title: Strategies for securing funding for abortion under the Hyde Amendment: a multistate study of abortion providers' experiences managing Medicaid.
abstract: OBJECTIVE
  We investigated systematic barriers, identified by previous research, that prevent women from obtaining Medicaid coverage for an abortion even when it should legally be available: when the pregnancy resulted from rape or incest or threatens the mother's life. We also aimed to document strategies to improve access to federal Medicaid funding in qualifying cases.
  
  
  METHODS
  We conducted in-depth interviews from 2007 to 2009 with representatives of 49 facilities that provided abortions in 11 states. Interviews focused on participants' experiences and strategies in seeking federal Medicaid funding for abortions. We coded data both inductively and deductively and analyzed them thematically.
  
  
  RESULTS
  Common strategies described by the few participants who secured Medicaid funding for abortions in cases of rape, incest, and life endangerment were facility-level interventions, such as developing relationships with Medicaid staff, building savvy billing departments, and encouraging clients to advocate for themselves, as well as broader legal and collaborative strategies.
  
  
  CONCLUSIONS
  Multipronged state-level interventions that combine advocacy, legal, and on-the-ground resources show the most promise of increasing access to federal Medicaid funding for abortion care.
authors.affiliation: adennis@ibisreproductivehealth.org
authors.forename: Amanda
authors.initials: A
authors.lastname: Dennis
authors.forename: Kelly
authors.initials: K
authors.lastname: Blanchard
authors.forename: Denisse
authors.initials: D
authors.lastname: Córdova
mesh_terms: D000028:Abortion, Induced / Q000706:statistics & numerical data*; D000554:Ambulatory Care Facilities / Q000191:economics* / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data*; D007407:Interviews as Topic; D008484:Medicaid / Q000458:organization & administration* / Q000706:statistics & numerical data*; D014481:United States