“I don’t care if women have abortions, I just don’t want my tax dollars paying for it.” Sound familiar? It’s a common response to questions about public funding for abortion care, even from people who generally identify as pro-choice. There’s a growing consensus among reproductive rights advocates, however, that bans on such funding are hurting American women. It’s time for them to stop, and we know how to do it: We have to bring an end to the Hyde Amendment.
As with all matters of public opinion, how you ask the question matters. While “taxpayer funding for abortion” remains unpopular, “expanding insurance coverage for abortion care” fares better. It seems clear that many of those who oppose such funding don’t understand how funding bans work or why they are so harmful. Like most policy issues, once you dig into them, it turns out that the Hyde Amendment is not as simple as the “no taxpayer funding” sound bite makes it seem.
In fact, even the phrase “the Hyde Amendment” is misleading. Instead of one discrete policy, it is really more of a shorthand for a series of restrictions designed to limit or ban insurance coverage for abortion through a wide range of programs backed by the federal government. Today, these restrictions effectively deny access to abortion to millions of American women.
To understand how Hyde denies access to so many women across so many different government programs, it is important to understand how it functions. Despite its broad reach, the Hyde Amendment, in most cases, isn’t technically a “law” at all. Instead, it is standardized language usually added to various federal measures as an amendment or “rider.” And exactly what that language says depends on the program it’s attached to. One thing is clear: The impact is enormous, and it has only grown over the past 40 years.
History of the Hyde Amendment
Almost immediately after the Roe v. Wade decision, anti-choice forces began strategizing new ways to undercut abortion rights in the United States. Realizing that a broad ban was not feasible in the wake of the Supreme Court’s ruling, they began to consider how they might limit access to abortion for as many women as possible. Restricting the use of federal funds for the procedure turned out to be one very effective way.
In 1973, North Carolina Senator Jesse Helms (R) championed the Helms Amendment, which essentially ended the use of U.S. foreign assistance funds for abortion. And in 1976, Illinois Representative Henry Hyde (R) added language to an FY ’77 spending bill that banned federal funding for abortion through Medicaid. Speaking of his amendment, Hyde asserted, “I certainly would like to prevent, if I could legally, anybody having an abortion, a rich woman, a middle-class woman, or a poor woman. Unfortunately, the only vehicle available is the…Medicaid bill.” It wouldn’t be the “only vehicle” for long.
Since that first application, legislators have vastly extended the reach of the Hyde Amendment, attaching it (or substantially similar language) to nearly a dozen other programs (see chart). In addition to those successful efforts, reproductive rights advocates have blocked attempts to attach the language to measures as diverse as scientific research bills and bills meant to aid victims of human trafficking. These victories, though important, have not prevented the Hyde Amendment from casting a particularly long shadow over American women. Excluding abortion from insurance coverage accomplishes an obvious goal—that of impeding access—but it also casts abortion as somehow…different…from other things covered by insurance. Instead of an extremely common and relatively minor medical procedure, it’s a taboo choice worthy of social condemnation. The exclusion of abortion from standard health insurance coverage feeds the narrative that an abortion isn’t really a right.
While Henry Hyde’s dream of ending legal abortion hasn’t (yet) come to fruition, it’s clear that the Hyde Amendment has had a devastating impact on American women’s access to abortion. With varying and narrow exceptions, insurance coverage for abortion is generally unavailable to:
- women enrolled in Medicaid in 35 states and Washington, D.C.,
- federal workers and their dependents,
- female service members,
- the dependents of service members,
- Peace Corps volunteers,
- many women insured by Affordable Care Act (ACA) plans,
- disabled women on Medicare, and
- American Indian and Alaskan Native women insured under the Indian Health Service.
By far the greatest burdens of Hyde fall, as burdens so often do, on the most vulnerable: poor and minority women. Poor women have much higher rates of unintended pregnancy than wealthier women—up to five times higher. And with an often-inadequate social safety net, an unplanned pregnancy can be a disaster.
The average cost of a first-trimester abortion in the United States is $500. Wealthier women are more likely to have the capacity to absorb an unexpected medical expense. Poor women who cannot use their Medicaid benefits to cover this cost frequently struggle to come up with enough money to pay for the procedure. Too often, these women wind up in a terrible Catch-22: The cost of an abortion increases the later in pregnancy it’s performed, and the more it costs, the longer it takes for women to find the needed resources. Many women report going without basic necessities in an attempt to come up with the money. This struggle leads to later abortions, which—in addition to being more expensive—are riskier. And thanks to the recent flood of state-level abortion restrictions, later abortions are even less accessible.
The Road Ahead
Reproductive rights advocates have long pointed out that the right to abortion is not particularly helpful without meaningful access to abortion. The current legislative reality makes that abundantly clear: We live in a country where despite the legality of abortion, some groups of women have far greater access than others. And this disparity only increases with the proliferation of state laws and the creeping expansion of Hyde.
That creeping expansion is insidious, and even choice advocates haven’t always realized how to fight it effectively. For example, the current fashion among anti-choice legislators is to claim that anything having to do with women’s reproductive health is somehow code for abortion. This exasperating (and very deliberate) falsehood leaves it up to reproductive health advocates to correct such claims by pointing out that it is currently illegal to use public funding for abortions. This accurate statement, however, still runs the risk of reinforcing the idea that there is something wrong with public funding for abortions.
We are making progress, however. The 2016 Democratic platform was the first in history to explicitly call for an end to the Hyde Amendment. Hillary Clinton was the first major party candidate to not only publicly call for an end to funding restrictions, but also to speak openly about the importance of real abortion access for all women, regardless of economic circumstance. She didn’t win the election, but it’s a sign of progress that her stance on this issue does not appear to be the reason for her loss.
With this president and Congress, there’s no chance of repeal. But a time of heightened danger for reproductive rights is also a time when more people are paying attention. We’re going to keep fighting to repeal Hyde—shouting about how it’s a fairness issue, an economic justice issue, and about the importance of recognizing that true reproductive freedom cannot exist when it is denied to so many.
Contact Stacie Murphy at firstname.lastname@example.org.