GAO Recommends CMS Action to Ensure Medicaid Abortion Coverage

The U.S. General Accounting Office (GAO) recently released the CMS Action Needed to Ensure Compliance with Abortion Coverage Requirements report.  Federal law prohibits federal funding for abortions in most circumstances, but state Medicaid programs are required to cover abortions if the pregnancy is the result of rape or incest, or the life of the pregnant woman is physically endangered by the pregnancy.  [See Pub. L. No. 115-245, §§ 506-7, 132 Stat. 2981, 9/28/18.]  The GAO report documents “state variation in Medicaid abortion coverage and payment requirements,” including South Dakota’s Medicaid state plan not covering abortions in cases of rape or incest, and 14 states not covering Mifeprex, a drug used in non-surgical abortions.  The GAO report also identifies “seven key factors that could pose challenges to women accessing abortions…:  gestational limits, mandatory counseling, out-of-pocket costs, parental involvement requirements, provider availability, stigma and harassment, and waiting period requirements.”  As the federal agency that oversees Medicaid, the Centers for Medicare & Medicaid Services (CMS) monitors state compliance with federal requirements.  The GAO report recommends CMS action to ensure South Dakota’s compliance with federal law, as well as to determine state Medicaid program coverage of Mifeprex and accurate reporting of fee-for-service abortions.