At RHTP, we worked not only to bring new reproductive health technologies to the US market but also to ensure meaningful access to existing technologies. The legal right to abortion means little if it is unavailable or unaffordable.
The purpose of health insurance is to ensure that individuals and families can manage unexpected medical bills in the case of an unplanned event. As such, insurance should provide coverage for a full range of pregnancy-related care, including abortion, so each person can make the best decision for her circumstances.
Restrictions on abortion coverage have a real impact on women and their families by limiting their ability to pay for abortion care. RHTP worked tirelessly to build the political platform needed to lift such restrictions and ensure that abortion care is both available and affordable.
Affordable Care Act
As of March 2017, the Affordable Care Act (ACA) is a federal law that requires health plans to include coverage for a range of reproductive health services, including birth control, prenatal care, and labor and delivery services. Unfortunately, the ACA does not require abortion coverage. Instead, each insurance company can decide whether abortion will be covered in the plans it offers. In addition, the ACA inflicts cumbersome administrative procedures on insurance companies that cover abortion, which may ultimately discourage them from offering such coverage.
The ACA also allows states to prohibit the sale of insurance plans that cover abortion in their health exchanges and at least half the states have already done so. Some states have also banned abortion coverage in insurance policies offered to state employees.
The Hyde Amendment
The Hyde Amendment is an annual appropriations measure reenacted each year that withholds abortion coverage for women who qualify for Medicaid, a joint federal-state insurance program for low-income people. It was upheld by the Supreme Court in 1980 in a close 5-4 ruling in the case of Harris v. McRae. Since then, Congress has extended the Hyde policy to virtually every federal plan and program.
The Hyde Amendment allows states to use their own Medicaid funds to cover abortion care for Medicaid enrollees and 15 states actively do so. Washington, D.C. has used its local funds to cover abortion care for its Medicaid enrollees in the past, but Congress currently prohibits it from doing so.
The Hyde Amendment disproportionately impacts women of color, who are over represented among those who qualify for Medicaid and are the least likely to be able to pay for care out of pocket. As a result of the Hyde Amendment, many women have to postpone having an abortion because of the time it takes to scrape together the funds to pay for the procedure, and others are forced to carry their pregnancy to term. A woman who is unable to obtain an abortion she seeks is more likely than those who were able to end their pregnancy to be living in poverty two years later.