“No taxpayer funding for abortion.” It’s an all-too-recognizable battle cry from the anti-choice community, and one that has forced reproductive health advocates to operate on the defensive. Planned Parenthood constantly needs to reiterate that it doesn’t use federal dollars to fund abortion procedures, and clings to the fact that abortion represents “just three percent” of its total health services. An amendment forced into the Affordable Care Act prevents federal subsidies from covering abortion directly, and has given abortion opponents an opportunity to enact state-level legislation that restricts insurance coverage of the procedure even further.
At nearly every turn, pro-choice lawmakers must reassure their conservative colleagues that they’re working to ensure that taxpayer dollars can’t be funneled toward abortion — and it’s still not enough for Republicans in Congress who continue pushing to make the distinctions even clearer.
In some ways, it’s a political concession that’s working out for Democrats. It’s easier for them to defend Planned Parenthood if they can tout the fact that it doesn’t do “taxpayer funded abortions.” The same logic also makes it easier to lobby to protect other publicly-funded family planning clinics. And in the end, it was possible to get health care reform passed by agreeing to work out a complicated abortion compromise for the government-sponsored insurance plans.
But the Hyde Amendment — the piece of legislation that officially prohibits federal money from paying for abortions — is much more than a political talking point. It’s a policy that dramatically impacts millions of women’s lives. As detailed in a new analysis from the Guttmacher Institute, prohibiting insurance plans from covering abortion has “dire consequences for women and their families.”
Most obviously, banning taxpayer funding for abortion procedures disproportionately harms low-income women. When the Medicaid program isn’t allowed to offer abortion coverage, the low-income women who rely on it for their health care often have no other way to afford the procedure, which typically costs hundreds of dollars out of pocket. According to Guttmacher, “one in four women with Medicaid coverage subject to the Hyde amendment who seek an abortion are unable to obtain one due to the lack of coverage.”
“The Hyde Amendment is a pernicious law that explicitly targets the poorest and most vulnerable women,” Heather Boonstra, the expert who conducted Guttmacher’s new analysis of the issue, noted in a press release regarding her work. Ironically, since Obamacare includes an expansion of the Medicaid program to extend public insurance coverage to additional low-income Americans, even more women will soon become subject to this reality.
But it’s not just women on Medicaid who are impacted by efforts to restrict public funding for abortion. In her analysis, Boonstra notes that the Hyde Amendment spawned a series of other policies that restrict abortion coverage for other populations, too. Federal employees, military personnel, federal prison inmates, poor residents of the District of Columbia, and Native American women are all subject to coverage restrictions — which haven’t always offered any exceptions in the cases of rape or incest (click to enlarge):
A couple things happen when women are denied insurance coverage for abortion. Some of them turn to abortion funds, nonprofit organizations that work to raise money to cover the cost of the procedure for people who can’t afford it, for help. Others rely on friends and family members to help raise the money they need. Many women are forced to divert money that’s intended to cover their living expenses — like rent, groceries, or utility bills — to scrape together the money for the procedure. If they’re really desperate, they’ll seek out illegal and potentially dangerous abortion options.
But abortion procedures become more expensive the longer you wait. Many low-income women run out of time while they’re trying to save up the money for it. And if they’re ultimately forced to give birth, like the one in four women on Medicaid who are unable to terminate their pregnancies, they’re more likely to slip deeper into poverty.
Boonstra points out that the Hyde Amendment, and the similar types of legislation it’s inspired, ultimately represents a failure within the national health care system.
“The whole purpose of health insurance is to ensure that individuals can afford unexpected medical bills in the case of an unplanned event, and unintended pregnancy — or a much-wanted pregnancy that goes horribly wrong — is the very definition of an unplanned event,” she writes. “Restrictions on insurance coverage of abortion fall hardest on poor women, who are already disadvantaged in a host of other ways, including in their access to the information and services necessary to prevent unplanned pregnancy in the first place.”
Indeed, unplanned pregnancies are increasingly concentrated among low-income women who don’t have access to family planning services. Between 1994 and 2006, the number of unintended pregnancies among women whose incomes fall below the national poverty line rose by 50 percent — but during the same time period, unintended pregnancies dropped among more economically privileged women. The Hyde Amendment ensures that these competing cycles of privilege and poverty remain firmly in place.
“No taxpayer funding for abortion” isn’t a theoretical concept or a political compromise. It’s the denial of disadvantaged women’s basic constitutional rights. And it means that reproductive rights are ultimately transformed into an issue of economic justice, whether or not anti-choice politicians are willing to frame them in that way.