The U.S. Supreme Court recently voted to overturn Roe v. Wade (1973) and Planned Parenthood v. Casey (1992). The implications of this decision are far reaching, with over 250,000 reported abortions1 in 2019 taking place in states likely to ban them2 following this ruling.
Our take: SCOTUS overturns Roe v. Wade
Regardless of personal convictions, leaders in every sector of the health care industry must grapple with how this decision will differentially impact women across states and demographic groups. Check out our insights and interactive maps below to see which groups will be most impacted by new abortion restrictions in each state.
1) Women in low-income households
Low income women are disproportionately likely to get an abortion: an estimated 75% of U.S. abortion patients earned incomes less than the federal poverty level in 2014. That means abortion restrictions will have an outsized impact on low-income women and households: one in three women aged 15-49 residing in states likely to ban abortions have low household incomes.3
What's more, the cost to travel for an abortion will impact these lower income women like a regressive tax, adding to the already high cost of abortion care among women with the greatest needs. This is particularly true for women living in states with limited eligibility for family planning services through Medicaid.
2) Under-insured and uninsured women
Women aged 15-49 who reside in the 21 states likely to ban abortion disproportionately lack health insurance. Although women in these states make up 41% of all US women of reproductive age, they account for 57% of all US women in this age group that are uninsured.
While this is partially due to the fact that 11 states likely to ban abortion have not expanded Medicaid coverage under the Affordable Care Act, all states likely to ban abortion also restrict Medicaid from covering abortions except in limited circumstances. This leaves an additional 5 million women that are effectively uninsured for abortion care in these states now facing added barriers to receiving abortions.
3) Black and Hispanic women
Across the 30 states and DC that reported race/ethnicity for abortions to the CDC in 2019, the abortion rate5 among non-Hispanic Black women and Hispanic women was 3.6 times and 1.8 times higher than that of Non-Hispanic White women, respectively.
Nearly three quarters (73%) of Hispanic women and 59% of non-Hispanic Black women obtained abortions in the 21 states likely to ban them in 2019. Most Hispanic women received abortions in Texas (31%) and Florida (27%). Florida was also the most common location for abortions obtained by non-Hispanic Black women (17%).4
Overall, Hispanic and Black women will be disproportionately impacted by new restrictions on abortion access following the overturning of Roe v. Wade, but it is important to remember that people of color and families with low incomes are also the most likely to lack health insurance and experience financial stress from medical debt. Given the additional costs associated with traveling to states with abortion access, carrying a pregnancy to term, or addressing self-induced abortion complications, abortion bans in these states will only intensify disparities in emotional and financial stress among households of color.
Total abortions and abortions by race/ethnicity data among women aged 15-44 are populated by the CDC's 2019 abortion surveillance data obtained from 47 states and the District of Columbia (California, Maryland, and New Hampshire did not submit abortion data to the CDC in 2019). The number and proportion of women aged 15-49 by income and insurance status is captured from the Guttmacher Institute's analysis of the 2019 American Community Survey.
How to use the maps
Use the drop-down menu at the top of each map to choose the indicator of interest. Each state is color-coded by each indicator, with dark red shading indicating a higher proportion or number relative to other states. Hover over any state for the totals of each indicator and download each tab's data by clicking the download button in the bottom left corner of each tab.
Note: Although a small proportion of abortions and pregnancies occur among transgender men or nonbinary people, we are limited to using abortion and population counts of women of reproductive age produced by the CDC and U.S. Census Bureau.
Yemi Zewdu Yimer, Phoebe Donovan, and Emily Heuser also contributed to this blog post.
1Among 47 states and DC that submitted abortion data in 2019 to the CDC (excluding California, Maryland, and New Hampshire).
2Based on the New York Times' assessment of the 21 states where abortion is prohibited or is likely to be banned or restricted (as of July 1, 2022).
3Incomes below 200% of the 2019 federal poverty level ($21,330 for a family of three in 2019).
4Only 30 states and DC reported 2019 abortions by race/ethnicity. For full transparency, 71% (15/21) of states likely to ban abortions and 50% (15/30) of states and DC not deemed likely to ban abortions reported abortions by race/ethnicity.
5Number of abortions obtained by women in a given racial/ethnic group per 1,000 women in that same racial/ethnic group.
6Among 45 states and DC that submitted abortion data by type in 2019 to the CDC (excluding California, Illinois, Louisiana, Maryland, and New Hampshire).
7Total number of abortions by racial/ethnic group per 1,000 women aged 15-49 in that same racial/ethnic group. Only 30 states and DC reported 2019 abortions by race/ethnicity.
The Supreme Court in June voted 6-3 to overturn the 1973 Roe v. Wade decision and the 1992 Planned Parenthood v. Casey decision, eliminating the constitutional right to an abortion and leaving the legality of abortion up to individual states.
Advisory Board experts break down what health care providers should think about moving forward.
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