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Today the Hyde Amendment, which bans Medicaid coverage of abortion with few exceptions, turns 35 years old. Not even its sponsor, Rep. Henry Hyde (R-IL), could have imagined its unfortunate success. In its three and a half decades, the Hyde Amendment policy has crept into every government-run or government-managed program, including Medicare, the Indian Health Service, the Peace Corps, the Federal Employees Health Benefits Program, the military’s Tricare program, and federal prisons. And with the passage of the Affordable Care Act in 2010, restrictions on abortion coverage crossed from the public into the private health insurance market as well.
While such restrictions have some effect on all women, poor women and women of color continue to bear the brunt of this cruel policy. Women enrolled in Medicaid—by definition those with the fewest resources—were the first targets of the Hyde Amendment, but two trends have converged to make them even more likely to need an abortion and less likely to be able to afford one.
The United States now has the highest number of people living in poverty since the Census Bureau started tracking the data in 1959. And 14.5 percent of women lived in poverty in 2010, up from 13.9 percent in 2009—the highest poverty rate for women in 17 years.
At the same time, poor women’s rates of unintended pregnancy are far outpacing those of more affluent women. The unintended pregnancy rate for women with incomes under the federal poverty level rose 50 percent from 1994 to 2006, while women with incomes at or above the poverty line saw their unintended pregnancy rate decrease by almost 30 percent. Poor women’s unintended pregnancy rates rose regardless of their education, race and ethnicity, marital status, or age.
And so the chasm between these two Americas continues to grow wider. A poor woman is five times as likely as her higher-income counterpart to have an unintended pregnancy (132 versus 24 per 1,000 women of reproductive age), six times as likely to have a birth resulting from an unintended pregnancy, and five times as likely to have an abortion (52 versus 9 per 1,000 women). Indeed, more than two-thirds (69 percent) of women who have an abortion are economically disadvantaged.
Put another way, abortion is becoming a poor woman’s problem—just as more women are becoming poor. Yet because of the Hyde Amendment, a woman who qualifies for Medicaid due to her low income is denied coverage for abortion care. Instead, she and her family must divert scarce resources to pay for a needed abortion out of pocket.
The Hyde Amendment’s blatant discrimination against poor women violates the fundamental principles of fairness and equality that our country aspires to achieve. At a time when Americans are experiencing record rates of poverty and economic hardship, the Hyde Amendment only compounds an already difficult situation and cuts off aid to those who need it most.
Until the Hyde Amendment is repealed and poor women receive adequate support for all of their reproductive health needs, rich and poor women will continue to live in two different countries with two different sets of rights. This 35th anniversary of Hyde is nothing to celebrate.
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Jessica Arons is Director of the Women’s Health and Rights Program at American Progress.