No state so far has applied to use Medicaid to help cover costs for people who cross state borders for abortions although President Joe Biden signed the executive order encouraging states to expand abortion access by using the health insurance program over two months ago.
States’ reluctance to immediately act on the administration’s offer is the latest example of how limited the ability of the White House is to mitigate the health care crisis Biden has repeatedly pointed to, absent congressional action.
According to Andrea Miller, president of the National Institute for Reproductive Health, part of the challenge is that there are real limits to executive branch authority so, on top of their efforts to find creative solutions, states must also butt up against the limits of their authority, which is frustrating for everyone.
The Hyde Amendment is one of the limitations state officials face since it prohibits using federal Medicaid money for abortions except in cases of rape, incest or to protect the pregnant person’s life.
The Biden administration has used a federal law governing emergency medical care to challenge several issues since the Supreme Court overturned Roe v. Wade in June, such as Idaho’s near-total abortion ban, among other efforts.
It has also warned pharmacists not to withhold prescription medications that can also be used to induce an abortion and asked mobile providers to share information about their data retention and data privacy policies.
However, it has largely been unable to preserve access for people living in states in which anti-abortion laws were imposed.
Following Biden’s executive order, health officials started debating if obtaining a Medicaid waiver, which is a monthslong process, is the best way to help low-income, out-of-state residents seeking abortion care.
They believe that it is easier and faster for states to help local organizations facilitate travel for out-of-state residents by using their own tax dollars than going through the labyrinth to access federal Medicaid funds.
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