Starting in 2023 in California, all abortion-related related services, including consultations and follow-up care, will be free. A new law prohibits insurance companies from imposing deductibles, copayments or other cost-sharing upon an individual seeking an abortion.
The California Health Benefits Review program estimates that the current average out-of-pocket cost is $306 for a medication abortion and $887 for a procedural abortion.
Medi-Cal, the state’s insurance program for low-income residents, funds the cost of abortion services with state money because the federal government, via the Hyde Amendment, prohibits most federal spending on abortion. California is one of 16 states to pay for abortions, and does so under court order.
Under state law, abortion and related services are considered basic health care and must be covered by all insurance providers, with the exception of self-funded insurance. California and New York are the only two states to require private insurance to cover abortion.
Private insurance may require prior authorization, meaning the patient must seek approval from the insurer prior to getting the abortion, but insurers are not allowed to refuse.
According to a UC San Francisco study on out-of-pocket abortion costs, 7% of those seeking abortion had private insurance coverage, compared to 34% with Medicaid (in California, Medi-Cal) and 29% who received funding from other organizations.
Who’s getting abortions in California
Most Medi-Cal abortions occurred among Californians in their 20s during the past seven years; they account for 57% of abortions.
However, this same age group also saw the steepest declines in the abortion rate between 2014-2020, decreasing by 32%.
California's abortion barrier: geography
In 2021, California contained 165 abortion facilities, according to UC San Francisco’s Advancing New Standards of Reproductive Health Facilities Database. The number of facilities appears to have increased — up from 151 facilities in 2017 — but large swaths of the state still lack a nearby abortion clinic.
Approximately 78% of Californians live in a census tract without a clinic — not necessarily an obstacle in dense cities where several census tracts are only a short drive or bus ride away, but potentially insurmountable for those living in remote rural areas where census tracts can span several counties.
And not all clinics are created equal, according to UCSF researcher Ushma Upadhyay, who leads the database team. More than half of the clinics provide only the abortion pill, and can’t conduct procedures beyond 10 weeks of pregnancy.
Anecdotally, and in other states, Upadhyay said there is some evidence that more primary care providers are prescribing abortion pills — but that’s impossible to verify in California given its refusal to collect state abortion data.
What Californians think about abortion
Over the past two decades, the share of California adults who support legal abortion has generally increased even as the issue has grown more partisan, according to the Public Policy Institute of California, which conducts non-partisan statewide surveys.
Today, the vast majority of Californians support Roe v. Wade’s guarantee of abortion access, with 77% of adults responding that it should not be overturned.
That majority holds regardless of political party, gender or race. Even among Republicans — the group with the highest proportion of voters opposed to abortion — 59% said they supported Roe.
Past polls have shown that public support declines to various degrees when people are asked whether they support using taxpayer dollars to pay for abortions, or allowing minors to obtain them without notifying their parents.