July 02,2024

Wyden and Warren Urges GAO to Review States’ Medicaid Coverage of Mifepristone in the Aftermath of the Dobbs Decision

In 2019, GAO found that 14 states were not in compliance with federal law by not covering mifepristone in their Medicaid programs

Washington, D.C. – Senate Finance Committee Chair Ron Wyden, D-Ore., and Senator Elizabeth Warren, D-Mass., wrote a letter to the Government Accountability Office (GAO) urging the agency to update its 2019 report on state Medicaid programs’ coverage of mifepristone, which, in addition to misoprostol, is the only Food and Drug Administration (FDA)-approved prescription for abortion medication in the United States.

“Since the Supreme Court’s June 23, 2022 decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade, patients have had to navigate a compromised and confusing reproductive health landscape,” the senators wrote. “Medication abortion has become a critical access cornerstone, especially for low-income women and women of color enrolled in Medicaid in states that are particularly hostile towards all types of reproductive health care, including women seeking an abortion in instances of rape, incest, or if a pregnancy endangers the patient’s life. In addition, mifepristone can also be prescribed for the treatment of Cushing's syndrome and uterine fibroids. It is imperative that patients, policymakers, and advocates have a full and accurate picture of the Medicaid medication abortion access landscape.”

In 2019, GAO found that 14 states were out of compliance with federal requirements to cover mifepristone for statutorily-authorized uses under the Hyde Amendment’s constraints. Although 10 states have updated their policies and practices since the 2019 GAO report was published, four states – Arkansas, Missouri, Oklahoma, and South Dakota – have failed to indicate whether they have made mandatory Medicaid coverage changes to include mifepristone and resolve this statutory violation. This updated report is necessary to provide a full picture of state Medicaid programs’ current coverage of medication abortion, which, in the wake of the Dobbs decision, now accounts for around 70 percent of all abortions.

The full letter can be found here.

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