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Quasebarth M, Boesche M, Turner T, Moore A, Young D, Stulberg D, Hasselbacher L. Patient experiences using public and private insurance coverage for abortion in Illinois: Implementation successes and remaining gaps. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2024. [PMID: 38605588 DOI: 10.1111/psrh.12259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
CONTEXT Insurance coverage for abortion in states where care remains legal can alleviate financial burdens for patients and increase access. Recent policy changes in Illinois required Medicaid and some private insurance plans to cover abortion care. This study explores policy implementation from the perspectives of patients using their insurance to obtain early abortion care. METHODOLOGY Between July 2021 and February 2022, we interviewed Illinois residents who recently sought abortion care at ≤11 weeks of pregnancy. We also interviewed nine key informants with experience providing or billing for abortion or supporting insurance policy implementation in Illinois. We coded interview transcripts in Dedoose and developed code summaries to identify salient themes across interviews. RESULTS Most participants insured by Illinois Medicaid or eligible for enrollment received full coverage for their abortions; most with private insurance did not and faced challenges learning about coverage status. Some opted not to use insurance, often citing privacy concerns. Participants who benefited from abortion coverage expressed relief, gave examples of other financial challenges they could prioritize, and described feeling in control of their abortion experience. Those without coverage described feeling stressed, uncertain, and constrained in their decision-making. CONCLUSION When abortion was fully covered by insurance, it reduced financial burdens and enhanced reproductive autonomy. Illinois Medicaid policy-with seamless enrollment options and appropriate reimbursement rates-offers a model for improving abortion access in other states. Further investigation is needed to determine compliance among private insurance companies and increase transparency.
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Affiliation(s)
- Madeline Quasebarth
- Ci3, Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, USA
| | - Madeleine Boesche
- Crown Family School of Social Work, Policy, and Practice, University of Chicago, Chicago, Illinois, USA
| | - Tecora Turner
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Amy Moore
- Ci3, Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, USA
| | | | - Debra Stulberg
- Department of Family Medicine, University of Chicago, Chicago, Illinois, USA
| | - Lee Hasselbacher
- Ci3, Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, USA
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Poehling C, Downey MM, Singh MI, Beasley CC. From Gaslighting to Enlightening: Reproductive Justice as an Interdisciplinary Solution to Close the Health Gap. JOURNAL OF SOCIAL WORK EDUCATION 2023; 59:S36-S47. [PMID: 38606421 PMCID: PMC11008595 DOI: 10.1080/10437797.2023.2203205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 04/13/2024]
Abstract
This conceptual article aims to inform social work educators on facilitating critical discourse among social work students by applying reproductive justice, leveraging interdisciplinary practice, and addressing the Social Work Grand Challenges. Reproductive justice tenets provide an interdisciplinary framework that assists in the development of the learning environment, participant's critical thinking, self-awareness, and self-regulation; preparing them for professional dialog and ethical decision making. This article will outline the tenets of reproductive justice, providing resources and tools for creating an environment that will assist in the facilitation of critical and professional conversations; while providing strategies that incorporate interdisciplinary partners into the classroom thus providing a reproductive justice sensitive analysis and solutions for approaching social issues that affect the people social workers serve.
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Affiliation(s)
- Catherine Poehling
- Catherine Poehling, School of Social Work, University of Southern Mississippi, 3085-3099 Pearl Street, Hattiesburg, MS 39401
| | - Margaret Mary Downey
- Catherine Poehling, School of Social Work, University of Southern Mississippi, 3085-3099 Pearl Street, Hattiesburg, MS 39401
| | - Melissa Indera Singh
- Catherine Poehling, School of Social Work, University of Southern Mississippi, 3085-3099 Pearl Street, Hattiesburg, MS 39401
| | - Candice C Beasley
- Catherine Poehling, School of Social Work, University of Southern Mississippi, 3085-3099 Pearl Street, Hattiesburg, MS 39401
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Hill SV, Pratt MC, Elopre L, Smith TV, Simpson T, Lanzi R, Matthews LT. "Let's take that [stop sign] down." Provider perspectives on barriers to and opportunities for PrEP prescription to African American girls and young women in Alabama. AIDS Care 2022; 34:1473-1480. [PMID: 35914114 PMCID: PMC9889573 DOI: 10.1080/09540121.2022.2105799] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 07/20/2022] [Indexed: 02/03/2023]
Abstract
HIV disproportionately impacts many groups, including Black adolescent girls and young women (AGYW) aged 13-24 living in the Deep South. Current prevention efforts have the potential to further exacerbate disparities within this population as HIV pre-exposure prophylaxis (PrEP) remains underutilized by Black AGYW in the South. We conducted in-depth interviews (IDIs) grounded in Andersen's Model of Healthcare Utilization exploring providers' PrEP prescribing practices to Black AGYW in Alabama. Eleven providers completed IDIs exploring providers' PrEP prescription knowledge and experiences. Cross-cutting themes included: (1) Community and provider-level stigmas (including those propagated by legislation) relating to HIV and sexuality limit sexual health discussions with Black AGYW clients; (2) Low PrEP knowledge and comfort with guidelines limits PrEP conversations and reinforces low uptake and prescriptions; (3) Healthcare systems and structural barriers impede PrEP access for youth. Multi-level (structural, community, and provider) barriers to PrEP prescription demands high activation energy for providers to prescribe PrEP. We present recommendations in training in sexual health assessment, updates to PrEP guidelines to accommodate risk assessment appropriate for AGYW, and increased implementation science focused on PrEP prescription for Black AGYW in order to reduce HIV incidence for this population.
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Affiliation(s)
- Samantha V. Hill
- Department of Pediatrics, University of Alabama at Birmingham (UAB), School of Medicine, Birmingham, AL, USA
| | - M. C. Pratt
- Division of Infectious Diseases, University of Alabama at Birmingham (UAB), School of Medicine, Birmingham, AL, USA
| | - L. Elopre
- Division of Infectious Diseases, University of Alabama at Birmingham (UAB), School of Medicine, Birmingham, AL, USA
| | - T. V. Smith
- Department of Pediatrics, University of Alabama at Birmingham (UAB), School of Medicine, Birmingham, AL, USA
| | - T. Simpson
- Department of Pediatrics, University of Alabama at Birmingham (UAB), School of Medicine, Birmingham, AL, USA
| | - R. Lanzi
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - L. T. Matthews
- Division of Infectious Diseases, University of Alabama at Birmingham (UAB), School of Medicine, Birmingham, AL, USA
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Riley T, Zia Y, Samari G, Sharif MZ. Abortion Criminalization: A Public Health Crisis Rooted in White Supremacy. Am J Public Health 2022; 112:1662-1667. [PMID: 36223577 PMCID: PMC9558193 DOI: 10.2105/ajph.2022.307014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
The Supreme Court decision to overturn Roe v. Wade and the growing onslaught of state laws that criminalize abortion are part of a long history of maintaining White supremacy through reproductive control of Black and socially marginalized lives. As public health continues to recognize structural racism as a public health crisis and advances its measurement, it is imperative to explicate the connection between abortion criminalization and White supremacy. In this essay, we highlight how antiabortion policies uphold White supremacy and offer concrete strategies for addressing abortion criminalization in structural racism measures and public health research and practice. (Am J Public Health. 2022;112(11):1662-1667. https://doi.org/10.2105/AJPH.2022.307014).
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Affiliation(s)
- Taylor Riley
- Taylor Riley and Yasaman Zia are with the Department of Epidemiology, School of Public Health, University of Washington, Seattle. Goleen Samari is with the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY. Mienah Z. Sharif is with the Department of Epidemiology, School of Public Health, University of Washington, Seattle, and the Center for the Study of Racism, Social Justice and Health, University of California, Los Angeles
| | - Yasaman Zia
- Taylor Riley and Yasaman Zia are with the Department of Epidemiology, School of Public Health, University of Washington, Seattle. Goleen Samari is with the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY. Mienah Z. Sharif is with the Department of Epidemiology, School of Public Health, University of Washington, Seattle, and the Center for the Study of Racism, Social Justice and Health, University of California, Los Angeles
| | - Goleen Samari
- Taylor Riley and Yasaman Zia are with the Department of Epidemiology, School of Public Health, University of Washington, Seattle. Goleen Samari is with the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY. Mienah Z. Sharif is with the Department of Epidemiology, School of Public Health, University of Washington, Seattle, and the Center for the Study of Racism, Social Justice and Health, University of California, Los Angeles
| | - Mienah Z Sharif
- Taylor Riley and Yasaman Zia are with the Department of Epidemiology, School of Public Health, University of Washington, Seattle. Goleen Samari is with the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY. Mienah Z. Sharif is with the Department of Epidemiology, School of Public Health, University of Washington, Seattle, and the Center for the Study of Racism, Social Justice and Health, University of California, Los Angeles
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