Women ages 18 to 44 in states with near-total abortion bans saw a 5.4% increase in annual out-of-pocket spending on employer-sponsored health insurance premiums after 2022, according to preliminary research from the University of Michigan. The study found larger increases for Black women, at 12.8%, and Hispanic women, at 13.7%; researchers did not find the same pattern among men. The analysis compared federal survey data from 2019 through 2025, before and after abortion bans took effect in many states following the U.S. Supreme Court’s 2022 decision overturning Roe v. Wade. The researchers examined women’s medical out-of-pocket costs and compared 10 states with near-total bans — Alabama, Arkansas, Indiana, Kentucky, Louisiana, Mississippi, North Dakota, Tennessee, Texas and West Virginia — with five states that did not impose bans: Massachusetts, Michigan, New York, Pennsylvania and Washington. States that expanded Medicaid during the study period were excluded to help separate the effects of those policy changes from the effects of abortion bans. Most women in the sample had incomes above 250% of the federal poverty level. The research has not been published in a peer-reviewed journal, and its authors describe the results as suggestive rather than conclusive. The study received financial support from the Center for Reproductive Rights, a Washington, D.C.-based advocacy organization. Joelle Abramowitz, a University of Michigan associate research scientist and co-author, said the results looked similar between the groups before the bans, then diverged afterward, with more women in ban states paying toward insurance premiums. She said the federal Current Population Survey was among the few data sources that could provide recent information on insurance coverage and household finances. One possible explanation, Abramowitz said, is that some pregnancies that might have ended in abortion before bans were enacted instead continued to delivery, potentially bringing higher medical costs. Earlier research estimated that pregnancy, childbirth and postpartum care averaged $20,416 nationally in 2021-23, including $2,743 in out-of-pocket costs for people with employer coverage who gave birth. Research has also linked abortion bans with higher rates of some adverse maternal and infant health outcomes, including cesarean deliveries and neonatal intensive care admissions. Such care can raise insurers’ costs, which may then be reflected in premiums, though the new study does not establish that bans caused the reported increases. Abramowitz said the findings point to possible economic effects of abortion restrictions beyond people who directly seek abortion care, reaching families through insurance costs.