How Restrictions on Abortion Coverage and Marginalization of Care Paved the Way for Discriminatory Treatment of Abortion in Health Reform and Beyond

Introduction: Two tactics, each bad in its own right, pave the way for exclusion of abortion from the ACA

Rosie Jimenez, a single mother and a poor Chicana, was the first woman known to have died from an unsafe abortion after Congress cut off funding for abortion care for women enrolled in Medicaid. Her picture has long been put forward as the face of the damage caused by restrictions on abortion coverage. The Patient Protection and Affordable Care Act (ACA) could change that—but not by improving abortion care for women like Jimenez. Although getting health services that aren‘t covered by insurance will always be hardest for women without financial resources—disproportionately low-income women, young women and women of color—with the new abortion restrictions included in the ACA, legislators have now constructed barriers to abortion coverage that affect women across the economic spectrum.

Two tactics—the slow accretion of legal restrictions banning coverage of abortion care for women who rely on government health care programs and the gradually increasing marginalization of abortion services within the health care field—have been noted with concern by reproductive health advocates for many years. While leaders in the reproductive health, rights, and justice movement have been critical of these developments and their consequences, there has been no sustained policy challenge to either.

This article was originally published in Reproductive Laws for the 21st Century Papers by the Center for Women’s Policy Studies.