Maryland Taps Affordable Care Act Fund to help pay for abortion care

Maryland is the first state to use a 15-year fund connected to the Affordable Care Act, to solve a more recent problem: helping to pay the costs of patients traveling to Maryland for an abortion.

The law was passed this spring and came into force on July 1.

Since the Supreme Court was destroyed Roe v. Wade In 2022, states such as Maryland where abortion remains legally, seen an increase in abortion procedures, including patients who cannot get legal abortion in their home state. Many of those patients need financial assistance for the procedure itself, or to pay for traveling from other states and accommodation while they recover.

That financial aid is often offered by local and regional abortion funds, such as the Baltimore Abortion Fund. They are non -profit organizations that help individuals pay for reproductive care, travel and related costs.

But because more and more patients have traveled to Maryland, some abortion funds have exhausted their means. That puts financial pressure on abortion providers in Maryland who want to serve those traveling patients, as well as uninsured or low incomes looking for the same care.

Doctors in Maryland carried out around 39,000 abortions last year, an increase of 26% compared to 2020, according to At the Guttmacher Institute, a non -profit organization focused on research into sexual health.

Maryland is now the first state in the nation that takes a law with the help of a much forgotten aspect of the affordable care act to help finance that care. The money comes from reimbursements paid by insurance companies participating in the ACA marketplaces.

Maryland’s movement is an innovative solution for states that have opened their doors for patients outside the state, but are struggling with the logistics and costs of the increased clinical demand in a postalCalf landscape.

“This bill is super important for Maryland, we ensure that our clinics remain open,” says Maryland State del. Lesley Lopez, a democrat that sponsored the bill. “Maryland has been a leader for many reproductive accounts for the past 30 years, so this bill fits in that in that way.

“It is also nationally important, because there are 25 or 26 other states who can take this model and run with it. We are looking for California, Illinois, New York, those larger states who are in potentially hundreds of millions of dollars to take what we have done here in Maryland and implement it there.”

Financial dilemma

With abortion now limited or illegal in 22 states, jurisdictions such as Maryland have become a destination for patients from as close as neighbor West Virginia and Texas.

With a staff of six, the Baltimore Abortion Fund Helps patients pay for bus or airline tickets, shelter in Maryland and sometimes even meals while they travel. The fund spends around one million dollars a year on that support. The calls to his confidential help line have since increased by 50-60% Calf was destroyed, said Lynn McCann-Yeh, the co-director of the fund.

The fund is helped weekly, measuring funds as people call. Often the weekly allocation is exhausted after just one or two days.

“Sometimes that means that our helpline closes within 24 to 48 hours at the start of the week, because there is just too much demand for the amount of resources we have,” said McCann-Yeh.

“There are many every week, many more dozens of callers who just get a voicemail message and say that we no longer have support.”

A new way to pay abortions

To help, Maryland’s legislative power turned a pot with money under the Affordable Care Act 2010. According to the Act, States can decide to demand insurance plans that are sold at the “market places” to cover abortion. The plans had to charge a minimum costs of at least $ 1/month for each plan that was purchased through the market.

That money was then placed in an account that would be used to pay when insured patients received abortion care.

More than 90% of patients at partners in Abortion Care receive financial assistance through various abortion funds.

Scott Maucione/WYPR

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Scott Maucione/WYPR

The state accounts were necessary because of another federal law, the Hyde amendment, which limits the federal government to pay abortions (except for matters related to rape, incest or serious medical risk for the patient.)

Because the federal government subsidizes partial insurance plans that have been sold through the ACA marketplaces, the commercial insurers had to use their own money to pay the monthly reimbursement for each policyholder.

“Insurers have quietly met the special rules of ACA, resulting in these separate bills that contain millions of dollars, intended for abortion coverage,” Duffy said.

In the course of time, the accumulated reimbursements in such accounts have surpassed the recordings for abortion care for women about those insurance plans. Maryland’s account has grown to $ 25 million and it continues to take around $ 3 million every year.

The new law of Maryland enables the state health department to tap those funds and to allocate up to $ 2.5 million a year to subsidies to the abortion funds that are active in Maryland, who can then use that money for traveling patients, patients with a low income in Maryland, or those who have no insurance cover at all.

“We know that we can use those funds wisely and to ensure that we do not reject a patient because of their inability to pay,” says Ramsie Monk, the Development Director in the Women’s Health Center of Maryland, a clinic at the border with West Virginia.

Without the help of abortion funds, many of the patients who are seen in clinics would not be able to pay for their care, says Dr. Diane Horvath, an OB/Gyn at partners in Abortuszorg, a clinic in College Park, Maryland. Unlike some other clinics, which only offer abortion up to 16 weeks of pregnancy, partners in abortion care can later offer an abortion. Those procedures are more complicated and more expensive.

More than 90% of patients at partners in Abortion Care receive financial assistance through various abortion funds.

“I would say that a typical patient we probably see every week is someone who already has at least one child, they are working on a job that does not offer substantial leave for medical care, it may not offer health insurance or the insurance it offers does not cover abortion, especially if they come from the state and they are struggling and horvath,” said.

Opponents push back on the role of the state

Anti-abortion groups in Maryland are opposed to the bill and claimed that it forces some insurance consumers to pay for procedures with which they may not agree.

“This bill uses insurance premiums of insured women to break down the children of uninsured women,” Laura Bogley, the executive director of Maryland Right to Life, told The state legislator on March 6.

“Many of those uninsured women are residents of non-Maryland who are traded in the state for abortions in the late term that are limited by other states.”

The supporters of the bill deny that traveling patients are traded when they are looking for their own will looking for healthcare.

The law officially took effect on July 1, and the first tranche of money must be transferred to the State Health Department against the fall before they can start subsidies.