Medicaid expansion helps more women

abortion picketers

Picketers on the sidewalk outside Whole Woman’s Health, 7405 N. University St., have become more aggressive in recent months. Picketers can legally yell, taunt and wave posters of fetal body parts inches from women driving onto the clinic property. (Photo by Clare Howard)

For those who consider access to safe, legal abortion a basic human right, there was a sense of justice when Gov. Bruce Rauner defied many in his base and signed House Bill 40 into law. The legislation, effective Jan. 1, makes Illinois one of 17 states to extend Medicaid to cover abortion.

This legislation is good public policy, advocates contend, but issues with implementation remain to be worked out.

Lorie Chaiten, attorney with the ACLU, said implementation is complicated, and the ACLU is looking at a variety of ways to help achieve the goal.

“While HB 40 is a huge step forward, there are still a lot of women who don’t qualify for Medicaid and will scramble to get money to pay rent or pay for a medical procedure,” Chaiten said.
She is optimistic about the ability to help more women seeking abortions.

HB 40 aims to provide poor and low-income women on Medicaid with equal access to abortion services that are already available to women with the financial means to pay for the procedure.

Chief House sponsor Rep. Sara Feigenholtz, D.-Chicago, praised Rauner for signing the legislation. In a released statement she said, “After repeated threats to overturn Roe vs. Wade by President Trump, today, Gov. Rauner chose to protect Illinois women by agreeing to sign HB 40 to keep abortion safe, legal and accessible to all Illinois women. Signing this legislation is necessary to safeguard a woman’s right to make decisions that affect her personal health.”

In January, Medicaid in Illinois will cover $198 for a first-trimester abortion. The actual cost is about $475. Healthcare providers have said the $198 reimbursement would not cover their costs, putting them in an untenable financial situation.

Not-for-profit groups dedicated to ensuring equal access to safe legal abortion for all women are exploring ways to supplement the gap in funding.

In signing HB 40, Rauner said, “I also believe that no woman should be forced to make a different decision than another woman would make purely based on her income. I believe that a woman living with limited financial means should not be put in the position where she has to choose something different than a woman of higher income would be able to choose.”

The United Nations has recognized access to safe, legal abortion as a basic human right.

Before HB 40, Medicaid in Illinois theoretically covered abortion when the pregnancy resulted from rape, incest or to save the life of the mother. That was the law, but the reality was even when a pregnancy resulted from rape, incest or jeopardized the life of the mother, Medicaid rarely paid. In response to a request for documents under the Freedom of Information Act, records show that Medicaid in Illinois, in the first three quarters of 2016, covered 36 abortions resulting from rape, zero resulting from incest, 8 to save the mother’s life and 63 to protect the health of the mother. That is statewide out of almost a million women of childbearing age (14 – 44) on Medicaid. Clearly, Medicaid was not helping women in any circumstance. HB 40 eliminates those theoretical carve-outs and covers all women on Medicaid.

Clare Howard

Clare Howard is the editor of the Community Word. She can be reached at

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