For far too long, the United States has penalized low-income people seeking abortion — forcing those already struggling to make ends meet to pay the biggest proportion of her income for safe, legal care.
Since 1976, the Hyde Amendment has blocked federal Medicaid funding for abortion services (since 1994, there have been three extremely narrow exceptions: when continuing the pregnancy will endanger the patient’s life, or when the pregnancy results from rape or incest). This means Medicaid cannot cover abortion even when a patient’s health is at risk and their doctor recommends they get an abortion.
When insurance coverage provides for all pregnancy-related health care except abortion, it interferes with the private health decisions that are best left to a patient, their doctor, and their family. The Hyde Amendment is a dangerous and unfair policy that lets politicians interfere in people’s personal health care decisions.
Credit: Center for Reproductive Rights
Hyde Hurts Medicaid Enrollees
When policymakers deny insurance coverage for abortion, people are either forced to carry a pregnancy to term or pay for care out of their own pocket.
So, the Hyde Amendment is particularly harmful to people with low incomes, people of color, young people and immigrants — who all disproportionately rely on Medicaid for their health care coverage.
Consider these facts:
15.6 million women (ages 19 to 64) have Medicaid coverage. If every state expands its Medicaid program, as the Affordable Care Act allows, about 1.5 million additional women will be newly eligible for Medicaid coverage.
Medicaid provides coverage to 1 in 5 women of reproductive age (15-44).
Due to the structural inequalities in our country that link racism, sexism, and economic inequality, people of color disproportionately comprise the majority of Medicaid enrollees. In fact, 30% of Black women and 24% of Hispanic women are enrolled in Medicaid, compared to 14% of white women.
The consequences? When someone has made the personal decision to end a pregnancy but cannot afford to, they may forgo basic necessities such as heat and electricity in order to save the required funds. They may even resort to self-inducing an abortion or obtaining an abortion from an untrained or unlicensed practitioner.
Hyde-Like Policies Affect Other Health Care Programs
Since Congress first passed the Hyde Amendment 40 years ago, anti-abortion politicians have extended similar policies to other federal health insurance programs, including coverage for federal employees and their families, military personnel and their families, Native Americans, Alaskan Natives, and inmates in federal prisons. While these are all different policies, the impact is the same: penalizing people seeking abortion, and forcing them to pay out-of-pocket in order to access safe, legal care — even if they cannot afford to do so.
Hyde in the States
The Hyde Amendment bans using federal Medicaid to cover almost all abortions but does not limit a state’s ability to use its own funds to cover abortion. As of 2016, 17 states use their own funds to extend abortion coverage to low-income Medicaid enrollees (although some of these states still make it difficult to access). An additional 6 states extend abortion coverage under specific exceptions, such as when a patient’s health is at risk.
That leaves more than half the country abiding by the Hyde Amendment. Notably, South Dakota’s Medicaid program goes even further than Hyde: It does not pay for abortion even when a person has been raped or is the victim of incest — a clear violation of federal law, which includes these exceptions. Moreover, Congress can control Washington, D.C.’s funding, and has restricted the District of Columbia from using its own funds to provide abortion coverage to people with low incomes.
Bottom Line: It’s Time To Stop Hyde
Everyone — no matter how much money they make or who provides their insurance — should be able to access the full-range of reproductive health care, including abortion. Everyone should be able to make their own decisions about pregnancy based on their own unique circumstances, and have the resources they need to exercise that decision with autonomy and dignity.
Abortion is health care. Politicians should not be able to deny anyone's access to health services, including abortion, just because of their income or their insurance provider. It is time to end the Hyde Amendment and stop political interference in people's decision-making.
Go to allaboveall.org to learn how you can take action.