The Cost of Exclusion: How Barriers to Health Care Affect Patients, Providers, and the Health Care System
New NAPAWF Research Finds Rising Costs and Immigration Fear are Blocking Healthcare Access
The Cost of Exclusion: How Barriers to Health Care Affect Patients, Providers and the Health Care System draws from a survey of 35 health care providers across 18 states and Washington, D.C., as well as small-group discussions with Asian American, Native Hawaiian, and Pacific Islander (AANHPI) abortion seekers, abortion support workers and providers.
This brief examines those dynamics through two complementary studies. In partnership with Ibis Reproductive Health, NAPAWF held small-group discussions with AANHPI people with abortion experiences and in-depth interviews with AANHPI health care providers and abortion support workers across the country.
The second study, in partnership with Physicians for Reproductive Health (PRH), surveyed their network about experiences working with immigrant patients, including the challenges those patients face when seeking abortions.
Together, these studies capture what health care exclusion looks like from both the patient and provider perspectives, with a particular focus on abortion care.
The findings capture the experiences of AANHPI individuals navigating an increasingly complex health care landscape.
- 89 percent of surveyed providers identified language access as a barrier to abortion care, while 80 percent cited a lack of knowledge about legal rights or available abortion services.
- Another 77 percent identified misinformation or difficulty finding correct information as an obstacle.
- 74 percent of surveyed providers identified fear of immigration enforcement as a barrier to abortion access. One provider reported an estimated 30-50 percent no-show rate during periods of increased enforcement activity.
Some abortion seekers reported being unaware that medication abortion at home was an option, while others emphasized the importance of discussing sensitive health information in their preferred language. Providers also described how concerns about immigration enforcement, privacy and family or community judgment can discourage patients from seeking care, attending appointments or disclosing necessary details.
The findings reveal how barriers to care can have consequences across the health care system, from more complicated and costly treatment to increased demands on providers and hospitals that are already stretched thin. Addressing these challenges requires system-wide investments in affordable health care coverage, reliable interpretation services, patient navigation, and other resources that increase access, rather than leaving patients and providers to navigate them individually.