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ANN ARBOR—Research finds abortion bans are associated with higher out-of-pocket health insurance premium costs for women, particularly among Black and Hispanic women. 

A new University of Michigan preliminary study shows that state abortion bans implemented following the Supreme Court’s Dobbs decision, in June 2022, are associated with women paying more for health insurance, adding to the financial pressure families face.

As abortion bans lead to increased birth rates, more pregnancy-related complications and emergencies and also infant and maternal death, these outcomes strain the healthcare system and incur costs that are passed onto families through their health insurance premiums.

“Births in general, and complicated births in particular, are very costly,” said Joelle Abramowitz, associate research scientist at U-M’s Institute for Social Research. “As abortion bans lead to more births and especially more complicated ones, insurers pass on these costs across the population they insure by raising premiums.”

The study, “Effects of Post-Dobbs Abortion Bans on Medical Out-of-Pocket Expenditures,” examines nationally representative data from U-M’s Current Population Survey Annual Social and Economic Supplement from 2018 through 2024 to assess how abortion bans affected medical out-of-pocket spending for 60,000 women of reproductive ages 18-44.

Key findings include:

• Abortion bans were associated with a 5.4% increase in annual out-of-pocket premium expenditures for women. 
• Average annual premium expenditures increased by an estimated 12.8% for Black women and 13.7% for Hispanic women.
• Among women of reproductive age, abortion bans were associated with a 2.6 percentage-point increase in private health insurance coverage. 

“Our findings suggest that the consequences of abortion bans extend beyond whether someone can access abortion,” Abramowitz said. “The data show that women in states with abortion bans are more likely to pay out of pocket for health insurance premiums, meaning these policies may impose costs on women and families through the healthcare system itself. Insurers may also be passing costs to beneficiaries in response to increased risk imposed by the spillover effects from abortion bans, like increased maternal and infant mortality and pregnancy care complications.” 

Abramowitz and colleague Olga Aristova, a U-M graduate student in economics, said that the impact of these costs on Black and Hispanic women is more pronounced, highlighting that the economic consequences of these abortion bans are not felt equally.  

“The bottom line is that abortion bans are a kitchen-table issue, adding costs to family budgets,” Abramowitz said. “We know that bans limit access to care. Now we have the data showing that they make health insurance more expensive, too.”  

This study was supported by the Center for Reproductive Rights.

Contact: Fernanda Pires, [email protected]