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Abortion Access – No Matter How Much Money You Make

Doctor counseling patient
Doctor counseling patient
Alexa Kolbi-Molinas,
Deputy Director, ACLU Reproductive Freedom Project
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December 10, 2015

At least you can say that Rep. Henry Hyde was honest.

In 1997, the congressman from Illinois introduced what would forever become known as the Hyde Amendment, the federal law that withholds federal Medicaid coverage for abortion. He was completely open about his intentions:

“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.”

While women of all economic and racial backgrounds have abortions, those most harmed by these bans are low-income women and women of color. It isn’t rocket science: When you withhold much-needed funds for medical care from the women with the least money, many of them will be unable to get that care at all. Rep. Hyde knew this, which is why the simple truth is that public insurance bans are, by design, abortion bans.

In the more than three decades since Hyde became law, multiple states followed suit with copycat bans. Today, 32 states and the District of Columbia exclude abortion coverage from otherwise comprehensive benefits programs. Seventeen states, however, provide abortion coverage in their existing Medicaid plans with state funds (the Hyde Amendment is only a restriction on federal dollars) In fact, 13 of those states were forced to restore coverage by court order under their state constitutions.

At the end of November, we filed a challenge against Maine’s abortion coverage ban that will hopefully bring that number to 18.

Maine is the second poorest state in New England as well as geographically its largest. Some women, including those from Maine’s poorest counties, have to travel over 200 miles each way just to get to their nearest abortion clinic. Their next closest option? Canada.

Without assistance, some women in Maine must make difficult and painful decisions about giving up the essentials, like food, rent, or heat for themselves and their families in order to save enough to have an abortion — not to mention to pay for travel costs, child care, and to cover lost wages. To use these bans to play with health care, hoping that women who use Medicaid benefits won’t be able to afford an abortion on their own, is unjust and immoral.

Somehow over the years, the true purpose of public insurance bans — which Hyde himself never intended to mask — has been concealed. Rather than come clean about what is really behind these bans time and again, we hear the (hollow) refrain — “no taxpayer funding for abortion” — as if that somehow sets these bans apart from other laws designed to prevent a woman who has decided to have an abortion from having one, such as mandatory delay laws and sham laws that force clinics to shut down. As if there is something “neutral” about providing comprehensive coverage for pregnancy-related care when a woman continues her pregnancy, but not when she decides to have an abortion. As if there is something unbiased about a law that targets a woman with the least resources and deliberately coerces her into continuing a pregnancy against her will. As one judge recently put it, there is “no other context where Medicaid engages in such a relentlessly one-sided calculus.”

Public insurance bans are government-imposed barriers to abortion access, the same as any other restriction that makes it difficult or impossible for women to obtain abortions. A woman has a right to make her own decision about whether to end a pregnancy without politicians withholding the resources she might need to make that decision — like Medicaid funding, if she qualifies for it. Withholding the benefits we provide as a nation from the people who qualify for them and need them is dangerous and wrong.

A woman, not politicians, should make the decision about whether to have a baby or not — no matter how much money she makes.


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