[Featured image: Thomas Hawk/Flickr/Creative Commons]
By Jeryl Hayes, J.D., LL.M., If/When/How Movement Building Director
Before I started law school, there were probably only two Supreme Court cases I could talk about with any detail: Brown v. Board of Education and Roe v. Wade. I knew that one case helped to end school segregation and the other legalized abortion for women. After completing my legal education, I’ve since learned that while there are a litany of other Supreme Court cases and policies that impact access to reproductive health care, including abortion, no other case seems to galvanize both supporters and opponents to abortion rights quite like Roe v. Wade.
And while polls may show that support for maintaining Roe is at an all-time high, with seven in 10 American voters asserting that Roe should not be overturned by the Supreme Court, the reality is that maintaining Roe is only one part of the picture. While there may have been a legal right to abortion since the landmark case was decided in 1973, for a growing population of the country actual access to abortion continues to remain out of reach.
Kalena Thomhave’s recent article brilliantly outlines many of the reasons why solely focusing on what happens next with Roe doesn’t fully address the concerns of people who are already living in a post-Roe reality because the increasing volume of state restrictions leave them without access to abortion care. One aspect of the abortion discussion that still needs to be amplified is the financial restrictions that continue to push abortion access out of reach.
Financing of abortion procedures is arguably the largest hurdle for people seeking abortion care. Even in places where abortion providers are readily available, the cost of the procedure, as well as the ancillary costs like transportation, childcare costs for patients who are already parents, and even unpaid time off work if sick leave is unavailable, can make the expense of getting an abortion almost insurmountable. For states with waiting periods, some patients have to factor in lodging costs as well, which only increases the total cost.
Although many private insurance plans cover abortion care, Congress and the Trump administration have been finding ways to make private insurance coverage of abortion more burdensome by creating additional administrative barriers to discourage both insurance companies and policy holders from maintaining coverage for abortion care. For some folks, even if they have private insurance coverage for abortion, there are still other factors that create barriers, like high deductibles and out-of-pocket costs, or not wanting a partner, parent, or employer to know that they received abortion care.
For people who have public insurance, such as Medicaid or Medicare, if they work for the federal government or military, or if they are in the immigration or prison detention system, their access to having their insurance cover their abortion is restricted because of the Hyde Amendment. Since 1976, those with public insurance are denied the ability to exercise their legal right to abortion based on the type of insurance they have. This policy, which is renewed annually as part of the budget appropriations process, is a discriminatory practice that restricts federal funding from being used to cover abortion care, with very limited exceptions. A handful of states have elected to use their state Medicaid funds to cover abortion for Medicaid recipients, but even those states still have issues with providers getting reimbursements for procedures.
And while many folks may be familiar with Roe, which established a constitutional right to abortion, fewer are likely familiar with the 1980 Supreme Court case, Harris v. McRae, which challenged the validity of the Hyde Amendment. The Supreme Court ruled that while Roe did establish a constitutional right to abortion, it did not mean that people had a constitutional right to have financial support from the government to exercise that right. In his dissent, Justice Thurgood Marshall accurately pinpointed the discriminatory nature of the Hyde Amendment and the most impacted by it, stating that “the Hyde Amendment [was] designed to deprive poor and minority women of the constitutional right to choose abortion.” More than 40 years after the Hyde Amendment was first introduced, it is still people of color and people with low incomes who are disproportionately harmed by the Hyde restrictions.
On the Roe anniversary, we have to push ourselves to think beyond the legal framework of Roe to address the current reality of what abortion access looks like in our country today. We have to uplift the ongoing work on abortion funds across the country, many completely run by volunteers, that are helping to fill the financial gaps to make sure that people can get the abortion care they need. We must stop siloing abortion care from other reproductive health care because our opponents are attacking access to reproductive health care on all fronts, from limiting the contraceptive coverage benefit to denying protections for pregnant workers to attempting to remove maternity coverage as a guaranteed benefit under the Affordable Care Act.
There are many ways to get involved today that would make a collective difference:
- Give money and/or volunteer with your local abortion fund or the National Network of Abortion Funds
- Contact your legislators frequently and tell them to support access to the full range of reproductive health care, including contraception, abortion, and maternity care
- Educate yourself about harmful restrictions, like the Hyde Amendment, and get involved with coalitions like All* Above All that are working to restore insurance coverage of abortion
We have to address the systemic issues of economic inequality that disproportionately impact people of color, young people, and immigrants. Because if we don’t, we don’t have to look that far to see what a post-Roe world looks like. Too many people are already living there.
The views and opinions expressed in this blog are those of the author(s) and do not necessarily reflect the views or position of If/When/How. If you like what you read on our blog, consider dropping a few bucks in our tip jar or sharing this post on Facebook or Twitter.