In examining the distances that low-income women in California travel for Medicaid-covered abortion care, some women travel substantial distances despite relatively high accessibility in the state. Rural women travel particularly far despite having abortion rates comparable to their urban counterparts, highlighting the need for greater geographic distribution of abortion providers who accept Medicaid. This could be accomplished by increasing the Medi-Cal reimbursement rate, increasing the types of providers who provide abortions (including nurse practitioners, certified nurse midwives, and physician assistants) and expanding use of telemedicine among Medi-Cal providers. If national trends in declining unintended pregnancy and declining abortion rates continue, careful attention should be paid to ensure that reduced demand does not lead to greater disparities in geographic and financial access to abortion care by ensuring that providers accepting Medicaid payment are available and widely distributed.