40 Years Later, Harmful Hyde Policy Continues To Attack Women's Health

Comprehensive, quality health care must include all family planning services. And all people, not just the privileged, should have their health rights respected. At the moment, and for far too many moments in our country's history, women -- particularly, low-income and women of color -- have not been able to fully realize their liberty and health rights.



For instance, low-income women, disproportionately women of color, are routinely denied access to abortion care that women of means are not. Like too much in our health care system, and the justice system for that matter, there are some who enjoy the full benefits of liberty and others who are denied them. In this case government policy has infringed on the ability of women to control their destinies and make their own health care decisions for themselves and their families. That must change.



Medicaid, our nation's largest health care provider, must once again include coverage of abortion care. Without such public insurance coverage, we are collectively failing our entire nation, but more so our nation's most vulnerable, those living on insufficient incomes or mired in poverty. That's why the National Health Law Program and many other public interest and advocacy groups have been speaking out and taking action to turn the tide on the Hyde Amendment, a congressional maneuver that greatly limits Medicaid funding for abortion care.



Forty years ago this fall, Rep. Henry Hyde pushed through a bill that banned public funding for abortion, thus denying low income women access to a full range of essential health service and undermining the genius and promise of Medicaid. Hyde, could not use the government to directly deny a fundamental liberty -- abortion -- so he settled for denying access to this liberty to our nation's most vulnerable: low-income women who qualify for Medicaid.



Susan Berke Fogel, NHeLP's Director of Reproductive Health programs, notes often that the work we do at NHeLP is about protecting the legal health rights of low-income and underserved people, and that reproductive care is core to the quality comprehensive health care that NHeLP protects. She elaborated on this at the Coalition for Liberty & Justice Forum in D.C. this month, in a discussion about Catholic-operated health care systems that too often limit reproductive care for women because of religious dictates --another limit on women's liberty. Indeed, the former acting U.S. Solicitor General Walter Dillinger has eloquently noted on several occasions the irony of conservative lawmakers who disdain so-called big government but have no qualms about interfering with personal health care decisions of women. "We hear the talks about government intrusions into health care - that this represents an extraordinary step about liberty," Dellinger said during a panel discussion at the 2011 ACS national convention. "And I just cannot, any longer, refrain from making the observation that it is really ironic and disturbing to hear that liberty lecture come from people talking about [a] government takeover of medical care, many of whom would legislate the imposition upon women of unnecessary waiting periods, government scripted lectures, compulsory sonogram viewings, and government mandated unsafe medical procedures."



Forty years on, and all evidence stacks up the way Justice Thurgood Marshall suspected it would when he wrote in his dissent to Harris v. McRae, the narrow Supreme Court opinion upholding the Hyde Amendment, that it would bar low-income women from their constitutional right to abortion, while women of greater means, mostly white women, would enjoy greater liberty.



At NHeLP we strive to protect and advance the health rights of low-income people. Medicaid, as pointed out in this new Commonwealth Fund survey, is popular, successful, and integral to our nation's health care system (and states expanding Medicaid are also seeing great benefits economically with lower health costs and more health care jobs). Medicaid serves about 73 million people in our country. And yet the Hyde Amendment, which blocks Medicaid funding for most abortions, continues to greatly hobble the noble law.



Although states may fund abortion care services through Medicaid, many do not. Further, as Ann M. Starrs writes for Guttmacher Institute 60 percent of reproductive-aged women eligible for Medicaid are living in states with restrictions on funding of abortion care, and a disproportionate number of them are women of color.



What the Hyde Amendment has wrought is inexplicably bad public policy. It's a policy that targets low-income women, limits their health rights and their constitutional rights, and either drives them into poverty or makes it increasingly difficult for them to overcome poverty. We cannot afford to hobble our nation's women this way.



Congress does not have to remain beholden to the Hyde Amendment, and it's far past time for it to move beyond this outdated and harmful policy.

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