How State Policies Shape Access to Abortion Coverage

How State Policies Shape Access to Abortion Coverage Editorial note: Updated April 27, 2026 with new updates for Pennsylvania. State and federal efforts to limit abortion coverage began soon after the 1973 Supreme Court’s Roe v Wade decision. In 1977, the Hyde Amendment banned federal funding for abortion, with exceptions for pregnancies that endanger the life of the woman, or result from rape or incest. Some states use their own funds to cover other medically necessary abortions for their Medicaid enrollees or have been compelled to do so by the courts. The passage of the ACA in 2010 led to renewed legislative efforts to limit abortion coverage, this time in private insurance plans. The ACA maintains the Hyde Amendment’s limits, and permits states to ban abortion coverage from Marketplace plans. Since 2010, many states have enacted private plan restrictions and also banned abortion coverage from Marketplace plans, some of which are more restrictive than the Hyde limitations. A handful of states, however, have enacted laws that require private plans to cover abortion and state funds to cover abortions for Medicaid enrollees. https://www.kff.org/womens-health-policy/state-policies-on-abortion-coverage-in-medicaid-private-insurance-and-aca-exchange-plans/