Nearly 40 years ago, when she was a young congressional staffer, Representative Barbara Lee watched as lawmakers cut millions of poor women off from abortion coverage. They did so via a provision barring Medicaid from covering the procedure. Henry Hyde, the Illinois Republican who sponsored the amendment, made little effort to conceal that his was an effort to undercut Roe v Wade, the Supreme Court ruling that legalized abortion just three years earlier; nor did he deny his amendment would disparately impact women in poverty. “If rich women want to enjoy their high-priced vices, that is their responsibility…that is fine, but not at the taxpayers’ expense,” he quipped during one debate. Later he admitted, “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.”
The amendment’s passage shocked Lee. “It was really earth-shattering for me as a young African-American woman, you know—why this guy would even want to interfere with women’s rights and women’s health-care decisions,” she remembers. After Lee was elected to Congress she served on the House Foreign Affairs committee, with Hyde as chairman. She thought often about how she might convince him that his amendment was hurting women. Eventually, Lee says, “I decided there was no way to convince him of that, so I’m going to just have to work to help try at some point to repeal it, when the political climate was right.”
Lee has waited a long time. Though Hyde is only a temporary provision, Congress dutifully tacks it onto an appropriations bill every year. Lawmakers have extended the abortion coverage ban to other people dependent on public insurance, including military servicemembers, Native Americans, and federal employees. There have been a few attempts to repeal the ban over the years—Bill Clinton tried, in 1993—but in general even pro-choice politicians have preferred not to talk about Hyde.
That’s changed, and rather quickly. Lee, along with Representatives Jan Schakowsky and Diana DeGette, introduced a bill this time last year that would ensure that anyone with federally funded health insurance has coverage for abortion care; they now have more than 115 co-sponsors. Hillary Clinton criticized Hyde directly on the campaign trail for “making it harder for low-income women to exercise their full rights.” And, for the first time, the Democratic Party platform draft explicitly calls for repealing Hyde, as well as the Helms Amendment, which applies to foreign aid—for “full-fledged taxpayer funding of abortion,” to quote one scandalized anti-abortion writer.
“We’re starting to see the ground shift,” says Destiny Lopez, the chair of a coalition called All* Above All formed specifically to advocate for ending the ban on public abortion funding. “After 40 years of this, we can actually see a future where [Hyde] is repealed.”
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According to Lopez, the Hyde Amendment is “one of, if not the most, onerous barriers to abortion care.” Effectively, it puts the legal right to abortion out of reach for many women on the basis of their income—and their skin color, as women of color are more likely to rely on Medicaid than other groups. Medicare alone covers nearly one of every six American women of reproductive age, and that number has likely gone up since many states expanded their Medicaid programs under the Affordable Care Act. All together, about 20 million women rely on one of the insurance programs affected by the ban on public funding for abortion. Hyde forces some women to delay an abortion while they round up the money, which can make their procedure both more expensive and more complicated. It forces others to have children against their will: Studies in a number of states indicate that as many as 35 percent of women who want to end a pregnancy ultimately carry it to term when public funding is cut off.
Yamani Hernandez is the executive director of the National Network of Abortion Funds (NNAF), which raises money to help people pay for their abortions—the procedure itself, which can cost from $300 to $2,000, as well as travel costs and other associated expenses. She says that the funds have seen a spike in requests for help in recent years due to clinic closures and other restrictive laws in states like Texas. The added barriers are particularly prohibitive for women without insurance coverage. About 116,000 people call abortion-fund help lines every year; they contemplate not paying rent, pawning furniture, or not buying as much food for their other children if they can’t get help. Hernandez says the network able to fund about 30,000 of them—less than a third.
“There are a lot of places in the Midwest and South where they just don’t have enough clinics for it to be geographically accessible, so people have to take time off work, they have to travel, stay in hotels, they’ve got to figure out what to do with their children,” Hernandez explains. “The cost is a huge issue. People expect to be able to use their insurance for their health care, and when they can’t, it presents a huge barrier. You have people, even middle-class people, who don’t have an extra $500 laying around somewhere.”
Politically, the wave of anti-abortion laws created a sense of urgency for repealing Hyde. “The anti-choice forces have just gone to far to the extreme,” Representative Lee told me. “I said, enough is enough.” Incidentally, the day before we spoke, Lee’s Republican colleagues proposed to gut the Title X family planning program that provides contraceptives for low-income adults, and $108 million for teen pregnancy prevention. “You can’t anymore be moderate with members of congress who are all the way right wing on this—trying to deny women just basic rights,” Lee said.
But Lee and other lawmakers say that it was activists, many of them women of color, who truly made Hyde part of the mainstream pro-choice agenda. All* Above All formed in 2013, sparked by a convention on abortion access for poor women organized by NNAF and the National Latina Institute for Reproductive Health. The coalition launched a national bus tour and social-media campaign the following year to raise awareness and galvanize a movement for overturning Hyde. Another reproductive justice group, URGE, held rallies in 20 cities. All* Above All commissioned a poll, which showed that 86 percent of voters, regardless of how they felt about abortion, thought that “politicians should not be allowed to deny a woman’s health coverage because she is poor.” Even 62 percent of Republicans agreed that “as long as abortion is legal, the amount of money a woman has or does not have should not prevent her from being able to have an abortion.”
The reproductive-rights groups began pushing members of Congress. NARAL Pro-Choice America reworked its endorsement criteria, according to president Ilyse Hogue, “to actually say that if you want to be a champion on this stuff, you’ve got to use your floor time to speak out every time the Republicans attach Hyde—move from the language of, ‘this is the law of the land’ to, like, ‘no, this is discrimination against low-income women.’” And Democrats did begin to push back, last year holding up two bills to which Republicans had attached Hyde-like provisions. Lee says all of that activism and advocacy “actually created the climate for us” to introduce the EACH Woman Act, and to incorporate the call for repeal into the party platform.
Hyde “was untouchable because it both dealt with poor women and it dealt with women of color…so we had to create some political space,” says Lopez. They did so, at least in part, by lifting up those women’s stories and, as Katha Pollitt writes, by “fram[ing] abortion as a normal event in women’s lives and a basic part of health care.” It helps that political space has also grown for a discussion about economic and racial inequality, thanks to movements like Occupy Wall Street, Fight for 15, and Black Lives Matter. Now, what was once a liability actually works in advocates’ favor, allowing them to put Hyde in the context of a broader national conversation about poverty, racism, and justice—and to shift the moral compass. “The culture is ready to have a discussion about embedded race and class discrimination and our ability to access our constitutional rights,” says Hogue.
Ending the Hyde Amendment is still a long shot in a Republican-controlled Congress. Yet Hogue thinks that it’s “inevitable,” given how blatantly discriminatory the measure is. In the wake of the Supreme Court’s ruling against two abortion restrictions in Texas, the pro-choice movement is eager for an offensive. That means pushing to expand abortion coverage at the state level, too; currently 17 states fund abortion care for Medicaid recipients themselves, though most do so not voluntarily but to comply with court orders. Other states ban even private insurance from covering abortion. “The Supreme Court decision was just stemming the bleeding,” says Hogue. “We’re so ready to move forward into the future where women actually control their own destinies.”