Women in poverty experience greater delays in the process of seeking abortion. Timely access to both safe abortion care and early prenatal care reduces morbidity and mortality among pregnant women. This article examines the impacts of a policy change intended to facilitate poor women's applications for pregnancy-related Medicaid (a federally funded, state-administered health coverage programme for the poorest Americans), in Oregon (Western U.S.). The mixed-methods data from this applied anthropology study demonstrate that though health coverage waiting times grew shorter on average, poor women and the clinic staff who cared for them continued to perceive delays in obtaining Medicaid coverage for abortion. Implementation of the Affordable Care Act in the U.S.A. (aka Obama-care) is now thought to be contributing to a return to greater delays in accessing prenatal care and abortion. More research and advocacy are needed to improve access to reproductive health care through state Medicaid programmes.