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EACH Person’s Right: The Importance of Federal Abortion Care Funding to Health Care Reform

Published online by Cambridge University Press:  30 January 2023

Cassandra LaRose
Affiliation:
1Northeastern University School of Law, Boston, MA, USA 2Northeastern University Bouvé College of Health Sciences, Boston, MA, USA
Michael S. Sinha*
Affiliation:
3Center for Health Law Studies, Saint Louis University School of Law, St. Louis, MO, USA
*
*Corresponding author. Email: michael.sinha@slu.edu

Abstract

The United States has a long and controversial history with abortion that did not end with Roe v. Wade. Almost immediately thereafter, anti-choice politicians commenced a decades-long effort to restrict access to abortion, recently culminating in the Dobbs decision that overturned Roe. One successful attempt to restrict access immediately following Roe was the Hyde Amendment. With more Americans covered by federally funded health insurance than ever, the Hyde Amendment creates an insurmountable barrier to abortion care for those who lack other sources of financing.

Despite the impacts of the Hyde Amendment, support for discontinuing the amendment has been weak. For the first time in over forty years, the United States is in a position to change its abortion funding policy. Beyond ending Hyde, the EACH Act has been introduced in Congress to ensure permanent funding for abortion through all federally funded insurance programs. To secure funding for abortion and reduce barriers to access, advocates must press the federal government to pass legislation such as the EACH Act.

Type
Articles
Copyright
© 2023 The Author(s)

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References

1 Restrictions on Public Funding of Abortion, The Poy Surveillance Program (Oct. 1, 2021), http://lawatlas.org/datasets/restrictions-on-public-funding-of-abortion [https://perma.cc/C62Q-AUEH].

2 Alina Salganicoff et al., The Hyde Amendment and Coverage for Abortion Services, Kaiser Fam. Found. (Mar. 5, 2021), https://www.kff.org/womens-health-policy/issue-brief/the-hyde-amendment-and-coverage-for-abortion-services/ [https://perma.cc/TR7F-REME].

3 Access Denied: Origins of the Hyde Amendment and Other Restrictions on Public Funding for Abortion, ACLU [hereinafter Access Denied], https://www.aclu.org/other/access-denied-origins-hyde-amendment-and-other-restrictions-public-funding-abortion [https://perma.cc/9XTC-5GDW] (last visited Apr. 9, 2022).

4 See Salganicoff et al., supra note 2.

5 See Access Denied, supra note 3.

6 See Salganicoff et al., supra note 2.

7 Id.

8 Cynthia Soohoo, Hyde-Care for All: The Expansion of Abortion-Funding Restrictions Under Health Care Reform, 15 CUNY L. Rev. 391, 416-19 (2012).

9 Women’s Health Insurance Coverage, Kaiser Fam. Found. (Nov. 8, 2021), https://www.kff.org/womens-health-policy/fact-sheet/womens-health-insurance-coverage/ [https://perma.cc/8ZHH-98KV].

10 Soohoo, supra note 8, at 416-18.

11 Press Release, U.S. Senator Elizabeth Warren, Warren at Hearing: Lowering Medicare Eligibility Age to 55 Could Cover Tens of Millions of Americans, We Can’t Waste This Opportunity to Expand Coverage and Lower Costs (Apr. 15, 2021), https://www.warren.senate.gov/newsroom/press-releases/at-hearing-lowering-medicare-eligibility-age-to-55-could-cover-tens-of-millions-of-americans-we-cant-waste-this-opportunity-to-expand-coverage-and-lower-costs [https://perma.cc/9L88-AEMT] (When questioning Chiquita Brooks-LaSure, then-nominee to be Administrator of the Centers for Medicare and Medicaid Services, Senator Warren commented, “I know President Biden has talked about dropping the Medicare age from 65 to 60, but frankly I think we should go even further.”).

12 Medicare for All Act of 2019, S. 1129, 116th Cong. (2019).

13 Id. at § 701(b)(3).

14 Roe v. Wade, 410 U.S. 113 (1973).

15 See Access Denied, supra note 3.

16 Heather D. Boonstra, The Heart of the Matter: Public Funding Of Abortion for Poor Women in the United States, 10 Guttmacher Poly Rev. 12, 12 (2007).

17 Id.

18 Karen Davis et al., Health Care of Black Americans: The Public Sector Role, 65 Milbank Q. (Supplement 1, Part 1) 213, 223 (1987).

19 See Access Denied, supra note 3.

20 Julie Rovner, Abortion Funding Ban Has Evolved Over the Years, NPR (Dec. 14, 2009, 6:00 AM), https://www.npr.org/templates/story/story.php?storyId=121402281 [https://perma.cc/8MWU-AWFE].

21 See Boonstra, supra note 16, at 12-13.

22 Pub. L. No. 103-112, § 509, 107 Stat. 1082, 1113 (1993) (making appropriations for the Departments of Labor, Health and Human Services, and Education, and other related agencies). It should be noted, though, that newer state laws banning or restricting access to abortion care are increasingly being proposed and passed without any exceptions.

23 Harris v. McRae, 448 U.S. 297, 299, 326 (1980).

24 Id. at 315.

25 Id. at 316.

26 Id. at 325.

27 Id. at 338.

28 See Access Denied, supra note 3.

29 Medicaid Coverage of Abortion, Guttmacher Inst. (Feb. 2021), https://www.guttmacher.org/evidence-you-can-use/medicaid-coverage-abortion [https://perma.cc/KPP5-R87J].

30 Distribution of the Nonelderly with Medicaid by Race/Ethnicity, Kaiser Fam. Found., https://www.kff.org/medicaid/state-indicator/medicaid-distribution-nonelderly-by-raceethnicity [https://perma.cc/CY7S-ELMF] (last visited June 5, 2022); QuickFacts United States, U.S. Census Bureau (2019), https://www.census.gov/quickfacts/fact/table/US/PST045219 [https://perma.cc/7XYS-VYUD] (choose “Race and Hispanic Origin” from “All Topics” dropdown).

31 Caitlin Gerdts et al., Side Effects, Physical Health Consequences, and Mortality Associated with Abortion and Birth After an Unwanted Pregnancy, 26 Womens Health Issues 55, 57 (2016).

32 Jamie Ducharme, Women Who Are Denied Abortions May Face Long-Lasting Health Problems, Study Says, Time (June 10, 2019; 5:00 PM), https://time.com/5603194/denied-abortions-physical-health/ [https://perma.cc/XZ3U-UAB4].

33 M. Antonia Biggs et al., Women’s Mental Health and Well-Being 5 Years After Receiving or Being Denied an Abortion: A Prospective, Longitudinal Cohort Study, 72 JAMA Psychiatry 169, 174 (2017).

34 Sarah C.M. Roberts et al., Risk of Violence from the Man Involved in the Pregnancy After Receiving or Being Denied an Abortion, 12 BMC Med., Sept. 29, 2014, at 5.

35 See id.

36 Ushma D. Upadhyay et al., The Effect of Abortion on Having and Achieving Aspirational One-Year Plans, 15 BMC Womens Health, Nov. 11, 2015, at 6-9.

37 Diana Greene Foster et al., Socioeconomic Consequences of Abortion Compared to Unwanted Birth (Oct. 30, 2012) (presentation), https://apha.confex.com/apha/140am/webprogram/Paper263858.html [https://perma.cc/6JPY-KPR3] (presentation at the 140th American Public Health Association Annual Meeting and Expo, October 27-31, 2012, in San Francisco).

38 Id.

39 Brief for the American Psychological Association et al. as Amicus Curiae in Support of Petitions for Rehearing, Harris v. McRae, 448 U.S. 917 (1980) (Nos. 79-1268, 79-4, 79-491).

40 Financial Management, Ctrs. for Medicare & Medicaid Servs., https://www.medicaid.gov/medicaid/financial-management/index.html [https://perma.cc/PG94-NE9E] (last visited June 5, 2022).

41 See Maher v. Roe, 432 U.S. 464, 464, 470, 480 (1977) (holding that state restrictions on Medicaid abortion care coverage do not violate the equal protection clause of the Fourteenth Amendment).

42 State Funding of Abortion Under Medicaid, Guttmacher Inst. [hereinafter Guttmacher: State Funding of Abortion] (June 1, 2022), https://www.guttmacher.org/state-policy/explore/state-funding-abortion-under-medicaid [https://perma.cc/RH2X-Q7PY].

43 Id.

44 Id.

45 State Funding of Abortions Under Medicaid, Kaiser Fam. Found. [hereinafter Kaiser: State Funding of Abortion] (May 1, 2022), https://www.kff.org/medicaid/state-indicator/abortion-under-medicaid [https://perma.cc/WA92-3Z2X].

46 See id.

47 Data Center, Guttmacher Inst., [hereinafter Data Center], https://data.guttmacher.org/states/table?state=MA+TX&topics=282+71+73&dataset=data [https://perma.cc/DYN8-38U3] (last visited June 5, 2022).

48 QuickFacts United States, U.S. Census Bureau, supra note 30 (To compare state populations, search “Texas” in the search field and press “Enter”; then search “Massachusetts” in the search field and press “Enter.”).

49 See Data Center, supra note 47.

50 Abortion in the U.S. Dashboard, Kaiser Fam. Found., [hereinafter Abortion in the U.S. Dashboard] https://www.kff.org/womens-health-policy/dashboard/abortion-in-the-u-s-dashboard/ [https://perma.cc/VGH3-JE6T] (last updated Oct. 13, 2022).

51 See Data Center, supra note 47.

52 Roosa Tikkanen et al., Maternal Mortality and Maternity Care in the United States Compared to 10 Other Developed Countries, Commonwealth Fund (Nov. 18, 2020), https://www.commonwealthfund.org/publications/issue-briefs/2020/nov/maternal-mortality-maternity-care-us-compared-10-countries [https://perma.cc/3HK3-FLMN].

53 Amirhossein Moaddab et al., Health Care Disparity and Pregnancy-Related Mortality in the United States, 2005-2014, 131 Obstetrics & Gynecology 707, 707-12 (2018).

54 Infant Mortality Rates by State, CDC (Mar. 3, 2022), https://www.cdc.gov/nchs/pressroom/sosmap/infant_mortality_rates/infant_mortality.htm [https://perma.cc/4J4S-3GL4] (choose “2019” from dropdown).

55 See Kaiser: State Funding of Abortion, supra note 45 (Mississippi follows federal standards funding abortions only in instances of rape, incest, life endangerment, and fetal impairment).

56 During the passage of the most recent budget-reconciliation bill, Democratic senators Joe Manchin, Bob Casey, and Tim Kaine, joined Republicans in support of the Hyde Amendment. See John McCormack, Manchin Says He’ll Support the Hyde Amendment in ‘Every Way Possible,’ Natl Rev. (June 11, 2021, 1:47 PM), https://www.nationalreview.com/corner/manchin-says-hell-support-the-hyde-amendment-in-every-way-possible/ [https://perma.cc/D3VF-HUWK].

57 Sarah Ferris & Heather Caygle, Democrats Dodge Abortion Fight with Plan to Keep Hyde Amendment, Politico (July 2, 2020, 6:52 PM), https://www.politico.com/news/2020/07/02/hyde-amendment-abortion-democrats-348272 [https://perma.cc/G2Q7-67V5].

58 Id.

59 Id.

60 Letter from Representative Jim Banks, Chairman, Republican Study Comm. and Steve Scalise, House Republican Whip to Nancy Pelosi, Speaker of the House of Represenatives, Chuck Schumer, Majority Leader, Kevin McCarthy, Republican Leader, and Mitch McConnell, Minority Leader, (Jan. 26, 2021).

61 See Salganicoff et al., supra note 2.

62 Eliza Collins, Trump Announces ‘Pro-Life Coalition,’ Supports Making Hyde Amendment Permanent, USA Today (Sep. 16, 2016, 6:02 AM), https://www.usatoday.com/story/news/politics/onpolitics/2016/09/16/trump-marjorie-dannenfelser-anti-abortion-rights/90431388/ [https://perma.cc/5A37-X7T7].

63 Katie Glueck, Joe Biden Denounces Hyde Amendment, Reversing His Position, NY Times (June 6, 2019), https://www.nytimes.com/2019/06/06/us/politics/joe-biden-hyde-amendment.html [https://perma.cc/8WGG-V6YW].

64 Heidi Przybyla, Joe Biden’s Long Evolution on Abortion Rights Still Holds Surprises, NBC News (June 5, 2019, 5:01 AM), https://www.nbcnews.com/politics/2020-election/biden-s-long-evolution-abortion-rights-still-holds-surprises-n1013846 [https://perma.cc/GG3N-MF2R].

65 Be Bold. End Hyde., AllAboveAll, https://allaboveall.org/abortion-coverage-2/ [https://perma.cc/H23H-A4B7] (last visited June 5, 2022).

66 See Abortion in the U.S. Dashboard, supra note 50.

67 Dobbs v. Jackson Women’s Health Org., 141 S.Ct. 2619, 2619-20 (2021) (mem.) (granting certiorari to review of a Mississippi statute prohibiting abortion after 15 weeks of gestation).

68 Elizabeth Nash, State Policy Trends 2021: The Worst Year for Abortion Rights in Almost Half a Century, Guttmacher Inst. (Jan. 5, 2022), https://www.guttmacher.org/article/2021/12/state-policy-trends-2021-worst-year-abortion-rights-almost-half-century [https://perma.cc/6PN4-AFHA].

69 Party Breakdown: 117th Congress House Lineup, U.S. House of Representatives, https://pressgallery.house.gov/member-data/party-breakdown [https://perma.cc/4B8R-25GA] (last visited June 8, 2022); 117th Congress (2021–2023), U.S. Senate, Party Div., https://www.senate.gov/history/partydiv.htm [https://perma.cc/7NMP-WR6P] (last visited June 8, 2022).

70 Jaime S. King, Covid-19 and the Need for Health Care Reform, 382 N. Eng. J. Med. 104 (2020).

71 See Salganicoff et al., supra note 2.

72 The Equal Access to Abortion Coverage in Health Insurance Act of 2021 [hereinafter EACH Act], S. 1021, 117th Cong. (2021) & H.R. 2234, 117th Cong. (2021).

73 EACH Act § 2.

74 Id.

75 Id.

76 See Shaye B. Arnold, Reproductive Rights Denied: The Hyde Amendment and Access to Abortion for Native American Women Using Indian Health Service Facilities, 104 Am. J. Pub. Health 1892, 1892 (2014).

77 EACH Act § 3.

78 Further Extending Government Funding Act of 2021, Pub. L. No. 117-70, 135 Stat. 1499.

79 Consolidated Appropriations Act, 2022, Public Law No: 117-103 (2022).

80 S.1021 - EACH Act of 2021, U.S. Congress, https://www.congress.gov/bill/117th-congress/senate-bill/1021/cosponsors [https://perma.cc/426R-TZY8] (last visited June 8, 2022).