In the Midwest, seven states have adopted the policy of the Hyde Amendment. Michigan, Indiana, Ohio, Iowa, Kansas, Missouri, and North Dakota all only offer public state funding for abortion in the cases of rape, incest, and life endangerment. In Wisconsin, public funding for abortion is only available in cases of rape, incest, life endangerment, and when it becomes necessary to prevent long-lasting damage to the woman's health. In Kansas and Illinois, abortion is covered under private insurance policies only in the case of life endangerment, but the states must also comply with the conditions set under the Hyde Amendment.
Of all the Midwest states, South Dakota is the most conservative when it comes to providing funding for abortions. State public funding for abortion is only available in the case of life endangerment. And if Roe v. Wade would ever be overturned in the future, abortion would be banned altogether. Besides limiting public funding for women seeking abortions, South Dakota also requires women to wait 72 hours between their initial appointment and their actual abortion-the longest waiting period required of all states. Women must also undergo counseling from pregnancy crisis centers which discourage the practice of abortions. Under South Dakota law, life is defined as beginning at conception, and the state also requires parental consent before a minor can receive an abortion.
Compared to South Dakota's lowest abortion rates in the United States, New York has the highest abortion rates and the least amount of restrictions on abortions. Most of New York's abortions are performed in New York City. Overall, New York performs the most abortions to minors, the most repeat abortions, and the most abortions that are considered late term (after 21 weeks) than anywhere else in the United States. Medicaid is not restricted, and it pays for low-income women seeking abortions. Also, minors do not need parental consent before receiving an abortion, and there are no required waiting periods (the most common waiting period mandated by other states is 24 hours). New York has thirty-four major clinics that perform over 400 abortions each year compared to South Dakota which only has two clinics that are licensed to perform abortions.
While the vast majority of the states have taken the Hyde Amendment as their own policy, a few states do offer other funding voluntarily. Most of the Midwest states have followed the trend of also providing public funding for abortions only in the case of rape, incest, and life endangerment, but this does not necessarily mean that Medicaid actually reimburses them. It has been shown that more than half of the abortions performed that are eligible for reimbursement from Medicaid under the Hyde Amendment are not reimbursed. According to various hospitals and doctors, the paperwork to receive reimbursement from Medicaid is too extensive and time-consuming. This leads to women, who are eligible for reimbursement under Medicaid, to give birth instead. Various police statements and doctors' notes are required before even being considered to receive reimbursement. This causes the process to be long and drawn-out and most doctors say that it is easier to fund abortions for low-income women through non-profit organizations.
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