Abortion Costs Vary Widely Across States Following Dobbs v Jackson Decision

Varied access to abortion care has been shown to significantly increase logistical costs for women in states with strict abortion bans on top of out-of-pocket payments for abortion care itself. A new study published in JAMA Network Open aimed to quantify the exact expenditures of self-pay prices and state Medicaid acceptance to help those seeking care expedite their search.¹

Following the Dobbs v Jackson decision delegating abortion restrictions back to states, brick-and-mortar abortion clinics closed throughout the country, especially in key access states like New York.² States with more lenient abortion restrictions and those with no restrictions have become havens for women seeking care in states with strict bans. For women in low-income brackets, knowing self-pay prices is important for dictating when and where they can afford care. However, only 20 states use government funds to cover abortion, and some facilities don’t use third-party billing for care. Also, since the Hyde Amendment of 1976, prohibiting federal Medicaid from covering abortions, 25 states have prohibited some or all private insurance from covering abortion.¹

Self-pay prices for abortion are determined by the facility providing care, but prices vary depending on gestation in the second and third trimesters, although most facilities’ first-trimester and procedural abortion prices are fixed.

The study compiled data from 3 sources to identify 130 health care facilities that provide abortion care at 23 weeks. Of them, 52 were clinics and 78 were hospital-affiliated centers. Researchers further categorized participating health care facilities by a gestation cap—what week they stopped providing abortion care—into 6 duration periods: 23, 25, 27, 29, 31, and 33 or more weeks. The number of hospitals declined as the duration periods increased.

From November 2024 to April 2025, researchers called each facility inquiring about the self-pay price for each duration period. Of the 28 states in which abortion was legal at 23 weeks, the 130 facilities included in the analysis were in 19 of those states; Washington, DC; and 1 state where abortion was prohibited at 12 weeks but allowed for medical exceptions.

Researchers made 522 calls overall to the 130 facilities for each 2-week pregnancy duration for which abortion services were advertised. They successfully reached 173 units at least once. The overall response rate for obtaining at least 1 quoted self-pay price or range was 60.2%.

The median (IQR) self-pay prices were $3000 ($2197-$4136) at 23 weeks (75 facilities [57.7%]), $6090 ($4250-$7044) at 25 weeks (19 [61.3%]), $7975 ($7750-$10,195) at 27 weeks (9 [81.8%]), $11,500 ($10,325-$12,900) at 29 weeks (4 [66.7%]), $19,000 ($16,750-$19,400) at 31 weeks (3 [60.0%]), and $17,250 ($16,375-$18,125) at 33 weeks (2 [66.7%]).

Although prices increased parallel to gestation, researchers observed a significant increase in price of $2435, specifically from 23 to 25 weeks (12 facilities) (P = .001).

There were 105 facilities in states with Medicaid coverage at the time, and 75 of them provided a response. In 4 states, some facilities advertising abortion care at 23 weeks reported not accepting Medicaid during at least 1 call, including California (14 of 28 [50%]), Maryland (1 of 2 [50%]), and Oregon (2 of 3 [67%]).

“Although the need for later abortion care is less common than earlier in pregnancy, timeliness is critical as even short delays are associated with substantial increases in self-pay prices,” the study authors wrote. “Prior studies have found that delays in care are often related to difficulty identifying appropriate facilities, particularly in the absence of referrals.”

The study was limited as researchers only contacted facilities that advertised abortion care at 23 weeks or later, thus excluding facilities that did not publicly advertise them; they may differ from those included in the study. Additionally, only a third of the facilities that responded gave a quote, leaving the study authors to caution those who use these data to treat them as representative of general pricing structures as opposed to a fixed amount.

“Improving self-pay price transparency and expanding the availability and visibility of later abortion care may support abortion seekers to access appropriate services more quickly,” the study authors concluded.

References:

1. Weitz TA, Schwartz MW. Later abortion care availability, quoted self-pay prices, and state Medicaid acceptance. JAMA Netw Open. 2026;9(6):e2616370. doi:10.1001/jamanetworkopen.2026.16370

2. Steinzor P. Abortion clinics are shuttering even in major access states. AJMC^®. February 18, 2026. Accessed June 1, 2026. https://www.ajmc.com/view/abortion-clinics-are-shuttering-even-in-major-access-states