Abstract
Background
Massachusetts has implemented reforms aimed at providing universal health care coverage
and covers abortion through subsidized state insurance programs. Three Massachusetts
abortion funds evaluated their referral processes for low-income women from April
to October 2010 to learn about women’s experiences applying for subsidized insurance
and to identify barriers to obtaining insurance or its use for abortion services.
Methods
Follow-up interviews were conducted with 39 low-income women thought eligible for
subsidized insurance at least 1 month after their initial contact with the funds.
Results
Health insurance literacy was low, and participants reported confusion distinguishing
between levels of subsidized insurance. The process of applying for subsidized insurance
delayed a substantial proportion of procedures. More than two thirds of the women
who applied for state coverage had become insured or expected to become insured shortly,
but only one third of respondents who applied were able to secure insurance in time
for their abortion care. Two women were unable to obtain abortions as a result of
delays. Delays also limited low-income women’s ability to obtain medication abortion.
Conclusion
This analysis suggests that the process for enrolling in subsidized insurance does
not currently meet the goal of providing women with coverage for abortion care (and
other health needs) in a timely way. Systemic improvements are needed to ensure that
enrollments are processed quickly and disruptions in coverage are minimized. Information
resources should be developed to help women and their families understand health insurance
and coverage of services.
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Biography
Danielle Bessett, PhD, was an Ellertson Fellow from 2008–2010 and is now Assistant Professor of Sociology at the University of Cincinnati, Cincinnati, Ohio. Her research interests are in medical and family sociology, focusing on sexual and reproductive health issues and inequality.
Biography
Katey Gorski studies Government at Smith College in Northampton, Massachusetts, and expects to receive her BA in the spring of 2011. She interns with the Abortion Rights Fund of Western Massachusetts.
Biography
Deepani Jinadasa, MPH, is a member of the Board of Directors of the Eastern Massachusetts Abortion Fund. Her public health interests include better understanding health disparities, social determinants of health, and barriers to healthcare access.
Biography
Marcy Ostrow has a BS in Zoology from the University of Massachusetts, Amherst. She is the Intake Hotline Coordinator, a hotline volunteer and a member of the Board of Directors of the Jane Fund of Central Massachusetts.
Biography
Megan J. Peterson is the Deputy Director of the National Network of Abortion Funds where she works to ensure access to abortion for low-income women through policy advocacy and support to member Funds who provide financial assistance to women in need.
Article info
Publication history
Accepted:
February 9,
2011
Received in revised form:
January 22,
2011
Received:
November 12,
2010
Identification
Copyright
© 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
