Telehealth, which now comprises 20% of all abortion care, has been celebrated as a mechanism to improve health equity by making abortion care more convenient and affordable to patients facing the greatest barriers to care. However, the impact of telehealth on health equity in abortion care is not well understood, especially for low-income patients. Many patients with Medicaid are not able to use their insurance to pay for their telehealth abortion due to barriers such as state restrictions and clinics not accepting Medicaid. This proposal seeks support for the ongoing Telehealth Equity Among Patients with Medicaid study (The TEAM Study), which focuses on individuals with Medicaid coverage in states where both abortion and telehealth for abortion are legal. The TEAM study aims to:

1) understand the acceptability of telehealth care among low-income populations,
2) compare acceptability between Medicaid patients who were able to use their insurance versus those who were not and
3) to understand the financial and digital barriers to care for Medicaid patients.

Leveraging our existing partnerships with 6 telehealth clinics, we will expand the quantitative arm to enhance our ability to detect differences in acceptability between those with and without out-of-pocket payments. We will also add a qualitative arm to the TEAM Study to deepen our understanding of the barriers and facilitators to telehealth care for low-income patients. Working with organizations such as NHelp and RHITES, the findings will be disseminated to telehealth advocates and policymakers, towards ensuring that more states allow Medicaid coverage of telehealth abortion.