abstract: 'Most women seeking abortion pay out-of-pocket for care, partly due to

  legal restrictions on insurance coverage. These costs can constitute a

  hardship for many women. Advocates have sought to ensure insurance

  coverage for abortion, but we do not know whether the intermediaries

  between policy and patient - abortion-providing facilities - are able

  and willing to accept insurance.

  We interviewed 22 abortion facility administrators, representing 64

  clinical sites in 21 states that varied in their legal allowance of

  public and private insurance coverage for abortion, about their

  facility''s insurance practices, and experiences.

  Respondents described challenges in accepting public and/or private

  insurance that included, but were not limited to, legal regulations.

  When public insurance broadly covered abortion, its low reimbursement

  failed to cover the costs of care. Because of the predominance of low

  income patients in abortion care, this caused financial challenges for

  facilities, leading one in a state that allows broad coverage to

  nonetheless decline public insurance. Accepting private insurance

  carried its own risks, including nonpayment because costs fell within

  patients'' deductibles. Respondents described work-arounds to protect

  their facility from nonpayment and enable patients to use their private

  insurance.

  The structure of insurance and the population of abortion patients mean

  that changes at the political level may not translate into changes in

  individual women''s experience of paying for abortion.

  This research illustrates how legal regulations, insurer practices, and

  the socioeconomics of the patient population matter for

  abortion-providing facilities'' decision-making about accepting

  insurance.'
affiliation: 'Kimport, K (Corresponding Author), Univ Calif San Francisco, ANSIRH,
  San Francisco, CA 94143 USA.

  Kimport, Katrina; Rowland, Brenly, Univ Calif San Francisco, ANSIRH, San Francisco,
  CA 94143 USA.'
author: Kimport, Katrina and Rowland, Brenly
author_list:
- family: Kimport
  given: Katrina
- family: Rowland
  given: Brenly
booktitle: 'HEALTH AND HEALTH CARE CONCERNS AMONG WOMEN AND RACIAL AND ETHNIC

  MINORITIES'
da: '2023-09-28'
doi: 10.1108/S0275-495920170000035003
editor: Kronenfeld, JJ
files: []
isbn: 978-1-78743-149-2; 978-1-78743-150-8
issn: 0275-4959
keywords: Abortion; insurance; Medicaid; poverty
keywords-plus: 'PROVIDERS EXPERIENCES; UNITED-STATES; COVERAGE; DISPARITIES; MULTISTATE;

  PREGNANCY; COSTS; RATES'
language: English
number-of-cited-references: '30'
pages: 39-57
papis_id: 4edaa3f499ef464b22d20d00eedb926c
ref: Kimport2017takinginsurance
series: Research in the Sociology of Health Care
times-cited: '6'
title: 'TAKING INSURANCE IN ABORTION CARE: POLICY, PRACTICES, AND THE ROLE OF POVERTY'
type: article
unique-id: WOS:000463494100003
usage-count-last-180-days: '0'
usage-count-since-2013: '4'
volume: '35'
web-of-science-categories: 'Ethnic Studies; Health Policy \& Services; Public, Environmental
  \&

  Occupational Health; Sociology; Women''s Studies'
year: '2017'