The Hyde Amendment withholds federal Medicaid funding from abortion except in the extremely narrow and dire circumstances when continuing the pregnancy will endanger the life of the woman or when the pregnancy results from rape or incest. Under the Hyde Amendment, federal Medicaid coverage cannot extend to abortion even when a woman’s health is at risk and her doctor recommends she obtain an abortion to preserve her health.
The Hyde Amendment is nothing more than an intrusive and unfair restriction on insurance coverage for millions of low-income women and their families, and it is an example of politicians interfering with a woman’s ability to make her own health care decisions. Nationally, Medicaid provides coverage to one in ten women. Over 14 million low-income women of reproductive age (18 to 44) have Medicaid coverage, and nearly three-quarters (72 percent) of adult Medicaid enrollees are women of reproductive age. In addition, the Affordable Care Act allows states to expand their Medicaid programs, and if every state expands its Medicaid program, roughly 4.6 million additional women will be newly eligible for Medicaid coverage.
Decisions about whether to choose adoption, end a pregnancy, or raise a child should be left to a woman, with the counsel of her family, doctor, and faith. But in order for a woman to be able to make a real decision based on what is best for her circumstances, she needs to be able to access and afford the care she needs. When insurance coverage provides for all pregnancy-related care except abortion, it interferes with private heath decisions that are best left to a woman and her family.
When a woman cannot afford to end a pregnancy, she may forgo basic necessities, and as a result, may end up shutting off her own heat and electricity, to pay for her abortion. She may even resort to self-inducing an abortion or obtaining an unsafe, illegal abortion from an untrained or unlicensed practitioner.
It is unfair that a woman be denied coverage of abortion simply because she has government-funded health insurance. Each woman – no matter the size of her wallet or what kind of insurance coverage she has – should be able to access the full-range of reproductive health care, including abortion, from a licensed, quality health care provider.
Since the Hyde Amendment was first passed in 1976, Congress has enacted other Hyde Amendment-like measures to further restrict government-funded health coverage of abortion. For example, the Federal Employee Health Benefits Program, Indian Health Services, federal prisons, and the military limit health coverage and access for abortion in the narrow circumstances of life-endangerment, rape, and incest. A Peace Corps volunteer cannot access coverage of abortion services under any circumstance – even when she has been raped or faces a life-threatening pregnancy.
The Hyde Amendment does not impact a state’s ability to use its state funds to cover abortion. To date, 17 states use their state dollars to extend health coverage to low-income women enrolled in Medicaid to ensure that they have access to a full range of health care services, including abortion. However, Congress can control DC’s funding, and last year, Congress incorporated a provision in an appropriations billto restrict DC from using its own funds to provide abortion coverage to low-income women. Unfortunately, members of Congress opposed to women’s health have proposed to do the same this year. Notably, South Dakota’s Medicaid program only pays for abortion when a woman’s life is endangered – a clear violation of federal law.