The Hyde Amendment

Women’s eNews has a great article about the anti-choice Hyde Amendment, and pro-choice efforts to dismantle it now that Hyde has left Congress.

A quick 101 for those who aren’t familiar with the Hyde Amendment: Passed in the late 1970s, the Hyde Amendment blocks federal Medicaid funding from paying for abortion. So if you’re a low-income woman who depends on government aid for your healthcare, your options are limited based on anti-choice ideology. The U.S. Supreme Court upheld the Constitutionality of the Hyde Amendment in 1980, arguing that while abortion must be legal in the United States, the federal government is not required to pay for it. On the coattails of Hyde, most states have also barred their Medicaid funds from paying for abortion (New York is a notable exception). Further, under the “it has to be legal but we don’t have to pay for it” theory supported by the Supreme Court, the federal government has refused to provide certain reproductive healthcare services for women in the military, women who depend on Indian Health Services for their healthcare, some federal employees, federal prisoners, Peace Corps volunteers, and women on disability insurance.

The Hyde – 30 Years Is Enough! Campaign is spearheading efforts to overturn the amendment, and they’re right — it’s about damn time. The Hyde Amendment encapsulates the extent to which women’s healthcare isn’t considered as fundamental as healthcare in general, and the degree to which wealthy, white politicians are more than happy to push an agenda which disproportionately affects poor women and women of color.

Many claim that abortion and birth control are political issues. They’re political only in the sense that women’s bodies are still largely viewed as community property, and so politicians and the public in general take no issue in asserting that the community should have some say when it comes to the level of healthcare those bodies are allowed to access.

About one in three American women will have an abortion at some point in her life. Most American women will become pregnant at some point, and most will attempt to prevent pregnancy at some point. Yet the degree to which women are able to access basic healthcare is deeply dependent on their economic status — especially when that healthcare is related to reproduction.

Since abortion is an “elective” medical procedure, you’ll hear conservatives (and many moderates) argue that there’s no reason the federal government should have to pay for it. But if the federal government is going to make a commitment to ensure that low-income people have a very basic level of healthcare through Medicaid, why are certain basic, extremely common medical procedures being denied to certain segments of the population because of their sex and economic level? I’ll remind detractors that pregnancy and childbirth is no walk in the park. The United States maintains disgraceful maternal mortality rates, and black women — who are more likely to rely on government aid for health care — die of pregnancy-related complications at four times the rate of white women. Women make up 70 percent of all adult Medicaid recipients, with 1 in 5 low-income women relying on it.

But rescinding the Hyde Amendment doesn’t seem to be on the lips of many leading Democrats.

It’s not hard to figure out why. The women who are being most negatively affected by Hyde are poor women, women of color, women who rely on government aid — you know, women who just don’t matter as much as wealthier white women who have the privilege and time to get out and vote, to contribute to the Democratic party, to attend the fundraisers. They’re the women who have already been successfully demonized by the Republican party as the welfare queens who suck up the hard-earned tax dollars of good Americans, who are over-sex and irresponsible, who have “litters” of “illigetimate” children with different daddies, whose reproduction it’s ok to control, as we’re both sterilizing them and barring them access to basic reproductive healthcare.

Keep in mind that these “welfare queens,” many of whom survive off of little to nothing, have to face a whole slew of “pro-life” policies when it comes to making reproductive choices: Federal funds won’t pay for abortion, but in many “pro-life” states they’re penalized for having more children if they’re dependent on public assistance. Tens of thousands of low-income women who would have preferred to terminate a pregnancy are prevented from doing so because of Hyde restrictions.

For these women, the “right to choose” is meaningless.

From the Women’s eNews article:

The reluctance to repeal the ban reaches into the Democrats’ rank and file.

“There are some pretty adamant pro-choice Congress members that just feel strongly that the Hyde Amendment needs to stay in place,” an organizer who works for one of the groups involved in the 30 Years is Enough Campaign said on the condition of anonymity. “Some of their answers have been, ‘Well, the American public feels that Medicaid is already an entitlement program. If you tie abortion into it, they’ll be less inclined to expand Medicaid services.'”

Medicaid — or, very very basic healthcare for poor people — is an “entitlement program.” We’ve got to be one of the only nations in the world which looks at people who want healthcare and thinks “entitled.”

Healthcare is not an entitlement the way that a priviliged rich kid feels “entitled” to go to Harvard. Healthcare is a human right. Access to it should not be contingent on economic status, or country of residence, or race, or gender. Healthcare is not something that only the world’s wealthiest should be able to obtain, while the dirty masses are spoiled children for having the audacity to argue that their bodies and their lives and their health are worth something, too. And I suspect that the people who consider Medicare to be an “entitlement program” are people who themselves feel fully entitled to the healthcare they undoubtedly receive — it’s just that they receive it through other (likely superior) means.

The decision to have a child should never be dependent on a woman’s economic status. Nine times out of ten in these conversations, someone pipes up with, “Well if they don’t want to have a child, they just shouldn’t have sex.” So let’s get that out of the way, too: The right to have sex should not be dependent on your economic status, or on your ability/willingness to raise a child. This is clearly a conclusion that Congress has already come to, at least when it comes to men — Viagra is now covered under Medicaid, so that men with erectile dysfunction can medically treat it. I may have missed the uproar, but I can’t find any reports of a controversy stemming from the fact that our hard-earned tax dollars are funding a man’s ability to get it up.

To be clear, I’m glad there wasn’t a controversy. Poor men have just as much a right to sexual healthcare as wealthier men. What boggles my mind, though, is the fact that sex is a god-given right for men to the point where federal funds are unquestioningly extended to cover male sexual performance drugs, but those same funds are barred from covering procedures which allow women to avoid a whole slew of medical issues that come with carrying a pregnancy for nine months and then birthing a child. Federal funds can be extended to allow men to have sex (when not having sex, though it sucks, isn’t often an economically perilous or health or life-threatening condition), but they cannot be extended to terminate pregnancies, when pregnancy is just about guaranteed to have far more an effect on a woman’s health and financial situation than not being able to get or sustain an erection will ever have on a man’s. It’s interesting, then, to see how our government spins terms like “medically necessary”:

“The law says if it’s an (Food and Drug Administration)-approved drug and it is medically necessary, it has to be covered,” said Gary Karr, spokesman for the Centers for Medicare and Medicaid Services, which administers the health insurance program for older Americans.

Viagra is covered, but RU-486 is not. Funny how that works.

No one suggests that the solution is for low-income men to just not have sex. And yet this is exactly the option conservatives offer to low-income women. That, or deal with the consequences. Because women’s bodies are not quite human, it’s fair to treat their reproductive health as optional or not “real” healthcare. Because the Hyde Amendment deals specifically with low-income women, it’s even easier to justify denying these women the most basic health services.

Healthcare should not be a political issue. All people should have access to it — even if some of those people are considered sub-human because they happen to possess a uterus, or because they don’t have as much money as your average United States congressperson.

Abortion is not simply an elective procedure which women have out of convenience or vanity and nothing more. It’s a procedure which, at the very least, allows women who do not want to carry a pregnancy to term avoid a process which is undeniably physically trying, which often leads to other health issues, and which in the worst of cases can kill you. Such a procedure should not be an optional part of healthcare coverage. It should be recognized as one of the most common medical procedures in the United States, one which has saved the lives of thousands of women, and has enabled millions more to live their lives as they see fit. Without reproductive rights, women simply would not be where we are today. I would aruge that compulsory pregnancy, more than just about anything else in history, has been at the root of women’s oppression. Only when pregnancy and childbirth are choices which are freely made, and only when child-rearing is truly valued, will women be anywhere close to achieving “equal” rights.

The fact that low-income women in this country lack access to basic healthcare — in addition to lacking even more basics, like the ability to feed their families — puts them strides behind middle and upper-class women when it comes to social mobility and economic achievement. We’re kidding ourselves when we posit that the United States is a meritocracy or a classless society when so many people in this country are busier worrying about how they’re going to support another child, or how they’re going to work and have their children cared for, or what they’re going to do about a family health crisis that they can’t afford, than they are worrying about college funds or work promotions or class mobility.

Tossing the Hyde Amendment must be a top priority for reproductive rights activists, and we must force it to be a top priority for Congressional Democrats. Anything less will amount to failing women in general, and throwing the most vulnerable among us under the bus (again) in the name of cohesive pro-choice politics and maintaining — instead of expanding — abortion rights.


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About Jill

Jill began blogging for Feministe in 2005. She has since written as a weekly columnist for the Guardian newspaper and in April 2014 she was appointed as senior political writer for Cosmopolitan magazine.
This entry was posted in Feminism, Politics, Poverty, Reproductive Rights and tagged , , , , , . Bookmark the permalink.

28 Responses to The Hyde Amendment

  1. Heraclitus says:

    Another excellent post, especially this:

    We’re kidding ourselves when we posit that the United States is a meritocracy or a classless society when so many people in this country are busier worrying about how they’re going to support another child, or how they’re going to work and have their children cared for, or what they’re going to do about a family health crisis that they can’t afford, than they are worrying about college funds or work promotions or class mobility.

  2. Sara no H. says:

    Viagra is covered, but RU-486 is not. Funny how that works.

    I think that line about sums it up for me. Funny indeed.

  3. Kyra says:

    Very well said.

  4. Great article, Jill. You’re absolutely right that the ability to control their reproductive lives (and conversely not being able to control them) has an absolute huge impact on women’s lives.

    No one suggests that the solution is for low-income men to just not have sex. And yet this is exactly the option conservatives offer to low-income women. That, or deal with the consequences. Because women’s bodies are not quite human, it’s fair to treat their reproductive health as optional or not “real” healthcare.

    I’m not sure I’d go as far as women’s bodies being considered not quite human, but I certainly agree that they are considered much less important. Your point about Viagra is well-made: a poor man’s right to have sex is certainly important, but the lack of equity in allowing this and refusing poor women the right to reproductive healthcare is blindingly obvious.

    In the UK, contraception is available free of charge on the NHS (although we still pay VAT on sanitary products – but that’s another grumble). Free or affordable reproductive healthcare seems to me to be a basic human right. It should not be subject to moralising. I hope that the 30 Years Is Enough campaign achieves its aim.

  5. Apologies for double-posting. Damn browsers…

  6. StacyM says:

    Wow. Great post, Jill.

  7. Frumious B says:

    Isn’t sex an elective procedure?

    (outside of rape and coercion, of which men are not the primary targets)

  8. bmc90 says:

    Frumious B, funny how the Bush administration touts marriage as a way out of poverty, and then says people who don’t want children should just be abstinent. You don’t need Dr. Phil to tell you that people who won’t have sex with their spouse are putting their marriage at risk for failure. But no – it’s so much better to set up some kind of sex jury to decide if your failure to prevent your pregnancy showed a sufficient amount of effort. That sounds like a great use of social resources. If they jury decides you are not a slut, then you can be entitled to a goverment funded abortion or an abortion at all, though of course if you are not entitled we are still going to kick you off welfare in 2 years so you can go work 3 minimum wage jobs that still won’t cover the cost of your childcare.

  9. Patrick says:

    Henry Hyde is/was in the House, not the Senate. From my state, I am sad to say.

  10. Jill says:

    Oh, whoops. Fixed.

  11. kate.d. says:

    brava. thank you for posting this.

  12. Bitter Scribe says:

    Whenever I read how Hyde is a “respected elder statesman of conservatism,” or some such nonsense, I just want to puke. (And in Illinois, that stuff was served on heaping platters.)

    His biggest legacies are denying poor women abortions and impeaching Clinton over nothing. What a waste of space (a lot of space) that guy is.

  13. BlackBloc says:

    In Quebec, abortions are paid for by our equivalent of Medicaid. The sky has yet to fall.

    I hope my American comrades can get the Hyde amendment repealed. And get a decent, single-payer Medicaid system, while you’re at it. ;)

  14. ScottM says:

    Well written… and under my radar until now. Thanks!

  15. ako says:

    To give props to the Peace Corps, they do try to minimize the impact of the Hyde Amendment on female volunteers. They’ll grant time away, fly the woman back to Washington DC, and provide room and board, all officially counted as medical evacuation. The procedure itself has to be payed for by the woman, but she can have the price deducted from her readjustment allowance (a few thousand dollars volunteers get at the end of service, technically her money,) so that she doesn’t have to find the cash herself. It’s probably the best they can do under the current rule.

    Still, it would be better if they didn’t have to jump through that particular hoop.

  16. deep6 says:

    I realize it’s just my liberalism interfering with divine revelation and some good ol’ misogyny, but I just don’t understand how such a large minority of people can confuse consent to sex with consent to pregnancy.

    The Hyde Amendment is a curse to Democrats. I bet many of them would support its repeal, but in 2006, as I learned from the C-Span broadcast of Speaker Pelosi’s inaugural women’s tea, women’s issues are to be defined by our needs as mothers and not our needs as individuals. Nevermind that I, and the largest population block not to have voted in the last election (aka single, childless women voters) overwhelmingly disassociate appeals to mothers’ interests with our own immediate political needs.

    I’m so tired of Democrats trying to get liberals’ votes without being liberal. It seems the only issues they’ll get behind are those that affect or are perceived to affect broad demographics. I don’t want to get negative so early, but why do issues need to appear to be broad-based in order to receive support?

    I miss the kind of radicalism of the 70s that made it okay for women to say I want these rights because I deserve them as a person instead of what I hear constantly chanted now, I want these rights because I deserve them as a wife/mother

    Or maybe that’s overstating it. Grr. That’s just what I perceive. Constantly ostracized, overlooked and taken for granted – the single, childless female American voter.

  17. David C says:

    If you want poor woman to be able to afford abortions, then pay for them out of your own pocket. You don’t have to pick the pockets of your fellow citizens regardless of their thoughts on abortion in the first place.

    And no, the government shouldn’t be paying for Viagra either.

    I do have a compromise: teach woman the “natural” family planning the Catholic Church likes. It actually works when followed correctly; in fact it is the only family planning method that is 100% effective. That way women won’t feel the need to have the government — or anyone else — buying them abortions.

  18. Jill says:

    If you want poor woman to be able to afford abortions, then pay for them out of your own pocket.

    Some of us do.

    You don’t have to pick the pockets of your fellow citizens regardless of their thoughts on abortion in the first place.

    Is it “picking the pockets” of my fellow citizens to have taxpayer dollars go to Medicaid/Medicare in general? Why draw the line at abortion — because people have differing opinions on it? That’s not how healthcare works. I, for example, am of the opinion that people who don’t “believe” in evolution, or who think that evolution shouldn’t be taught in schools, shouldn’t reap the benefits of evolution — i.e., things like flu shots and a whole lot of modern medicine. But I don’t get to decide who does and does not receive healthcare based on my personal or political beliefs. Why do people with anti-abortion views have that right when the rest of us don’t?

  19. Jill says:

    I do have a compromise: teach woman the “natural” family planning the Catholic Church likes. It actually works when followed correctly; in fact it is the only family planning method that is 100% effective.

    Where the heck did you learn that it’s 100% effective? Link to a scientific study, please?

    Actually, NFP has a pretty high failure rate for a variety of reasons. A recent study, which I don’t have the time to look up right now, found that many women ovulate twice in a single month — meaning that if they’re using NFP and assuming they’re only ovulating once, they have a pretty decent chance of getting pregnent.

    Women’s health isn’t a “compromise.” That’s the point. It’s not up to ideological detractors to decide what kind of healthcare women should have access to, even when it comes to preventing pregnancy. It’s up to women and their doctors.

  20. zuzu says:

    I do have a compromise: teach woman the “natural” family planning the Catholic Church likes. It actually works when followed correctly; in fact it is the only family planning method that is 100% effective. That way women won’t feel the need to have the government — or anyone else — buying them abortions.

    Dude, they don’t call it “Vatican Roulette” for nothing.

    As for pocket-picking — I’m sure you’ve renounced your right to collect Social Security, right?

  21. Bitter Scribe says:

    “natural” family planning…is the only family planning method that is 100% effective.

    Suuuure it is. And the wine really is transubstantiated into Christ’s blood, too.

    What do you call people who practice “natural family planning”? Parents.

  22. Jewel says:

    Take away my feminist card – I was unaware of the heinous Hyde amendment. Thanks, Jill, for the informative piece.

    On another note, a friend who is morally opposed to contraception got pregnant on NFP. Had a terrible pregnancy, too – months upon months of non-stop morning sickness. I haven’t heard from her recently but I wonder if that experience will change her views on birth control.

  23. anna says:

    Catholics do also have the option of tubal litigation/vasectomies. Does medicare cover that? (Google is failing me on this.)

  24. Sayna says:

    Not all Catholics are anti-choice when it comes to abortion and contraception. Look at this site:

  25. ako says:

    I looked up the numbers, and Catholic organizations claim 99% effectiveness for natural family planning with perfect use. Which involves charts and special thermometers (not exactly free).

    Interestingly, this page puts the perfect use failure rate at 2%, and more importantly, the typical failure rate at 25%. And if you want a nice peer-reviewed study that looks at what women actually do, then there’s this, which puts periodic abstinence (the actual substance fof NPF “Just don’t have sex for half the month!”) at 21%. Whether you believe these numbers or Stanford (or it’s varying year by year), telling poor women to buy a bunch of charts and thermometers, attend classes, and go without for the up to six months it can take to chart their cycles and a week or two every month still doesn’t reduce pregnancy.

    And if you want a more detailed breakdown, the Mayo Clinic puts the average use failure rate for basal body temperature at 80%, the the calendar method at 13%, and counting your cycle on a string of beads at 12%. They don’t have any numbers for combined use, but doing everything at once appears to decrease effectiveness, as opposed to with easier artificial methods.

  26. ako says:

    Sorry, mistake. I meant still doesn’t reduce pregnancy that much. I could have sworn I’d typed it that way the first time.

  27. Nick Kiddle says:

    I had to check the site. Failure rate for basal body temperature is given as 20% (80% effectiveness). 80%, according to a table I looked at when I was a teenager, is the failure rate of “no contraception”.

  28. ako says:

    Oops, I must have mentally flipped the numbers for failure rate and effectiveness rate. I really am sorry. I guess I should be more careful to proofread before posting.

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