Ibis Reproductive Health, Cambridge, Massachusetts.
Ibis Reproductive Health, Cambridge, Massachusetts.
Womens Health Issues. 2020 Nov-Dec;30(6):416-425. doi: 10.1016/j.whi.2020.07.001. Epub 2020 Aug 12.
Abortion is a critical reproductive health service that is difficult for many in the United States to afford owing to policies aimed at restricting insurance coverage of this basic health service. This article assesses whether the resulting high out-of-pocket cost for abortion could be considered a catastrophic health expenditure, and explores potential policies that could prevent households from experiencing financial hardship or impoverishment.
We assessed if the average costs of a first and second trimester abortion procedure in 2016 were catastrophic health expenditures by applying a 40% threshold to the monthly nonsubsistence income of households earning their state's median income in all 50 states and Washington, DC.
The out-of-pocket cost for a first trimester abortion procedure would have been catastrophic for households earning their state's median monthly income in 39 states. In nine of these states, the average cost was between 100% and 199% of a household's nonsubsistence income, and in another nine states, this cost was at least double a household's nonsubsistence income. The out-of-pocket cost of a second trimester abortion would have been catastrophic for households earning their state's median monthly income in all 50 states and Washington, DC.
In a majority of states, the out-of-pocket cost of an abortion is financially catastrophic for households earning no more than their state's median monthly income. The United States should implement policies to create or improve health care safety nets to guarantee abortion care for all individuals, regardless of their income or insurance status.
堕胎是一项重要的生殖健康服务，但由于政策旨在限制对这项基本健康服务的保险覆盖范围，许多美国人难以负担堕胎费用。本文评估了堕胎的高额自付费用是否可以被视为灾难性的健康支出，并探讨了一些潜在的政策，以防止家庭陷入经济困难或贫困。
我们通过将 40%的门槛应用于各州和华盛顿特区中等收入家庭的月非生存收入，评估了 2016 年第一和第二孕期堕胎手术的平均费用是否构成灾难性的健康支出。
在 39 个州，第一孕期堕胎手术的自付费用对于赚取本州中等月收入的家庭来说将是灾难性的。在其中九个州，平均费用在家庭非生存收入的 100%至 199%之间，在另外九个州，这一费用至少是家庭非生存收入的两倍。在所有 50 个州和华盛顿特区，第二孕期堕胎手术的自付费用对于赚取本州中等月收入的家庭来说将是灾难性的。
在大多数州，对于收入不超过本州中等月收入的家庭来说，堕胎的自付费用在经济上是灾难性的。美国应该实施政策，建立或改善医疗保障安全网，以确保所有个人都能获得堕胎护理，无论其收入或保险状况如何。
