The right to have an abortion in the United States has always come with an asterisk, particularly for low-income women and women of color. And for the nearly one in six women of reproductive age who get their insurance through Medicaid, abortion funding is largely restricted, making Roe v. Wade more of a political abstraction than a constitutional right.
But a coalition of House Democrats have announced a measure to expand access to abortion regardless of the kind of insurance a woman has or how much money she makes. The Equal Access to Health Insurance Act—the EACH Woman Act—is a direct challenge to the Hyde Amendment, which bans federal funding for abortion except in cases of rape, incest and life endangerment.
The EACH Woman Act would require that all healthcare and insurance provided by the federal government cover abortion. It would also prohibit states from placing restrictions on private health insurance companies looking to offer a full range of reproductive health services, including abortion.
“It’s past time to be bold, it’s past time to repeal Hyde,” California Rep. Barbara Lee, the lead sponsor of the legislation, said during a Wednesday press conference.
The Hyde Amendment disproportionately impacts low-income women because that’s precisely what it was designed to do. "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,” former Illinois Rep. Henry Hyde said in 1973. “Unfortunately, the only vehicle available is the… Medicaid bill."
The original version of Hyde passed in 1976, and while it has changed slightly over the years, its founding principle—denying low-income and marginalized women the opportunity to exercise their constitutional rights—has held since then. And the amendment has had its intended effect: according to data from the Guttmacher Institute, one in four women are forced to carry an unwanted pregnancy to term because they can’t afford the procedure without insurance.
Yamani Hernandez, Executive Director, National Network of Abortion Funds, put it in blunter terms on Wednesday: “Practically speaking, for those struggling to make ends meet, a coverage ban may as well be a ban altogether.”
She also recounted stories of women she's met who took extreme measures to terminate a pregnancy when cost was an insurmountable barrier. She said that one woman she met "was willing to pay people $10 each to beat her up and force a miscarriage rather than have to come up with hundreds of dollars to afford or even explain an abortion."
The consequences of cost barriers is something that Dr. Willie Parker, chair-elect with Physicians for Reproductive Health and a provider at the last abortion clinic in Mississippi, has seen firsthand. “I provide abortion care in the South, home to some of the poorest Americans. The women I see…. are often living paycheck to paycheck and the cost of an abortion only pushes them deeper into poverty,” he said in a statement. “Daily, we see patients, many of whom are already mothers, who need to sell their belongings or skip rent payments in order to afford their care.
The EACH Woman Act is by far the most ambitious strike against Hyde and effort to counteract a proliferation of abortion restrictions at the state and federal level on the table right now, but it stands virtually no chance of passing the Republican-controlled House. The words “taxpayer-funded abortion” also tends to rile up conservative voters, and Democrats, including President Obama, have been reluctant to touch the issue in the past. As a result, low-income women's access to healthcare has been played as a bargaining chip in negotiating other legislation.
But a poll from Hart Research, released in conjunction with the measure, suggests that the public views this as a gross overstep: 86 percent of respondents agreed that politicians shouldn’t be able to deny a woman abortion coverage just because she’s low-income, and that's precisely what Hyde does.
The EACH Woman Act would lift the Hyde restrictions and open up abortion coverage to all women, regardless of how they're insured or how much money they make. "And that’s meaningful change for all of us," Hernandez said.