States vary in their policies on health insurance coverage of abortion, so the Charlotte Lozier Institute (CLI) has compiled a table to show which states require, permit, or prohibit coverage of elective abortion through marketplace (ACA) plans, private insurance, and/or Medicaid.
Americans should be able to make an informed decision about their healthcare coverage, a choice that is impacted by their values. Therefore, this table seeks to clarify state health insurance laws or regulations related to abortion coverage. This table refers to “elective abortions” as all abortions that cannot receive federal funding under the Hyde Amendment, which only allows federal Medicaid funding for abortions performed to save the life of the mother or for reasons of rape or incest. All states provide some type of coverage for these exceptions; however, coverage for elective abortion varies widely. States are able to use their own Medicaid funds to subsidize abortions despite Hyde, as the table below shows some have done.
The table distinguishes among states that require insurance plans to cover abortion, states that prohibit insurance coverage, and states that do not have any requirements or limitations in their laws. The information in the table is solely based state laws and regulations and does not reflect whether women use health insurance to cover elective abortion in a particular state or whether, in practice, any individual insurance company covers abortion. For example, some states which technically permit private insurance to cover abortion have pro-life laws which restrict most abortions.
Table 1. Health Insurance Coverage of Elective Abortion by State and Coverage Type
| State | Marketplace (ACA) Plans (Permitted/Required/Prohibited) | Private Insurance (Permitted/Required/Prohibited) | Medicaid Coverage (Yes/No) |
| Alabama | Prohibited | Permitted | No |
| Alaska | Permitted | Permitted | Yes |
| Arizona | Prohibited | Permitted | No(1) |
| Arkansas | Prohibited | Permitted | No |
| California | Required | Required | Yes |
| Colorado | Required | Required | Yes |
| Connecticut | Permitted | Permitted | Yes |
| Delaware | Required | Required | Yes |
| District of Columbia | Required | Required | No |
| Florida | Prohibited | Permitted | No |
| Georgia | Prohibited | Permitted | No |
| Hawaii | Permitted | Permitted | Yes |
| Idaho | Prohibited | Prohibited | No |
| Illinois | Required | Required | Yes |
| Indiana | Prohibited | Prohibited | No |
| Iowa | Permitted | Permitted | No(2) |
| Kansas | Prohibited | Prohibited | No |
| Kentucky | Prohibited | Prohibited | No |
| Louisiana | Prohibited | Permitted | No |
| Maine | Required | Required | Yes |
| Maryland | Required | Required | Yes |
| Massachusetts | Required | Required | Yes |
| Michigan | Permitted | Permitted | No |
| Minnesota | Required | Required | Yes |
| Mississippi | Prohibited | Permitted | No(2) |
| Missouri | Prohibited | Prohibited | No |
| Montana | Prohibited | Permitted | Yes |
| Nebraska | Prohibited | Prohibited | No |
| Nevada | Permitted | Permitted | Yes |
| New Hampshire | Permitted | Permitted | No |
| New Jersey | Required | Required | Yes |
| New Mexico | Permitted | Permitted | Yes |
| New York | Required | Required | Yes |
| North Carolina | Prohibited | Permitted | No |
| North Dakota | Prohibited | Prohibited | No |
| Ohio | Prohibited | Permitted | No |
| Oklahoma | Prohibited | Prohibited | No |
| Oregon | Required | Required | Yes |
| Pennsylvania | Prohibited | Permitted | No |
| Rhode Island | Permitted | Permitted | Yes |
| South Carolina | Prohibited | Permitted | No |
| South Dakota | Prohibited | Permitted | No |
| Tennessee | Prohibited | Permitted | No |
| Texas | Prohibited | Prohibited | No |
| Utah | Prohibited | Prohibited | No |
| Vermont | Required | Required | Yes |
| Virginia | Permitted | Permitted | No(2) |
| Washington | Required | Required | Yes |
| West Virginia | Permitted | Permitted | No(2) |
| Wisconsin | Prohibited | Permitted | No |
| Wyoming | Permitted | Permitted | No |
1. Arizona is required by a court order to cover “medically necessary” abortions beyond the standard established by the Hyde Amendment.
2. Medicaid also covers abortions when the unborn baby has received a poor prenatal diagnosis.
Sources
1. Alabama: Code of Ala. § 26-23C-2-4; Ala. Admin. Code. R. 560-X-6-.09
2. Alaska: Planned Parenthood of the Great Northwest v. Streur, et al.
3. Arizona: Simat Corp. v. Ariz. Health Care Cost Containment Sys., 56 P.3d 28 (2002); A.R.S. § 20-121
4. Arkansas: Ark. Code Ann. § 23-79-156
5. California: Abortion Accessibility Act; CA Department of Insurance
6. Colorado: SB23-189; SB25-183
7. Connecticut: Abortion Access in Connecticut
8. Delaware: HB 110 (2024)
9. District of Columbia: Code of D.C. § 31–3834.03a
10. Florida: Fla. Stat. § 641.31099; Fla. Stat. § 627.64995; Abortion Certification Form
11. Georgia: O.C.G.A. § 33-24-59.17; § 45-18-4
12. Hawaii: Hawaii Medicaid
13. Idaho: Idaho Code Ann. § 41-1848; Idaho Code Ann. § 41-3439; Idaho Code Ann. § 41-3924
14. Illinois: Illinois Department of Insurance Reproductive Health FAQs; ; 215 ILCS 5/356z.4a; 305 ILCS 5/5-5
15. Indiana: IAC § 5-28-7; Ind. Code Ann. § 27-8-33-4; Ind. Code Ann. § 27-8-13.4-2; Ind. Code Ann. § 27-13-7-7.5
16. Iowa: 441 IAC §78.1(249A)(17)
17. Kansas: Kan. Stat. Ann. § 40-2,190
18. Kentucky: KRS § 18A.225; KRS § 304.5-160
19. Louisiana: La. Rev. Stat. Ann. § 49:200.51; La. Rev. Stat. Ann. § 22:1014
20. Maine: Maine DHHS: Access to Abortion Care in Maine; 22 MRSA §3196; 24-A MRSA §4320-M
21. Maryland: Abortion Care Access Act
22. Massachusetts: Bulletin 2023-01 – Abortion and Abortion Related Care; Massachusetts State Law Protects Access to Abortion; Act Expanding Protections for Reproductive and Gender Affirming Care
23. Michigan: Reproductive Health Act [repealing MCL §§ 550.541 to 550.551]; MCL § 400.109a; Certification for Induced Abortion
24. Minnesota: Minn. Stat. 62Q.524; Abortion Rights
25. Mississippi: Miss. Code Ann. § 41-41-91; Miss. Code Ann. § 41-41-97; Miss. Code Ann. § 41-41-99
26. Missouri: Mo. Rev. Stat. § 376.805; Mo. Rev. Stat. § 188.205; Stangler v. Shalala
27. Montana: MCA § 33-22-116; Planned Parenthood of Montana v. State of Montana
28. Nebraska: Neb. Rev. Stat. § 44-8403; Neb. Rev. Stat. § 44-1615.01; Medicaid Services
29. Nevada: Nevada Medicaid Web Announcement 3505; Silver State Hope Fund v. Nevada Department of Health and Human Services
30. New Hampshire: Certification of the Decision to Terminate Pregnancy
31. New Jersey: NJ Reproductive Health Information Hub; New Jersey Department of Banking and Insurance, Freedom of Reproductive Choice Act, Report to the Governor and Legislature
32. New Mexico: NM Health; New Mexico Right to Choose/NARAL v. Johnson
33. New York: New York State Payment Options; 11 NYCRR 52.16 [o] [1]; https://www.health.ny.gov/health_care/managed_care/famplan10ques.htm
34. North Carolina: N.C. Gen. Stat. § 58-51-63; NC Medicaid Clinical Coverage Policy No: 1E-2
35. North Dakota: N.D. Admin Code 75-02-02-08; N.D. Cent. Code 14-02.3-01─03
36. Ohio: ORC Ann. § 5101.56; ORC Ann. § 3901.87
37. Oklahoma: O.A.C. § 317:30-5-6; 63 OK Stat § 1-741.1
38. Oregon: Reproductive Health Equity Act; Oregon Health Authority: Paying for an Abortion
39. Pennsylvania: 18 Pa.C.S. § 3215; 40 Pa.C.S. § 33
40. Rhode Island: Equality in Abortion Coverage Act
41. South Carolina: S.C. Code Ann. § 1-1-1035; S.C. Code Ann. § 38-71-238
42. South Dakota: S.D. Codified Laws § 28-6-4.5; S.D. Codified Laws § 58-17-147
43. Tennessee: Tenn. Code Ann. § 56-26-134; Tenn. Code Ann. § 9-4-5116
44. Texas: Tex. Ins. Code § 1218.001-004; 1 Tex. Admin. Code § 354.1167
45. Utah: Utah Code Ann. § 76-7-331; Utah Code Ann. § 31A-22-726
46. Vermont: 8 V.S.A. § 4079
47. Virginia: Va.Code. Ann. §§ 32.1-92.1, 32.1-92.2
48. Washington: Reproductive Parity Act
49. West Virginia: W. Va. Code § 9-2-11
50. Wisconsin: Wis. Stat. § 632.8985; Wis. Stat. § 20.927
51. Wyoming: Wyo. Stat. § 35-6-138
