September 30, 2012 marks the 36th anniversary of the passage of the Hyde Amendment. For nearly four decades, the Hyde Amendment has limited the abilities of low-income women to implement timely decisions about ending a pregnancy by banning federal Medicaid coverage of abortion except in cases of rape or incest or when a pregnancy threatens a woman’s life. States have the option to use state Medicaid funds to cover abortion care, but most follow the federal example and prohibit this coverage.
It is not only the federal and state restrictions on Medicaid coverage that harm women. The exceptions carved out under the Hyde Amendment cause harm as well by “reinforcing the idea that some abortions are more justified than others,” as Tracy Weitz terms it, or as Steph Herold and Megan Smith write, “creating a hierarchy of abortion situations.”
Research we have conducted at Ibis Reproductive Health supports these critiques, showing that the exceptions can contribute to the stigmatization of abortion in certain circumstances. We have also found that the exceptions can lead to a de-facto ban on coverage of abortion in all circumstances—including rape, incest, and life endangerment.
The Hyde exceptions also create information barriers, and can prevent a woman from accessing accurate information about the benefits she is entitled to her under her insurance. In a recent study, we surveyed Medicaid staff in 17 states, and found that they are often confused by current abortion coverage policies, are commonly unable to provide accurate information about the circumstances that qualify for coverage, and are often unaware about the process for securing it. This is evidenced by one Medicaid staff person who told us, “There has got to be something wrong in order to get coverage,” and another staff person who told us incorrectly that a woman would need to have been raped and simultaneously have a pregnancy diagnosed with a fetal anomaly to qualify for Medicaid coverage of an abortion. Medicaid staff in states where only the Hyde exceptions are covered were more likely to provide incorrect information compared to staff in states where Medicaid broadly covers abortion, highlighting the difficulties of administering an insurance program that unjustly limits coverage of a medical procedure to certain circumstances.
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Taken together with previous research, our findings suggest that for a woman to consider her pregnancy options, make an informed decision about whether or not to terminate a pregnancy, and access the care she chooses, we must repeal the Hyde Amendment. Every woman should be able to make the best decision for her health and life regardless of her income, insurance status, or personal circumstances. The Hyde Amendment and its exceptions only harm women and interfere with their personal decision making.