This month marks the 43rd year since the passage of the Hyde Amendment. This, however, is not an anniversary worth celebrating. Attached to federal budgets, the Hyde Amendment restricts government funds from being used to cover abortion, except in extremely limited circumstances. For over four decades, anyone who relies on government health care has been unable to use their benefits to cover the cost of an abortion. This includes people who receive Medicaid, military personnel, federal employees, and Indigenous folks. More than half of the 7.5 million women affected by this coverage ban are women of color.

Forward Together, the social justice organization I lead that fights to dismantle the ways that society marginalizes people based on race, sexuality, and gender, has spent the last 30 years working to win reproductive justice for women of color and end oppressive legislation like the Hyde Amendment.

Unfortunately, many people are unaware of the budget rider and its negative impact within their communities. Here are ten reasons to care about Hyde and how it perpetuates harm against women of color and Indigenous folks in the United States.

1. Sixteen is not enough.

Medicaid funds come from two places: states and the federal government. Because of the Hyde Amendment, federal Medicaid dollars can only be used for abortion care in extremely limited circumstances. Sixteen states, including Maine starting in 2020, have opted to use their own state dollars to cover abortion care for Medicaid recipients in their state, according to the Guttmacher Institute. But if you don’t live in one of those states, you are out of luck. Where you live shouldn’t determine if you have access to the abortion care you need.

2. Abortion is especially out of reach in rural communities.

Nearly 20 percent of the U.S. population lives in rural areas. Health care is one of the top challenges facing these communities. In very rural states like New Mexico, South Dakota, and Wyoming, many people have to travel over 180 miles to reach an abortion clinic. The Hyde Amendment creates an often insurmountable barrier to abortion care in these parts of the country.

3. Rural communities and communities of faith support the availability of the full range of reproductive health care services, including abortion.

New Mexico has the highest poverty rate within its rural communities of any state, and 79 percent of all New Mexicans identify with a religious faith. A poll conducted by Forward Together and our partners showed that 74 percent of rural New Mexicans agree that “personal decisions about abortion need to remain with women, their families, and their medical providers.” People of faith—79 percent of Catholics in New Mexico and 72 percent of other Christians in New Mexico—are clear that one’s moral views should not dictate others’ decisions.

4. Hyde harms Indigenous communities.

Hyde is a racist abortion ban that disproportionately harms Indigenous people covered by Indian Health Services (IHS). IHS provides health care to more than 2.5 million Native American and Alaska Native folks, many of whom may need an abortion at some point but will not receive coverage because of the Hyde Amendment. Throughout history people in positions of power have staked claim over the decision-making of Indigenous communities, and Hyde is another example of that.

5. Women of color have been at the forefront of fighting the Hyde Amendment.

Since its passage in 1976, there has been a vocal resistance against this ban from communities of color. But for decades, mainstream pro-choice groups viewed overcoming the ban as an insurmountable obstacle, and have not stopped Democratic lawmakers from, budget after budget, undermining the right to an abortion for poor people in this country. Women of color have always thought it was possible—and knew it was necessary—because it affects low-income people of color the most. Building on years of grassroots organizing, in the past decade groups led by women of color, like Forward Together, have organized to raise awareness and align the reproductive health, rights, and justice movements to focus on ending Hyde.

Hillary Clinton, the Democratic Party platform, and Alexandria Ocasio-Cortez speaking out on Hyde? You can thank women of color organizations for that.

6. Systemic barriers to abortion care still exist, even with the passage of laws to advance reproductive justice.

Since the Trump Administration took office, a handful of states have passed reproductive health equity laws, modeled after the Reproductive Health Equity Act (RHEA) in Oregon. RHEA passed in Oregon in 2017 and expanded coverage to thousands of Oregonians regardless of income, citizenship status, or gender identity. Anyone watching these developments might believe progress has been made and reproductive justice has been achieved. But unfortunately, RHEA did not expand access to people in the state still affected by the Hyde Amendment: federal employees covered by the government’s plan, service members using military health insurance, and people covered by Indian Health Services. There is still more work to do to break down the existing systemic barriers that restrict abortion access for thousands of people in Oregon and across the country.

7. The Affordable Care Act (ACA) didn’t make all health care affordable.

Remember when abortion was one of the main issues hanging up the passage of the Affordable Care Act? Even though millions of us spoke up, the health-care reform law still allowed states to prohibit plans in the ACA’s insurance marketplaces from covering abortion. President Obama even signed an executive order to assure anti-choice lawmakers that the health-care law would be consistent with the “longstanding Federal statutory restriction that is commonly known as the Hyde Amendment,” and that no federal funds would be used for abortions, except in limited circumstances. Since then, many states have enacted abortion coverage limitations for plans sold through their state health insurance marketplace for anyone who receives federal income-based subsidies.

8. People in federal prisons deserve access to abortion care.

Nearly 13,000 women are currently in federal prison, but the Federal Bureau of Prisons is not allowed to cover the cost of abortion, except in extremely limited circumstances. So people in federal prisons must come up with the money for their abortion, even if it would have been covered if they were not in prison. In fact, there are nearly 220,000 women behind bars in the United States on any single day, at local jails, in state prisons, or in federal custody. While all people who are incarcerated have “the right” to an abortion, state standards regarding abortion access for incarcerated people don’t necessarily uphold that right—their access to abortion care is often left up to the discretion of correctional officials on a case-by-case basis.

9. All pregnant people need access to abortion care.

Just as cisgender women may experience unintended pregnancy and need access to abortion care, we know that trans, non-binary, and gender-nonconforming people may also experience unintended pregnancies and need abortion care. However, access to abortion care is often farther out of reach for LGBTQ communities, who are more likely to live in poverty and receive their health care through Medicaid.

10. Repealing Hyde is not solely about choice; it’s about reproductive justice for all people to have agency over their bodies and lives.

Reproductive justice focuses on addressing the control and exploitation of our bodies, sexuality, and reproduction as an effective strategy of controlling communities, particularly those of color. Reproductive justice focuses on dismantling systems of white supremacy and cisheteropatriarchy that seek to control and exploit our bodies, sexuality, and reproduction, focusing particularly in the reproductive oppression of communities of color. Repealing the Hyde Amendment would mean a leap toward reproductive justice for affected communities, particularly Indigenous communities and communities of color.

I have been fighting for reproductive justice and the repeal of Hyde since I was 19 years old. It’s time to end Hyde now.