaps in medication abortions received between the two groups. Conclusion: Medicaid coverage of abortion reduced insurance-related disparities for Medicaid patients, as shown by decreased gaps in average gestational age among Medicaid and non-Medicaid patients. It was also associated with increased medication abortions among Medicaid patients.
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