How Hyde Affects our Patients

This week marks the 40th anniversary of the Hyde Amendment, which bars Medicaid recipients from using their benefits to pay for abortion care in many states. Our volunteers are sharing the stories of why our work is vital in the face of these restrictions. Today, case manager Olivia C. shares what she sees on the help line.When I ask a DC Abortion Fund patient if they have health insurance, I hold my breath. If the patient tells me they have Medicaid, I should be relieved. More often than not, however, I have to talk to my patients about how a program that's supposed to provide healthcare won't in this instance. Because of the Hyde Amendment, a sweeping federal restriction on funding for abortion, most of our patients on Medicaid can't use it to pay for their abortion, leaving them to scramble for funds.For almost 40 years, Hyde has made true reproductive choice a theory rather than a reality. Hyde bans the use of federal money for abortion except in the most limited circumstances: life endangerment, rape, and incest. A handful of states — 15, to be exact —  use their own funds to provide abortion to people enrolled in Medicaid, but 33 states don’t, and the District of Columbia can’t — leaving 60 percent of women enrolled in Medicaid without abortion coverage. The patchwork of funding make abortion access a privilege based not just on income, but on ZIP code.We see this play out every day at the DC Abortion Fund. Our Medicaid-enrolled patients in Maryland have abortion coverage up to 22 weeks of pregnancy, at least if they're on the state’s primary Medicaid program (Maryland’s Children's Health Insurance Program and family planning program don't offer abortion coverage). Patients with Medicaid calling us from the District of Columbia, Virginia, and other states aren't as lucky, nor are our patients who are federal employees or military service members or veterans who have insurance provided by the federal government.Hyde hits the people who are most in need. Poor and low-income women are the most likely to experience an unplanned pregnancy and want an abortion. Because of social and economic inequality linked to racism and discrimination, Hyde disproportionately affects women of color (30 percent of black women and 24 percent of Hispanic women are enrolled in Medicaid), youth, immigrants, and transgender or gender non-conforming individuals, and people with disabilities. The result is that a program intended to promote equality in health care access perpetuates inequality instead.At the DC Abortion Fund, we work with patients who experience this inequality first-hand. The average cost of an abortion can be more than one-third of a patient’s monthly income, and even more as a patient gets further into pregnancy. Without much money to spare, our patients may find themselves needing to divert funds from food, rent, and utilities to pay for their abortion. They might find themselves in a vicious cycle of fundraising, being unable to hit their target, and having to reschedule for a later, more costly appointment. While the DC Abortion Fund and our partners often can meet the need of our patients, there are other people for whom abortion is still financially out of reach, forcing them to carry an often unplanned, and often unwanted, pregnancy to term.The DC Abortion Fund and our fellow funds exist to help patients fill the gap left by Hyde, but we can't do it without our volunteers and donors. Moreover, we can't meet the needs of every patient nationwide affected by abortion coverage restrictions. We need abortion coverage that doesn't discriminate on wealth and address.It's high time to repeal Hyde. Advocates across the country are banding together to call on Congress and our next president to end restrictions on abortion funding. Join the DC Abortion Fund and send us a selfie telling us why you stand up against Hyde. Write to your Congressperson asking them to support the EACH Woman Act, which mandates abortion coverage in insurance. And on Sept. 30, the 40th anniversary of the Hyde Amendment, be bold and shout your support for abortion access. It's time for us to restore decision making to the people who need abortion and make choice a reality.by volunteer Olivia C.