As women’s health advocates, we danced for joy on August 1st as we celebrated better access to many critical reproductive health services under the Affordable Care Act (ACA), including well-woman visits, breastfeeding counseling & supplies, birth control and emergency contraception. While this is an important first step in eliminating many of the health disparities faced by women of color, the new policies do not help to ensure the availability or affordability of abortion care. And this means some inequities in health care will persist, if not grow.
The Affordable Care Act requires cumbersome administrative procedures that will limit coverage of abortion in the new health care exchanges. In fact legislators in several states have already passed legislation prohibiting plans in their state exchanges from covering abortion care. And while ACA will eventually expand the numbers of people eligible for Medicaid coverage – that coverage will not include abortion. So while more low-income Latinas will have access to health care, if the health care they need is a safe, legal abortion procedure, they are not covered.
Unfortunately, this is not the first time that abortion has been unfairly singled out from health care coverage. Since the passage of the Hyde Amendment in 1976, Congress has withheld health care assistance for abortion, even when a woman is eligible for government-funded health insurance. In fact, the first woman to die of an unsafe illegal abortion after Roe v. Wade was a Latina, Rosie Jimenez, who couldn’t afford an abortion and couldn’t get coverage from Medicaid. For a woman struggling just to get by, withholding abortion coverage means she may not have the chance to make the best decision for her and her family. Decades under this policy have resulted in too many women and their families pushed further into poverty as they scramble to find the money for an abortion.
The Hyde Amendment intentionally targets poor women, who are disproportionately women of color. According to the most recent Census data, 25.3 percent of Latinas are living in poverty meaning that many low-income Latinas rely on Medicaid for their health care coverage. Living on a limited income means that Latinas are less likely to be able to pay for reproductive health care out-of-pocket. This puts them at risk for seeking alternative, unsafe abortion methods.
Fifteen states , including a few with high concentrations of Latinos such as California, New York and New Mexico, provide abortion coverage through their state Medicaid programs. The remaining states, such as Texas and Florida, limit their funding to rape, incest and life endangerment. And research shows that even for those women who do meet the qualifications, their claims are frequently denied by a complex and opaque bureaucracy.
The fact is that women were denied abortion coverage as a political compromise in order to pass the health care reform bill. But withholding insurance coverage or trying to influence a woman’s decision about whether to end a pregnancy just because she has government-funded health insurance is unfair.
For a woman to be able to make a real decision based on what’s best for her own circumstances, she needs to be able to afford it. However we feel about abortion, it’s not our place to make a personal decision for someone else. And it’s certainly not the place of our elected officials.
That’s why we should use some of our health care insurance funds to cover abortion to ensure that women have access to safe, legal medical care from a licensed, quality health care provider.
This value is shared by a majority of Latino voters. In a recent survey by Lake Research Partners, 61% of Latino voters agreed that the amount of money a woman has or does not have should not determine whether she can have an abortion when she needs one.
Holding back benefits from someone who is eligible and in need, just to make it impossible for her to have an abortion, is unconscionable. We can’t continue to let abortion coverage be excluded from health care benefits just for political reasons. It is unfair and it is simply bad health care policy!
– Morgan Meneses-Sheets, Reproductive Health Technologies Project