Why America Is a Global Outlier on Abortion

Just like Bahrain and Belarus, the U.S. rarely funds abortions for poor women.

Kevin Lamarque / Reuters

A pregnant American woman on Medicaid, the government health-insurance program for the poor, is covered if she goes into labor and has a baby. But if she opts to have an abortion, she’s on her own. A policy called the Hyde Amendment restricts government funding of abortion through Medicaid in most cases.

And in this, the U.S. is an outlier: Most other governments that allow abortion also publicly fund it in some way, according to an analysis of 80 countries published Friday in the journal Contraception. Just 21 nations, including the likes of Belarus, Bahrain, and Kyrgyzstan, provide as little government support for abortion care as the U.S. does.

For the study, researchers from the University of California, San Francisco and Ibis Reproductive Health examined countries where abortion is generally legal upon request.

Eleven provided no funding for abortion, and 10, including the U.S., only provided funding in “limited,” or exceptional, cases. In the U.S., abortions can be covered by Medicaid in cases of rape or incest, or when the woman's life is in danger.

Thirty-four of the countries provided full government funding of abortion, and 25 more provided what the study authors called “partial” support, or funds only for poor women or in public clinics.

The countries with limited or no funding for abortion are home to about 13 percent of the women the area covered by the study:

Compared to the U.S., Canada and Europe are more open to mixing public funds with family planning. Just nine of the 36 European countries surveyed provide little or no funding for abortion.

In the U.S., states exercise some autonomy in abortion funding. Seventeen states fund the procedure for poor women voluntarily. Meanwhile, 25 limit abortion coverage on insurance plans sold by the Obamacare insurance exchanges to “exceptional” circumstances.

The Democratic Party included repealing the Hyde Amendment in the latest iteration of its platform, but accomplishing that will be difficult. Even other Democrats who are pro-life opposed the provision to repeal it.

Some pro-life advocates argue that, because abortion is such a controversial issue, those who want the procedure should pay for it themselves.

However, that’s not an option for many American women. Low-income women are more likely to have unintended pregnancies. About half of women seeking abortions live below the poverty level. Getting a first-trimester abortion in the U.S. costs about $430, more than twice the amount most uninsured women spend annually on all of their healthcare out of pocket. When researchers interview women about why they self-induced their abortions, they typically cite cost as a major factor.

Conservatives often speak of the importance of “defunding” Planned Parenthood and other organizations that provide abortions. But for many U.S. abortion patients, a lack of funding is already the reality.