Toni on The Hyde Amendment
Toni (she/her) is a Black woman reproductive justice practitioner and advocate, and a worker in movements that are invested in liberation (including, but not necessarily limited to, the abortion access and reproductive health, rights, & justice movements). She is a Helpline Volunteer for Carolina Abortion Fund (CAF), and is a CAF Intern for the Spring 2024 term. She is a native New Yorker, but has recently made a home in Charlotte, NC.
Hi friends,
Over the next few weeks through these blog posts, I’m going to take you on a journey of the injustices I’ve experienced and observed in my life, shaped by the intersections that I and many people in this country hold. I’ll cover topics ranging from reproductive justice to disability justice to labor justice–because they’re all connected! We don’t live singular or simple lives in an oppressive state.
Let’s talk about… the Hyde Amendment.
The Hyde Amendment chipped away at abortion rights and abortion access way before Dobbs decision ever did. In 1976, U.S. Representative Henry Hyde posed the idea that federally-funded health insurance programs like Medicaid should not cover abortion. And along with other members of Congress, this amendment was passed as a rider onto an appropriations bill and has been law ever since. Although there are “limited” exceptions to the Hyde Amendment–similar to the exceptions in abortion bans in individual states–they would require “proof” to law enforcement and reporting officials.
In the years afterward, the Hyde Amendment was extended to other federal programs and agencies, such as Medicare, the Children’s Health Insurance Program, Indian Health Services and the Veterans Health Administration, preventing these programs from covering abortion services as well. The amendment has been renewed annually every year by the Department of Health and Human Services with these restrictions to this day, despite numerous attempts to repeal it. This law states loudly and proudly that abortion isn’t real healthcare, which is why it is worthy of being sacrificed; and that those who rely on government programs do not deserve to have their whole needs and wants taken care of. It’s a real slap in the face to everyone who wasn’t born into/obtained class privilege or is generally oppressed by the U.S. Empire on a day-to-day basis, such as people of color, LGBTQIA+ folks, immigrants and refugees, and people with disabilities.
Roe v. Wade, which granted the federal right to abortion in the U.S., was passed in 1973; so Hyde was quick to think of a way to reverse bodily autonomy for pregnant people–but once again, only for certain people. Before Roe, higher-income people were able to travel to states (and other countries) where abortion was legal; and after Roe, those same people could still travel far distances if they wanted to gain access to renowned and trusted medical professionals, who could treat them with patient-centered care and as soon as possible–because they were able to pay for that experience. In other words, Roe guaranteed the right to an abortion, but it didn’t guarantee access to an abortion, or even a safe one. Low-income, under/uninsured, non-white people were still at risk of a predatory and racist medical industrial complex, which believed that they didn’t deserve access to safe and compassionate abortion care. And then 3 years later, they were at risk of the federal government, which believed that those folks didn’t deserve an abortion at all, and should be forced to carry out a pregnancy, give birth, and parent–all which do not receive proper support in the United States.
All of this information may sound bleak–but there was one silver lining from the Hyde Amendment. Ironically similar to Dobbs, individual states had some autonomy with how to navigate this law, because the Hyde Amendment may block federal funds from covering abortion, but it doesn’t block the use of state funds from covering abortion. Because Medicaid is a joint federal and state program, this means that states can decide if they would like abortion to be a covered service under Medicaid, as long as they use their own money to pay for it. However, this method still relies on politicians–state politicians, but politicians nonetheless–to decide the reproductive futures of low-income pregnant people; and as we’ve seen in the nearly 2 years since the Dobbs decision came down, that hasn’t been going so great.
Now you might be wondering, “Toni, why are you raving about the Hyde Amendment? This isn’t new.” It is because I have found myself in the exact position where the Hyde Amendment would apply to me.
For the second time in less than 2 years, I have been fired from a job in the repro movement, because supervisors and senior leaders at my organization were more invested in a white supremacist culture where Black employees suffer, than they were in creating an environment that was safe and sustainable for all–the irony of which is not lost on me. As a result, I no longer have an income and I lost my health insurance; and I now live in a state where it is incredibly difficult and takes too much time to get public benefits. Previously, I lived in New York, where you can apply for Medicaid and find out immediately after completing your application if you’re eligible for coverage starting that same day. Here in North Carolina, my Medicaid application asked me invasive questions that I never thought I’d have to answer–which made me want to not submit it at all–and at the end, I was told I’d still have to wait up to 45 days to receive a decision. As a chronically-ill disabled person, not having health insurance for a few weeks and the security it gives was my worst nightmare. Just like no one should have to work this hard to get life-changing abortion care, no one should have to fight this hard just to see a healthcare provider without going bankrupt, or to receive the life-saving medications that they so desperately need. No one should be forced to make these life-or-death decisions, and it is not a part of the autonomous world that I dream of.
Recently, I had the realization that this moment I find myself in puts me in circumstances similar to many of our callers on the helpline. Most abortions performed in the Carolinas start at around $600; and the patients who call the helpline requesting abortion funding assistance don’t call because their insurance is covering most of the procedure with a small co-pay, it’s because their insurance isn’t covering it at all–if they are insured. In both North and South Carolina, Medicaid coverage of abortion is banned, because the states have chosen not to use their state funds to cover abortion; and private, commercial insurance is not required to cover abortion in these states either. This means that whether you’re low-income and uninsured enough to qualify for Medicaid, or, for instance, have insurance through your employer, it is still not guaranteed that you will be able to obtain or afford your abortion procedure. This of course doesn’t even factor in the limited amount of abortion clinics in the Carolinas (especially in South Carolina), the fact that those clinics are backed up from serving so many patients from total and near-total ban states, the lack of staffing since only physicians are allowed to provide abortions, the multitude of restrictions in each state, the difficulty that comes with a patient needing to travel to a clinic for their appointment(s), and many others.
If I wanted or needed an abortion right now, my health insurance wouldn’t cover it, I wouldn’t be able to use my own personal funds, I might not be able to drive to my appointment, and I would be entirely reliant on the assistance of abortion funds. Abortion funds and clinic staff make the impossible possible, but the responsibility of life-saving work shouldn’t be put on them. Simply, it should not be this hard to get the health care, services, and supplies that you need to live a healthy and fulfilling life.
Sources
https://states.guttmacher.org/policies/north-carolina/abortion-policies
https://states.guttmacher.org/policies/south-carolina/abortion-policies