Government began legislating abortion in the mid nineteenth century and has controlled access to this service for women ever since. With the creation of hospital boards after WWII, state control over access became further entrenched. Regulations and restrictions since Roe v. Wade limit the availability of abortion services for women served by Medicaid and other social assistance programs. The existence of a class bias around access can be seen throughout the topic's history and legislation has unfairly targeted and therefore disproportionately affects poor women. The data show that these restrictions have no impact on the number of unintended pregnancies over the last 20 plus years. Without the ability to personally fund the procedure, poor women do not enjoy the same choices as women in other social classes. In the next decade, we are likely to experience more of the same without having a realistic conversation about Medicaid funding of abortion.