Oct 11, 2021
California is often held up as the beacon of abortion rights. The “Golden State” doesn’t only recognize a woman’s right to have an abortion, without the restrictions found in many other states; it also mandates that health insurers cover abortion. And despite the federal Hyde Amendment, which forbids federal funds to be used for almost all abortions, Medi-Cal, California’s health insurance for the poor, pays for abortions also.
But despite all this, women still face real difficulties and barriers in getting an abortion, especially for the working class and poor. First of all, more than 20, mostly rural, California counties have no clinic that provides abortions.
And it’s not just abortion. In some rural parts of California, there is not even basic healthcare available for women. In 2014, about one third of rural counties in California had no hospital obstetrical units. So, women often have to travel as much as 300 miles to find an abortion provider. But many working-class women can’t take time off to travel such long distances, either out of fear of losing their jobs or because they don’t have anyone to take care of their other children when they are away.
As for insurance coverage, yes, California requires health insurers to cover abortions. But even with insurance, the out-of-pocket cost for deductibles and co-pays can range anywhere between 300 dollars (for a medication abortion) and more than 1,000 dollars.
So, even though insurance may cover abortion, many can’t afford it anyway.
Of course, for the poorest segment of the working class, Medi-Cal does provide coverage for abortion for free. But the barrier there is that many healthcare providers in California, including abortion clinics, don’t accept Medi-Cal because the reimbursement rate is so low, they don’t even cover the providers’ basic costs.
Like all legalities, rights granted on paper don’t necessarily come true in the real world—not in capitalist society, which erects obstacles in front of the working class and the poor in all areas of life.