EACH Act Would End Hyde Amendment and Restore Insurance Coverage for Abortion Care

EACH Act Would End Hyde Amendment and Restore Insurance Coverage for Abortion Care
Stop Abortion Bans Rally in St. Paul, Minn., on May 21, 2019. (Fibonacci Blue / Flickr)

“A person’s income level, wealth, or type of insurance should not prevent them from having access to a full range of pregnancy-related health care, including abortion services.” 

—Sec. 2(2) of the EACH Act, introduced into Congress on March 25, 2021.

Each year since 1976, anti-abortion politicians in Congress have passed the Hyde Amendment, barring coverage of abortion health care in federal insurance programs, including Medicaid—but that may soon change. 

On Thursday, Representatives Barbara Lee (D-Calif.), Ayanna Pressley (D-Mass.), Diana DeGette (D-Colo.), Jan Schakowsky (D-Ill.), and Senators Tammy Duckworth (D-Ill.), Mazie Hirono (D-Hawaii) and Patty Murray (D-Wash.) introduced the Equal Access to Abortion Coverage in Health Insurance Act of 2021 (the EACH Act) with 127 co-sponsors in the U.S. House and 22 in the Senate.

The legislation would reverse the Hyde Amendment and guarantee abortion coverage in federal health insurance programs. It would also prohibit federal interference with decisions by states or private health insurance companies to offer coverage for abortion care. 

The bill is endorsed by All* Above All, a women-of-color led coalition of more than 130 national and state organizations leading the nationwide grassroots movement to end Hyde and coverage restrictions.

“The Supreme Court has repeatedly affirmed a person’s constitutional right to make their own reproductive decisions, making clear that the government has no place getting in between individuals and their doctors,” said Sen. Duckworth at a press conference on Tuesday. “But for decades, conservative lawmakers have worked to whittle down that constitutionally-protected right to the point where it’s now effectively inaccessible for low-income people who rely on Medicaid, for service-members and for millions more Americans nationwide. The Supreme Court didn’t protect these rights only for the wealthy few, and they didn’t say only for those who live in certain states. That kind of discrimination is not right, not fair and it’s certainly not equal.”

While 16 states use their own Medicaid funds to cover abortion health care, 34 states and the District of Columbia do not cover the procedure within their state Medicaid programs except for very limited exceptions. Half of Medicaid-enrolled women of reproductive age—seven million women—are subject to the Hyde Amendment’s ban on abortion coverage.

The harms of the Hyde Amendment fall particularly hard on women of color, who are more likely than white women to be low-income and enrolled in Medicaid. In 2018, 31 percent of Black women and 27 percent of Hispanic women aged 15–44 were enrolled in Medicaid, compared with 16 percent of white women.

“The Hyde Amendment was designed to deny low-income women and women of color access to the full range of reproductive rights, including abortion care. Let’s call this Amendment what it is: It’s anti-choice and it’s blatantly racist,” said Rep. Lee.

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By restricting Medicaid coverage of abortion, policymakers force one in four low-income women seeking abortion to carry an unwanted pregnancy to term, making these women more likely to fall into or stay in poverty. Moreover, low-income women are more likely than more affluent women to have an unintended pregnancy, especially low-income women of color.

“Despite Roe v. Wade affirming the constitutional right to abortion, federal coverage restrictions have made abortion accessible only to those with means,” said Senator Murray. “This is absolutely unacceptable—and it’s having a devastating impact on women of color, women with low-incomes, and immigrants.” 

In addition to the Medicaid ban, the Hyde Amendment blocks abortion health care insurance coverage for federal employees and their dependents, military personnel and veterans, Native Americans, federal prisoners and detainees, Peace Corps volunteers, low-income residents of the District of Columbia, and survivors of human trafficking. 

The EACH Act not only eliminates these funding restrictions, but also bars the federal government from prohibiting, restricting or inhibiting insurance coverage of services by state and local government or by private health insurance plans. And it would end Section 1303 of the Affordable Care Act, which requires a burdensome separation of payments scheme, and ends unnecessary restrictions on multi-state plans.

Movement to End Hyde Amendment Gaining Momentum

Support for ending the Hyde Amendment has been building in recent years. A bill to end the Hyde Amendment was first introduced in 2015 as the EACH Woman Act. In the last Congress, the bill had 186 co-sponsors in the U.S. House and 24 in the U.S. Senate. In 2019, after years of voting for the Hyde Amendment, President Biden came out against Hyde. House Appropriations Committee Chairwoman Rosa DeLauro (D-Conn.), a long-time opponent of Hyde, has committed to introducing appropriations legislation without the Hyde Amendment and House Speaker Nancy Pelosi has expressed support for ending Hyde.

The public also supports ending Hyde: Polling last year revealed 62 percent of national voters support Medicaid coverage of abortion care.

“We must seize this moment,” said Rep. Lee in a press conference on Tuesday. “Repealing the Hyde amendment is not just an issue of reproductive justice. It’s an issue of racial justice and inequality. The same communities who are harmed most by racist police violence, who bear the brunt of COVID-19’s economic fallout, and who are experiencing white supremacy in communities and in health care systems, are the same people most harmed by Hyde, the coverage bans, and abortion restrictions. It’s way past time to get this done. It’s past time to end the harmful, discriminatory Hyde Amendment once and for all. Enough is enough.”

Take Action to End Hyde

All* Above All is encouraging everyone to contact your members of Congress and ask them to support the EACH Act.

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Carrie N. Baker, J.D., Ph.D., is the Sylvia Dlugasch Bauman professor of American Studies and the chair of the Program for the Study of Women and Gender at Smith College. She is a contributing editor at Ms. magazine. You can contact Dr. Baker at cbaker@msmagazine.com or follow her on Twitter @CarrieNBaker.