By Priya Pandey

This past summer, our nation experienced an egregious setback on reproductive rights when the Roe v. Wade decision was overturned by the U.S. Supreme Court. The court upended over 50 years of legal precedent that protected the right to an abortion and its ruling opened the floodgates to new attacks on access to reproductive care. As many across the nation grapple with the reality of a post-Roe world, the truth is that federal rules denied access to abortion services for many people even when Roe was the law of the land.  As we work to restore abortion access, we must ensure we do so for all, and eliminate the inequities that existed under Roe.

The Hyde Amendment, passed in 1976, prohibits the use of federal funds for abortion services, except in cases of rape or incest or when the mother’s life is as risk.  This makes it much harder and more expensive for people insured by Medicaid or another insurance programs with federal funds to obtain an abortion. While the Dobbs decision overturning Roe v. Wade exacerbates this inequality, it’s important to note that for decades abortion access has never been equal across income level or states, in large part due to the Hyde Amendment. 

The Hyde Amendment creates problematic restrictions and perpetuates a system of inequality that is restricting access to abortion based on income, and the impact is disproportionately experienced by people of color. Because of systemic racism, women of color are less likely to have access to well-paying jobs that provide private health insurance, and thus to rely on Medicaid for insurance coverage. In 2020, 25% of Black women and 22% of Hispanic women between the ages of 15-29 were enrolled in Medicaid in comparison to just 12% of white women.   

 Today, 7.8 million women covered under Medicaid are left without abortion coverage as a result of the Hyde amendment. Sixteen states choose to cover abortion services for people insured by Medicaid by using state dollars, but in the 34 other states and the District of Columbia, the Hyde Amendment makes abortion access incredibly difficult and inequitable. Since the Dobbs decision, 17 states have banned or restricted abortion (as of September 2022) and Montana, one of the 16 states that supplements abortion services with state funds, could ban or restrict abortion access in the near future. 

 By making it difficult for people with low incomes to access an abortion, the Hyde Amendment puts their economic security, mental wellbeing, and livelihoods at risk. States across the country that are banning abortions push pregnant people into further economic precarity. People seeking an abortion are caught in a vicious cycle of long waits, difficulty obtaining funds, and having to consider travel out of state now as an additional cost and emotional burden in obtaining this service. 

Numerous studies show that women who are denied an abortion are more likely to be pushed into or remain in poverty longer compared to those who can access an abortion. People forced to carry an unwanted pregnancy to term could deal with additional financial hardship for any health risks associated with pregnancy, and significant mental health repercussions. These policies harm those with the least resources, undermining their bodily autonomy, and deepening already existing inequities.  

The impacts of Hyde are not limited to people who are insured by Medicaid. Individuals who receive their healthcare through other federal programs including government employees, service members and veterans, those currently incarcerated, and Peace Corps volunteers, are also denied coverage for abortions. If they live in a state with abortion access, they may still be able to receive abortion care, but the costs will entirely be out of pocket and not covered by insurance.  Women of color are also far more likely to receive health coverage through federal funding sources. 

The Hyde Amendment has curtailed access to abortion for millions of people. We must create a future where reproductive access is not dependent on whether federal dollars pay part of your health insurance premium, your socio-economic status, or race. Policymakers must not only codify Roe but also do away with additional restrictions on abortion such as the Hyde Amendment and restore the agency and autonomy of all people to make their own reproductive choices.