Imagine a woman who has come to the decision to end a pregnancy. A single mom with three children, she works in the service industry, relies on Medicaid for her family’s health care needs, and lives paycheck to paycheck. She was on birth control, so the pregnancy was unexpected, and she knows carrying the pregnancy to term will mean providing less for her kids and likely losing her job. Although ending the pregnancy is not an easy resolution, she discusses it with her doctor and concludes it’s best for her family.
Unfortunately for her, even though abortion is an essential part of reproductive health care, it’s not available for many poor women and their families because of the decades-old Hyde Amendment. The U.S. Congress and the Louisiana Legislature consider it acceptable to invade this woman’s right to privacy, force her to carry to term an unplanned pregnancy, and push her family into years of poverty.
Health care should be a right, not a privilege. In our country, however, it is often a privilege with money being the determining factor, especially when it comes to women’s reproductive health. With members cowing to the conservative base and crowing about the sanctity of life, these politicians limit health care for poor women and their families, who are vulnerable, powerless and make few campaign contributions.
This results is more women and children living in poverty with little hope of getting out.
It's now 43 years that the Hyde Amendment has blocked federal funds from being used to pay for abortions, with very narrow exceptions. This amendment not only prohibits people in the Medicaid from accessing funds for abortions; it also prohibits accessing funds through any federal program.
The Hyde Amendment’s intent has always been controlling women’s reproductive care, specifically for low-income people who use government-funded health care. According to Kaiser Family Foundation, 48 percent of all low-income women were enrolled in Medicaid in 2016. Women of color are disproportionately likely to be insured through Medicaid because of social and economic inequality and structural racism. This is why women of color have been leading the opposition to the Hyde Amendment for decades and consider it a matter of reproductive justice.
The cost of abortions continues to rise as laws and regulations increase the operating costs of clinics and reduce the numbers of facilities providing abortions. In Louisiana, there are only three remaining abortion clinics. Without coverage, low-income people are scraping together the money to pay for the abortion, while at the same time missing work to make two trips to the clinic (as mandated by Louisiana law), and, in many cases, traveling hundreds of miles and paying for child care. Often people must decide whether to buy food, pay rent or divert that money to pay for ending a pregnancy.
The politicians get their wish, with one in four poor women seeking abortion being forced to carry an unwanted pregnancy to term. And then these same elected officials turn their attention away, failing to recognize that women who are denied an abortion are four times more likely to fall below the poverty line.
Access to the full range of health care you need should never depend on the type of insurance you have, how much money you make or where you live. Yet location does matter, and while 16 states allow the use of their own funds to pay for abortions for low-income women insured by Medicaid, others, including Louisiana, block those funds as well.
Now some in Louisiana want to go even further by amending the state constitution, blocking all funding for abortion.
If we can’t get reproductive justice from the Louisiana Legislature, we can ask Congress to act to protect people across this country, including those of us living in Louisiana, from being denied access to all reproductive health care including abortion.
By passing the Equal Access to Abortion Coverage in Health Insurance (EACH Woman) Act, Congress will restore full reproductive health care coverage and access to care to individuals employed, insured, or otherwise covered by the federal government. While we can never repair the government’s 43 years of purposeful neglect, we can end to this discriminatory policy, restore reproductive justice and help American families.
Michelle Erenberg is executive director of Lift Louisiana, a women's health advocacy nonprofit based in New Orleans.