As the Hyde Amendment turns 40 this month, activists and legislators are seeking to permanently end the prohibition on federal funds from covering abortion care. According to sexual and reproductive health rights nonprofit group the Guttmacher Institute, between 18 percent and 35 percent of people insured by the federal Medicaid program who have experienced an unwanted pregnancy have been forced against their will to carry that pregnancy to term under Hyde.
Penned by former Rep. Henry Hyde (R-Illinois), the Hyde Amendment has been added to every federal budget since 1976 and signed into law by every president regardless of party -- making presidential candidate Hillary Clinton's vocal opposition to the amendment this January historic.
"I believe we need to protect access to safe and legal abortion -- not just in principle, but in practice. Any right that requires you to take extraordinary measures to access it is no right at all," Clinton declared at a New Hampshire campaign rally. "Not when patients and providers have to endure harassment and intimidation just to walk into a health center. Not when making an appointment means taking time off from work, finding childcare and driving halfway across your state. Not when providers are required by state law to recite misleading information to women in order to shame and scare them. And not as long as we have laws on the book like the Hyde Amendment making it harder for low-income women to exercise their full rights."
The Democratic Party platform committee adopted a similarly uncompromising position -- also a first -- after hearing from reproductive justice advocates. The Democratic Party platform reads: "We will continue to oppose -- and seek to overturn -- federal and state laws and policies that impede a woman's access to abortion, including by repealing the Hyde Amendment."
But even with voter support for abortion rights at an all-time high -- 86 percent of voters agree access shouldn't be denied due to a person's economic situation -- many campaign positions and party platforms don't guarantee action post-election. The question remains: how do we end Hyde for good?
The Effects of the Hyde Amendment
The Hyde Amendment has only ever had one purpose: to prevent as many abortions as possible. Hyde told his colleagues during a congressional debate over Medicaid funding in 1977: "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."
Over the years, other federal insurance programs have been added to the list, increasing the number of people denied the human right to bodily autonomy. TRICARE, which serves active duty military personnel, retired personnel and their families; all federal employees; residents of the District of Columbia; Children's Health Insurance Program (CHIP) enrollees; those serving time in federal prison; members of the Peace Corps; and the clinics that are part of The Indian Health Service (IHS) all deny those they insure access to abortion care with rare exceptions for the patient's health.
Due to the makeup of these groups, low-income people of color are disproportionately affected by Hyde. Those who are already discriminated against have shouldered the burden of being the political tradeoff, even during a time of health insurance access expansion. Twenty-five states prohibit abortion coverage on their health insurance marketplaces beyond the limited cases of rape, incest and life endangerment.
Outspoken abortion advocate Rep. Barbara Lee (D-California) told Truthout that now is the time to end the practice of denying health care to those who need it.
"By including language to repeal the discriminatory Hyde Amendment in the platform, Democrats are going on [the offensive] to ensure all women can exercise their constitutional right to abortion care," said Lee. "Accessible, affordable reproductive healthcare is a human right. All women, no matter their income, employer or ZIP code, should be able to make the health care decisions that are right for them and their family."
Strategies for Ending Bans on Abortion Coverage
Destiny Lopez, codirector of the All* Above All coalition seeking to lift abortion coverage bans, was one of those who advocated for ending Hyde to become part of the Democratic platform.
"The partisan rancor about abortion politics often masks the truth that the American people want abortion to be safe, legal and accessible. Even those who personally oppose abortion generally don't want politicians making these personal decisions for a woman," Lopez told Truthout. "All* Above All Action Fund is proud to have provided testimony to the platform committee of the Democratic National Committee -- and proud that the platform reflects an unprecedented commitment to lifting coverage bans."
Lee, her colleague Jan Schakowsky (D-Illinois) and All* Above All have been working to build support for federal legislation that would do just that. However, she concedes that even though more than one quarter of the House of Representatives has signed on in support, that isn't enough to make the bill law.
"Last year, I introduced the EACH [Equal Access to Abortion Coverage in Health Insurance] Woman Act to repeal the Hyde Amendment and ensure all women have access to a full range of reproductive health options, including abortion. We now have 120 co-sponsors [122 total representatives including Lee and Schakowsky], but we still need to keep raising our voices and building a coalition to end Hyde," said Lee. "The American people are broadly in support of ending this discriminatory practice that disproportionately hurts poor women, students and women of color. Eighty-six percent of Americans agree that politicians shouldn't be able to deny women health coverage because [they're] poor. These Americans need to continue raising their voices and demanding an end to this injustice. Through the power of grassroots action and advocacy, we will get this amendment off the books."
Hyde could technically be taken off the books simply by a presidential pen stroke. It is an amendment to the federal budget, which means it expires when the current federal budget expires. If all proceeds according to the Congressional Budget Act of 1974, which created the outline used for building the "budget resolution" with input from the White House as well as Congress, each new budget begins as the new fiscal year begins on October 1. The detailed proposal from the president which kicks off budget negotiations could include a hard line that any congressional budget resolution with Hyde-like language attached would be returned.
A continued refusal to sign budget legislation with abortion coverage bans would result in the Hyde Amendment becoming history. Should Republicans be consistent in following their recent strategy regarding the federal budget, a firm refusal to sign such legislation could result in a government shutdown, but it is an option that a new president could use unilaterally. This approach would be effective immediately, but it would not ensure protections beyond that president's tenure or will to have such a fight with Congress on an annual basis. It would, however, be one of the first opportunities to tackle the issue, as a president's initial budget proposals are supposed to come by the first Monday in February. Though delays in sending proposals to Congress are common following the inauguration of a new president, the budget is among the first tasks of a new administration due to the schedule outlined in federal law. And refusing to sign a budget with coverage bans would not preclude supporting more lasting legislation.
There's no word from the Clinton campaign on which approach she will take to confronting Hyde. Her campaign website says only that "[s]he will repeal the Hyde amendment to ensure low-income women have access to safe reproductive health care," and the campaign didn't respond to Truthout's requests for details and clarification on specific policies and/or actions that would achieve that goal.
Both activists and state-level legislators are gearing up to press her on accomplishing this goal should she win in November.
"We should demand that all our candidates make clear their views on abortion coverage bans and it's up to us to hold them accountable to the pledges they've made," said Lopez, who wants to see Clinton "take a strong stand" against Hyde in her very first budget. "Our nation's leaders need to recognize, as presidential candidate Hillary Clinton has, that bans on abortion coverage are bad policy, bad politics, and that voters are paying attention."
Municipal Efforts to Repeal Bans on Abortion Coverage
The city council of Ithaca, New York, did its part to increase the pressure against restrictions on abortion coverage last week. Joining localities around the country, such as Cook County, Illinois; Cambridge, Massachusetts; New York, New York; Philadelphia, Pennsylvania; Travis County, Texas; Seattle, Washington; and Madison, Wisconsin, the Ithaca city council passed a resolution calling on Congress and President Obama to enact the EACH Woman Act to repeal current and prohibit future insurance bans on abortion coverage -- including those funded by federal dollars.
Planned Parenthood of the Southern Finger Lakes, which operates a full-spectrum reproductive health care facility in Ithaca, praised the resolution via press release following the vote.
"For too long, politicians across the country have interfered in women's health decisions by restricting insurance coverage for abortion care in public insurance, impacting women enrolled in Medicaid, state and federal employees, Peace Corps members, beneficiaries of Indian Health Services, and military insurance programs," said Planned Parenthood of the Southern Finger Lakes interim CEO Angela Riddell. "New York has helped fill the need for our own residents by providing coverage to women enrolled in Medicaid, but a woman's ability to make decisions about whether to parent shouldn't be based on what state she lives in."
According to Guttmacher, only 17 states buck the national trend of only paying for abortion in cases of life endangerment, rape and incest. While four states use their Medicaid funds voluntarily, 13 only do so because of court orders. Because so few municipalities and state legislatures have been willing to be bold on abortion care, every governmental group that passes proactive laws or resolutions is an important standout. As history has proven on other issues over the years, building political will to match high voter support is a challenge for advocates of all types -- a challenge made easier when legislators see their colleagues taking action.
"This is a movement that's bigger than politics or any one election -- and that means building an ecosystem of social change," said Lopez. "We need a bold policy agenda and champions willing to carry it forward; we need organizing at the local and state level; we need innovative and culturally-competent campaigns to transform the way we think and talk about abortion. The good news is all of these pieces are coming together, and our collective unity and strength are greater than ever before."
City of Ithaca's First Ward Alderperson Cynthia Brock is one of those local officials speaking and taking action in furtherance of such bold policy on behalf of her constituents.
"This resolution is about giving all women the opportunity to control their reproductive future," Brock said in a press release following the vote. "We as a community know that when women have not only the financial freedom to access quality health care, but also the power to decide their future, we empower women and enable a strong and vibrant community for everyone."
The National Institute for Reproductive Health (NIRH) also lauded the Ithaca city council's actions.
"Ending these bans is one step toward ending the system-wide inequities that so many in our communities face," NIRH president Andrea Miller said via press release. "The National Institute has supported local resolutions like this one across the country and applauds Ithaca for joining the national movement to protect access to abortion for all women, particularly those for whom the cost of an unwanted pregnancy or abortion would be devastating."
Keeping Abortion Access Part of the Electoral Conversation
Awareness about Hyde and other abortion restrictions is growing, thanks in part to extreme rhetoric against abortion from candidates during this and the past few election cycles, and now is the time to offer voters alternatives to support. Activists continue to focus on awareness through campaigns, storytelling, and going hard at legislators and candidates who don't vocally support abortion access.
"One of our biggest hurdles is that many people still don't know how deeply abortion coverage bans are harming women and communities, so the first step is to spread the word," said Lopez. Get informed and make sure your friends and family know about these policies. Injustice flourishes where silence reigns."
Lopez also emphasizes vigilance.
"As we've seen in the years since Roe v. Wade, there will always be those who try to reverse progress and undo our good work," she said. "When Donald Trump says he wants to punish women for the decision to have an abortion, we're all appalled -- but we need to recognize that the Hyde Amendment actually makes good on those awful promises. Fortunately, the new American majority is ready to help us hold onto and attain even more gains for women's health and reproductive justice."
Young people of color have been leading the reproductive justice movement to make Hyde a mainstream issue in policy development. While the Clinton campaign didn't respond to requests from Truthout about plans to include these advocates in decisions about potential policies and/or legislation should she win the presidency, Lopez remains optimistic and makes it clear that the White House isn't the only target for abortion advocates.
"It is my ardent hope that all our elected officials -- from the White House to the school board -- seek and listen to the advice of women of color leading social justice movements across this country," she said. "As we wrestle with issues of economic, gender and racial justice in particular, the perspectives and leadership of women of color must be at the center of our policymaking. Women of color are leading the movement to end the Hyde Amendment and we are prepared to work with our leaders to build a brighter future."