New study shows limits with online abortion clinics
Exclusively online clinics proliferated in many states after Dobbs. Challenges remain with insurance coverage and age restrictions.
A new study shows the limitations faced by women who use online clinics to get abortion medication.
Researchers with Advancing New Standards in Reproductive Health, a collaborative research group at the University of California at San Francisco, published Virtual clinic telehealth abortion services in the United States one year after Dobbs: a landscape review in the Journal of Medical Internet Research earlier in this year.
“While abortion was becoming unavailable, essentially in some states, patients options for telehealth abortion were really increasing in states where telehealth abortion is available,” study co-author Leah Koenig said.
They spent two years tracking and monitoring online clinics to see how much they grew and what challenges they faced in emerging as leading abortion providers. In 2022, there were 11 such clinics available in 26 states and Washington, D.C.
Two years later, that had grown to 20 clinics in 27 states and D.C.
The average price for telehealth abortions was $250
“That's considerably lower than costs for in-clinic medication abortion care,” Koenig said. “However, there were some policies where we see room for virtual clinics to take action to make sure they can make even more patients.”
Along the way, the researchers discovered inequities faced by the women who used the services. Limited insurance options presented difficulties for those who needed an abortion.
“So while that cost of care is lower, there's really limited private insurance and Medicaid acceptance, which means that while those prices were lower, actually, for some patients, it may be less accessible than care that is covered by insurance or Medicaid,” Koenig said.
The patient needed a credit or debit card to pay the fees at many clinics. Some clinics offered some forms of financial assistance.
Age restrictions also hampered access. Many clinics did not serve patients under the age of 18
“A lot did not serve minors, which, as you can imagine, young people stand to benefit, especially for models of care where they can access care at lower costs and avoid needing to travel.”
The remaining 23 states that don’t have exclusively online clinics can be categorized into two groups: those with restrictive or total bans and those with restricted telehealth.
Many states have enacted shield laws that have protected many of these clinics, but that sometimes doesn’t help women who live in restrictive areas.
“However, there is still a risk of criminalization for patients in those states, which is obvious,” Koenig said. “That's something that folks are concerned about and maybe a major source of concern for some patients.”