The Next Big Fight for the Pro-Choice Movement: Taxpayer-Funded Abortions
Almost 40 years ago, as a young congressional staffer, Rep. Barbara Lee watched lawmakers exclude millions of poor women from abortion coverage. They did so via a provision prohibiting Medicaid from covering the procedure. Henry Hyde, the Illinois Republican who sponsored the amendment, made little effort to conceal that it was an effort to undermine Roe versus Wade, the Supreme Court decision that legalized abortion just three years earlier; nor did he deny that his amendment would have a disparate impact on poor women. “If rich women want to profit from their costly vices, that’s their responsibility…that’s fine, but not at the taxpayers’ expense,” he joked during a debate. He later admitted, “I would certainly like to prevent, if I legally could, anyone having an abortion, whether it’s a wealthy woman, a middle-class woman, or a poor woman. Unfortunately, the only vehicle available is the… Medicaid bill.
The passage of the amendment shocked Lee. “It was really upsetting to me as a young African American woman, you know, why would this guy even want to interfere with women’s rights and women’s health decisions,” she recalled. After Lee was elected to Congress, she served on the House Foreign Affairs Committee, with Hyde as chairman. She often thought about how she could convince him that his amendment harmed women. Eventually, says Lee, “I decided there was no way to convince him of that, so I’m going to have to work to help try to repeal it at some point, when the political climate is right. “
Lee waited a long time. Although Hyde is only a temporary provision, Congress dutifully incorporates it into an appropriations bill each year. Lawmakers extended the ban on abortion coverage to other people dependent on public insurance, including military members, Native Americans and federal employees. There have been a few attempts to repeal the ban over the years – Bill Clinton tried, in 1993 – but in general, even pro-choice politicians preferred not to talk about Hyde.
That changed, and quite quickly. Lee, along with Reps. Jan Schakowsky and Diana DeGette, introduced a bill around this time last year that would ensure anyone with federally funded health insurance would have health care coverage. ‘abortion; they now have over 115 co-sponsors. Hillary Clinton criticized Hyde directly on the campaign trail for “making it harder for low-income women to fully exercise their rights.” And, for the first time, the Democratic Party’s platform bill explicitly calls for the repeal of Hyde, as well as the Helms Amendment, which applies to foreign aid – for “full-fledged funding abortion by taxpayers,” to quote one outraged anti-abortion writer. .
“We’re starting to see the terrain change,” says Destiny Lopez, chair of a coalition called Everything* above all formed specifically to advocate for an end to the ban on public funding of abortion. “After 40 years of this, we can actually see a future where [Hyde] is repealed”.
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According to Lopez, the Hyde Amendment is “one of, if not the most onerous, obstacle to abortion care.” Effectively, he puts the legal right to abortion out of reach for many women on the basis of their income—and their skin color, as women of color are more likely to rely on Medicaid than other groups. Medicare alone covers almost one in six American women of childbearing age, and that number has likely increased since many states expanded their Medicaid programs under the Affordable Care Act. All together onefight 20 million women rely on one of the insurance programs affected by the ban on public financing of abortion. Hyde forces some women to delay an abortion while they scrape together the money, which can make their procedure both more expensive and more complicated. It forces others to have children against their will: studies in a number of states indicate that up to 35 percent of women who wish to terminate a pregnancy end up carrying it to term when public funding is cut.
Yamani Hernandez is the executive director of the National Network of Abortion Funds (NNAF), which raises money to help people pay for their abortion — the procedure itself, which can cost anywhere from $300 to $2,000, as well as travel and other associated expenses. She says the funds have seen an increase in requests for help in recent years due to clinic closures and other restrictive laws in states like Texas. The additional barriers are particularly prohibitive for women without insurance coverage. About 116,000 people call the abortion fund’s helplines each year; they consider not paying rent, pawning furniture, or buying as much food for their other children if they can’t get help. Hernandez says the network was able to fund about 30,000, or less than a third.
“There are a lot of places in the Midwest and the South where they just don’t have enough clinics to make it geographically accessible, so people have to take time off from work, they have to travel, stay in hotels , they have to figure out what to do with their kids,” says Hernandez. “Cost is a huge issue. People expect to be able to use their insurance for their health care, and when they can’t, it’s a huge barrier. You have people, even middle-class people, who don’t have $500 more lying around somewhere.
Politically, the wave of anti-abortion laws created a sense of urgency for Hyde’s repeal. “The anti-choice forces have just gone too far to the extreme,” Rep. Lee told me. “I said, enough is enough.” Incidentally, the day before our conversation, Lee’s Republican colleagues offers to gut the Title X family planning program that provides contraceptives to low-income adults and $108 million for teen pregnancy prevention. “You can no longer moderate with members of Congress who are completely right on this topic, trying to deny women their basic rights,” Lee said.
But Lee and other lawmakers say it’s activists, many of them women of color, who really made Hyde part of the mainstream pro-choice agenda. All* Above All formed in 2013, sets off by a convention on access to abortion for poor women organized by the NNAF and the Latina National Institute for Reproductive Health. Coalition spear a national bus tour and social media campaign the following year to raise awareness and galvanize a movement to overthrow Hyde. Another reproductive justice group, URGE, held rallies in 20 cities. All* Before everything ordered a survey, which showed that 86% of voters, regardless of their opinion on abortion, believed that “politicians should not be allowed to deny a woman health coverage because she is poor.” Even 62% of Republicans agreed that “as long as abortion is legal, the amount of money a woman has or doesn’t have shouldn’t stop her from being able to get an abortion.”
Reproductive rights groups began pushing members of Congress. NARAL Pro-Choice America has reworked its endorsement criteria, according to President Ilyse Hogue, “to basically say that if you want to be a champion on this topic, you need to use your speaking time to speak out whenever Republicans tie Hyde – moving from language of ‘it’s the law of the land’ to ‘no, it discriminates against low-income women.'” And Democrats began pushing back, last year maintain two bills to which Republicans had attached Hyde-like provisions. Lee says all of this activism and advocacy “actually created the climate for us” to introduce the EACH Woman Act and to incorporate the call for repeal into the party platform.
Hyde “was untouchable because he cared for both poor women and women of color…so we had to create political space,” Lopez says. They did this, at least in part, by evoking the stories of these women and, as Katha Pollitt writes, by “fram[ing] abortion as a normal event in women’s lives and a fundamental part of health care. It helps that the political space has also expanded for a discussion of economic and racial inequality, thanks to movements like Occupy Wall Street, Fight for 15 and Black Lives Matter. Now what was once a liability is actually working in the defenders’ favor, allowing them to place Hyde in the context of a larger national conversation about poverty, racism and justice – and shift the moral compass. “The culture is ready to discuss embedded racial and class discrimination and our ability to access our constitutional rights,” Hogue says.
Ending the Hyde Amendment is still a long way off in a Republican-controlled Congress. Still, Hogue thinks it’s “inevitable,” given how blatantly discriminatory the measure is. In the wake of the Supreme Court’s ruling against two abortion restrictions in Texas, the pro-choice movement is eager to go on the offensive. It also means pushing to expand abortion coverage at the state level; currently, 17 states fund abortion care for Medicaid recipients themselves, although most do not do so voluntarily but to comply with court orders. Other states even prohibit private insurance from covering abortion. “The Supreme Court’s decision only stemmed the bleeding,” Hogue said. “We are so ready to move towards a future where women truly control their own destiny.”