The Economic Impacts of Abortion on Society Living Below the Poverty Line in North America

AP Seminar

January 2023

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The Economic Impacts of Abortion on Society Living Below the Poverty Line in North America

Abortion has always been a controversial topic in society. But with the recent overturning

of Roe V. Wade, it is now harder for women to access abortion, especially those living below the

poverty line. The challenges in accessing abortion services have many economic impacts on

those in society who have less access to financial resources. About 75 percent of abortion

patients are considered low-income, with 35 percent receiving Medicaid (Guttmacher Institute,

2018). It is said that if women were more financially stable, many would be more likely to end

an unintended pregnancy because they could afford to do so (Pollitt, 2016). The economic issues

associated with abortion access will continue until there is increased insurance coverage of the

procedure, there are fewer or no out-of-pocket costs associated with having an abortion, and

women are not forced to have unwanted children due to lack of access to abortions. This is

particularly true for African American women who historically have been generally more likely

to live in poverty and have more difficulty in accessing services to terminate unwanted

pregnancies.

Gretchen E. Ely et al, Professor at the University of Tennessee, stated that “The

economic difficulties surrounding abortion access in the United States are often attributable to a

lack of insurance coverage for abortion care” (Ely et al, 2020). This is in part due to the Hyde

Amendment, a budget rider that forbids the use of federal Medicaid money for funding abortions

except in rare cases when the mother’s life is in danger, or the pregnancy is due to rape or incest

(Ely et al, 2020).

Women who live in poverty are usually unable to pay for insurance. According to

Gretchen Borchelt, vice president of reproductive rights and health at the National Women’s

Law Center, despite the advancements by the United States’ Affordable Care Act (ACA), in
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making health care more available and affordable for millions of American women, financially

unstable women still face major challenges when it comes to getting needed care, including

abortion (Borchelt, 2018). Almost 90 percent of women in the country now have health

insurance coverage, including over 33 million women of colour who historically have been more

likely to be uninsured, financially unstable, and go without health care because of cost (Borchelt,

2018). Nevertheless, women still struggle to access needed health insurance care services,

especially abortion. Approximately 10 percent of women remain uninsured, especially among

low-income and women of colour. States have the option to opt out, and in these cases, low-

income individuals, mostly women, are left lacking the coverage they need (Borchelt, 2018).

On the other hand, for others who can afford private insurance, many plans will not cover

abortions as the procedure is not seen as an essential health care service. Gretchen Borchelt later

stated, “Unfortunately, most poor women are prohibited from using insurance coverage for

abortion. Many women with private insurance also cannot get abortion coverage… It explicitly

prohibits abortion from being considered one of the ‘essential health benefits’ that certain plans

must cover” (Borchelt, 2018). The essence of her argument is that whether you have access to

insurance or not, most people have to pay out-of-pocket to get an abortion.

Many women seeking abortion face economic hardship either by having to shoulder out-

of-pocket costs that are uninsured or the costs and financial sacrifices associated with bearing an

unwanted child. Women who live below the poverty line face extreme financial hardship when

they have to pay out-of-pocket for an abortion and are faced with the choice to either not get an

abortion, or make do without essential goods and services. According to Dr.Diana Greene Foster

et al, from the University of California, San Francisco, half of women live below the Federal

Poverty Line and three-quarters of them struggle to pay for food, housing, and transportation.
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Denial of abortion services exacerbates this hardship (Foster, D. G. et al, 2022). Data from the 5-

year turnaway study found large and statistically significant differences in the socioeconomic

trajectories of women who were denied wanted abortions compared to women who received

abortions. Many women seeking abortion already face economic hardship (Foster, D. G. et al,

2022). The women who were denied abortions faced more economic hardships as a result of not

getting an abortion and carrying the unwanted pregnancy to term led to almost a 400 percent

increase in the odds that a woman's household income was below the poverty line (Foster, D. G.

et al, 2022). Preventing women from obtaining abortions may prevent them from engaging in

full-time employment, increase poverty, increase the number of single mothers raising children

alone, and more reliance on public assistance, with the net result being very serious economic

consequences for women and children (Foster, D. G. et al, 2022).

Likewise, Dr.Samuel L. Dickman et al, part of The Texas Policy Evaluation Project,

University of Texas at Austin, surveyed patients seeking abortions at 12 Texas clinics regarding

costs and financial hardships related to abortion care. They compared average out-of-pocket

costs and the percentage reporting hardships across income and insurance categories. The results

showed that patients reported out-of-pocket costs for abortion care, whether they received

financial assistance from abortion funds (non-profit organizations that help cover some costs)

and whether they experienced financial hardships, including needing to sell valuable possessions

or delaying expenses (rent, bills, food, childcare, medical care, or other expenses) to pay for

abortion care (Dickman et al, 2018). He also stated that 20% of uninsured women seeking

abortion care delayed buying food for their family and found that abortion care because it is

often excluded from insurance coverage and may be more likely to lead to food insecurity than

other unexpected medical conditions (Dickman et al, 2018).

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According to Anna Berstein, research associate, and Kelly M. Jones, research economist,

at the Institute for Women’s Policy Research, evidence shows that the economic effects of

abortion are not uniform across all demographic groups (Berstein and Jones, 2019). African

Americans in general are more likely to live in poverty and therefore, they are more likely to be

unable to pay for an abortion (Berstein and Jones, 2019). African American women are more

likely to be living in poverty than caucasian women and so generally face greater barriers to

accessing reproductive health care, and are less able to overcome barriers to abortion access

(Berstein and Jones, 2019). Abortion access also has greater economic impacts on African

American women than on Caucasian women.

Being unable to access an abortion further affects women already living in poverty.

According to Gretchen Borchelt, women forced to carry an unwanted pregnancy to term were

more likely to be living in poverty, less likely to be employed in a full-time job, and more likely

to be receiving public assistance four years afterward (Borchelt, 2018). Additionally, unwanted

pregnancies may also prevent them from enrolling in or completing their college education

(Bernstein and Jones, 2019). Lack of access to abortion could push more women and their

families closer or even further into poverty.

In conclusion, the lack of access to abortion services, either due to financial, legal, or

moral barriers, creates undue financial pressure on women, many of whom are already struggling

with poverty. These pressures usually lead to a negative financial trajectory for individual

women and can also result in adverse associated mental and physical health impacts that carry

additional significant costs. These socioeconomic impacts have important implications for public

policymakers and society at large, and so removing barriers to abortion services could well have

a greater positive overall financial and social benefits, not only to the individual but to society
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overall.

Works Cited

Bernstein, Anna, and Kelly M. Jones. "The Economic Effects of Abortion Access: A

Review of the Evidence." Institute for Women’s Policy Research. Washington DC

(2019).

Borchelt, Gretchen. “The Impact Poverty Has on Women’s Health.” Human Rights, vol. 43, no.

3, Apr. 2018, pp. 16–19. EBSCOhost, search.ebscohost.com/login.aspx?

direct=true&db=aqh&AN=131332927&site=ehost-live.

America Magazine. “Brookings on Abortion.” America, vol. 212, no. 11, Mar. 2015, p.

10. EBSCOhost, search.ebscohost.com/login.aspx?

direct=true&db=aqh&AN=101695638&site=ehost-live

Dickman, Samuel L. et al. “Financial Hardships Caused by Out-of-Pocket Abortion Costs in

Texas, 2018.” American Journal of Public Health, vol. 112, no. 5, May 2022, pp. 758–

61. EBSCOhost, https://doi.org/10.2105/ajph.2021.306701.

Ely, Gretchen E., et al. “An Exploration of the Experiences of Florida Abortion Fund Service

Recipients.” Health & Social Work, vol. 45, no. 3, Aug. 2020, pp. 186–94. EBSCOhost,

https://doi.org/10.1093/hsw/hlaa012.
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Foster, D. G., et al. “Socioeconomic Outcomes of Women Who Receive and Women Who Are

Denied Wanted Abortions in the United States.” American Journal of Public Health, vol.

112, no. 9, Sept. 2022, pp. 1290–96. EBSCOhost,

https://doi.org/10.2105/ajph.2017.304247.

Guttmacher Institute. (2018a). Induced abortion in the United States. Retrieved from

http://www.guttmacher.org/sites/default/files/factsheet/sfaa-fl.pdf

Kapadia, Farzana. “Abortion Care Is Health Care: A Public Health of Consequence, September

2022.” American Journal of Public Health, vol. 112, no. 9, Sept. 2022, pp. 1242–44.

EBSCOhost, https://doi.org/10.2105/ajph.2022.307008.

Pollitt, Katha. “Poverty and Choices.” Nation, vol. 302, no. 25/26, June 2016, pp. 6–8.

EBSCOhost, search.ebscohost.com/login.aspx?

direct=true&db=aqh&AN=115875057&site=ehost-live.