For low-income women in Idaho who have unintended pregnancies, abortion can be a tough decision that becomes much harder because they must pay for the procedure out of pocket.
Idaho bans insurance plans from covering abortions, except in cases of rape, incest or to save the woman’s life. The state’s Medicaid program does not cover them, and insurance plans sold on Idaho’s health exchange don’t either.
Hundreds of Idaho women seek help each year from a regional nonprofit that offers grants for abortion costs.
The Northwest Abortion Access Fund gave $76,250 in grants to Idaho women last year. Most of the money helped pay for their abortions. Some of it covered travel — bus or airplane tickets, cab or Lyft fares — and lodging.
The fund provides aid to women in Washington, Oregon, Idaho and Alaska, but the Gem State’s restrictions on abortion give it an outsized demand on the fund. More than half of the calls for grants come from Idaho.
‘It was a really hard decision to make’
One woman in Boise relied on the fund earlier this year to pay for an abortion provided by a clinic in Meridian.
The woman, who is in her 30s and has children, declined to be named because of fear of backlash from people who disagree with her choice.
It wasn’t a choice she wanted to make. She didn’t think she would need to, because she wasn’t supposed to have been able to conceive anymore. “My doctor was kind of blown away,” she said.
At the time, she was a full-time student and a “hands-on mom” who did not want to put her studies on hold or spend less time with her partner and children. She said those concerns were amplified by her history of difficult pregnancies, including going into labor too early. During her last pregnancy, she lost 30 pounds because of constant vomiting. Doctors gave her a long-term IV to replenish all the fluids she was losing. Home-health and hospice nurses had to take care of her.
“The way I found out I was pregnant [this year] was I was puking everything and anything,” she said. “I missed a ton of school. I couldn’t do anything.
“So, it wasn’t just as simple as, ‘Do you want a kid? Do you not want a kid?’ ” she said. “It was, ‘How am I going to be able to handle this? Can my body sustain it?’ I have good morals, I have good values, and it was a really hard decision to make.”
She was on Medicaid, so her insurance would not pay for the abortion. The Planned Parenthood clinic referred her to the fund. She qualified for a grant and was grateful not to have to worry about money at a time when “my brain had so many thoughts flying through it.”
After the abortion, she cried her eyes out.
She tries not to think about it now. But ending her pregnancy was the best decision to make for her family at that time, she said.
Some Idaho women must travel hours
Her case was fairly typical. But a lot of women have different stories when they call the abortion fund for financial aid. Some must drive hundreds of miles to get to one of Idaho’s few abortion providers.
Trina Stout, communications chair for the fund, said one woman in Twin Falls had to drive to Yakima, Washington, to get an abortion because she could not find any providers closer to her that would do the procedure. The fund helped cover the procedure and got her a place to stay so she wouldn’t have to sleep in her car, Stout said.
“This unfortunately happens a lot, people having to travel out of state for care,” Stout said. “Usually it’s due to what we call ‘chasing the fee’ — a person finds out they’re pregnant in the first trimester and makes the decision to have an abortion, but doesn’t have the money to pay for the procedure. And then while she’s trying to come up with the cost of a first-trimester procedure, time passes and she crosses over into the second trimester, where the price starts jumping by at least $100 with each additional week.
“This caller was chasing the fee for a few weeks before she heard about us. As soon as she called us, we were able to help close the $600 gap.”
The average cost of a first-trimester abortion in the Northwest is $650, according to the fund. But the volunteer-run fund, supported by individual donations, operates on a week-to-week budget of about $3,300, and its grant money usually runs out by midweek. Women who are further into their pregnancies are pushed to the front of the line. (Idaho providers usually won’t do abortions after week 14 of pregnancy, Stout said.)
Idaho women received 1,213 abortions in-state in 2015, the last year for which data are available. An additional 473 women had their abortions out of state, mostly in Washington. Idaho’s abortion rate is about one-third the national average.
Abortion is legal nationwide in the first and second trimesters under the Supreme Court decision in Roe v. Wade in 1973. It is legal in the third trimester if needed to save the life of the mother. Idaho requires a pregnant woman to provide “informed consent” before agreeing to the procedure, and the state publishes a booklet describing the procedure and its risks.
The grantee in Boise said she felt compelled to share her story as a way of “giving back” to the fund that helped her.
“I think a lot of people don’t realize, when you’re making those decisions, people shame you for those decisions, and I think it’s great that there’s a group of people who won’t judge you … won’t ask you why,” the woman said.