The harmful legacy of the Hyde Amendment

As the policy turns 40 years old, it’s left a lot of victims in its wake.

Activists protesting for abortion access at the Supreme Court CREDIT: All*Above All
Activists protesting for abortion access at the Supreme Court CREDIT: All*Above All

Many of us have defining moments that transform how we think about an issue and call us to take action. As the leader of the only national organization fighting for reproductive health, dignity, and justice for 28 million Latinas and their families, I was called to this fight for social justice by the unforgettable story of Rosie Jiménez — a Latina who died four decades ago because she couldn’t get insurance coverage for her abortion.

Rosie was a 27-year-old Latina mother, enrolled in Medicaid for her health insurance, and on a promising path to become a special education teacher in her home state of Texas. But her dreams for the future were tragically cut short: she died from septic shock after an unsafe and illegal abortion, because she couldn’t afford safe, legal care. Rosie’s daughter Monique was only five years old, the same age my son is today, when she lost her mother.

Rosie was the first known victim of a very harmful restriction on abortion called the Hyde Amendment. This federal policy — which bans abortion coverage for women who get their health insurance through Medicaid — was enacted just two months before her death.

In the four decades since then, Hyde has continued to deny needed health care to low-income women like Rosie, with devastating consequences.

Hyde, which marks 40 years on Friday, prevents federal insurance programs from covering abortion services. In practice, that means low-income women — who are disproportionately women of color — can’t get their insurance plans to cover the cost of ending a pregnancy. Over the years, the Hyde Amendment has also been extended to deny coverage to federal employees and their dependents, military service members, Native Americans, Peace Corps volunteers, immigrants, and residents of Washington, D.C. As a result of these restrictions, nearly 29 million women of reproductive age do not have insurance coverage for abortion.

More than one in three Latinas is enrolled in health care from a program, insurer, or employer affected by the Hyde Amendment or similar federal restrictions, while 23.6 percent of Latinxs* live below the poverty level. These statistics mean that Latinx families are among the least likely to be able to afford out-of-pocket costs for abortion.

Hyde is so harmful because women already have too many barriers to getting abortion services, including cost. In 2011, the average cost to patients for first-trimester abortion services was $397, and the average for second trimester care was $854. Bans on insurance coverage for abortion force low-income people to struggle to raise these funds, putting them in untenable economic situations. In fact, restricting Medicaid coverage of abortion forces one in four poor women seeking abortion to carry an unwanted pregnancy to term.

The author speaking at a rally to protect abortion access at the Supreme Court earlier this year. CREDIT: All*Above All
The author speaking at a rally to protect abortion access at the Supreme Court earlier this year. CREDIT: All*Above All

Consequences can be dire: a woman who wants to get an abortion but is denied is more likely to fall into poverty than one who can get the care she needs. A woman who is unable to raise the necessary funds may even decide to take matters into her own hands if she cannot get care from a provider in her community. Additionally, immigrant women — particularly those who are undocumented — experience added barriers and fewer options in accessing basic health care, including reproductive care.

No person, whatever their income, should be faced with choosing between groceries and paying for an abortion. Yet as long as Hyde remains in place, that’s exactly what’s happening.

In the Lower Rio Grande Valley of Texas, women’s narratives tell a bleak story about the shifting landscape for reproductive health access in the region. The findings from the 2012 Nuestro Texas report reveal widespread violations of Latinxs’ reproductive freedom and human rights.

Like Rosie 40 years ago, Fatima — who lives a colonia near Mission, Texas — was forced to make unimaginable choices after state-level abortion restrictions closed down a clinic where she used to get free birth control. “The girls, they come first. If I needed that money to buy them shoes or something like that, the choice was clear,” Fatima told the researchers who compiled that report. “I finished a month [of pills], then the next month I could not afford them. That’s when I got pregnant.”

Rosie’s story is a powerful symbol of the impact that insurance restrictions have on people who can’t afford abortion care. Her death marks the beginning of a four-decade long struggle.

Rosie’s story is a powerful symbol of the impact that insurance restrictions have on people who can’t afford abortion care. Her death marks the beginning of a four-decade long struggle — as long as I have been alive — to repeal Hyde and prevent politicians from interfering with reproductive decisions.

But there is a clear path forward to make change.

The Hyde Amendment is added annually to appropriations legislation, and in order to remain in effect, it must be reenacted each year. Each year, Congress has the opportunity to do the right thing and lift the Hyde Amendment.

And thanks to a growing grassroots movement led by the people who are most affected by Hyde, this issue is being elevated to the halls of Congress. Activists are lobbying on Capitol Hill, testifying before lawmakers, and successfully changing the national conversation.

For the first time, the National Hispanic Leadership Agenda (NHLA)’s Hispanic Public Policy Agenda earlier this year called for an end to the Hyde Amendment, as well as offered support for proactive legislation that aims to remove barriers to abortion care. This is the most gender & LGBTQ inclusive agenda in NHLA’s history. NHLA recommends that Congress enacts the EACH (Equal Access to Abortion Coverage in Health Insurance) Woman Act, which would eliminate federal restrictions on abortion coverage such as the Hyde Amendment and ensure coverage for abortion for every woman, however much she earns or however she is insured.

This week, to mark 40 years of Hyde, the momentum continues with the United for Abortion Coverage Week of Action, organized by All* Above All and led by young people and people of color across the country. We want to let politicians know, ¡YA BASTA! Enough is enough! Our lives are at risk and politicians must stop interfering in our personal decision-making.

This activism is driven by a simple idea. At the National Latina Institute for Reproductive Health (NLIRH), we believe that all people should have access to the full range of pregnancy-related care, including abortion care, regardless of their ability to pay.

We’re not alone in this belief. A recent national poll on attitudes on abortion shows that 81 percent of Latino/a voters believe that politicians should not be allowed to deny a woman’s health coverage for abortion just because she’s poor. Honoring Rosie’s legacy means making that goal into a reality.

* Note on terminology: NLIRH embraces gender justice and LGBTQ liberation as core values and recognizes that inappropriately gendered language marginalizes many in our community. As such, we’ve moved towards using the gender-inclusive term “Latinx” when appropriate. NLIRH defines “Latinx” as a term that challenges the gender binary in the Spanish language and embraces the diversity of genders that are often actively erased from spaces.

Jessica González-Rojas is the Executive Director of the National Latina Institute for Reproductive Health and the Co-Chair of All* Above All.