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For far too long, the United States has penalized low-income women 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 woman’s life, or when the pregnancy results from rape or incest). This means Medicaid cannot cover abortion even when a woman’s health is at risk and her doctor recommends she 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 the woman, her doctor, and her family. The Hyde Amendment is a dangerous and unfair policy that lets politicians interfere in a woman’s personal health care decisions.

Credit: Center for Reproductive Rights

Hyde Hurts Women on Medicaid

When policymakers deny a woman insurance coverage for abortion, she is either forced to carry the pregnancy to term or pay for care out of her own pocket.

So, the Hyde Amendment is particularly harmful low-income women, women of color, young people and immigrants — who 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, women 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 a woman has made the personal decision to end a pregnancy but cannot afford to, she may forgo basic necessities like heat and electricity in order to save the necessary funds. She may even resort to self-inducing an abortion or obtaining an abortion from an untrained or unlicensed practitioner.

Hyde-Like Policies Impact Other Health Care Programs

Since Congress first passed the Hyde Amendment 40 years ago, anti-women’s health politicians 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 women 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 women enrolled in Medicaid (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 woman’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 woman has been raped or is the victim of incest — a clear violation of federal law, which includes these exceptions. Moreover, Congress can control Washington DC’s funding and has restricted DC from using its own funds to provide abortion coverage to low-income women.

Bottom Line: It’s Time To Stop Hyde

Each woman — no matter how much money she makes or who provides her insurance — should be able to access the full-range of reproductive health care, including abortion. Each woman should be able to make her own decisions about pregnancy  based on her own unique circumstances, and have the resources she needs to exercise that decision with autonomy and dignity.  

What shouldn’t be happening? Politicians should not be able to deny a woman’s health coverage just because of her income or her insurance provider. It is time to end the Hyde Amendment and stop political interference in women’s decision-making.

Go to allaboveall.org to learn how you can take action.