My View

It’s Time to End the Federal Ban Preventing Some Poor Women From Accessing Abortions

In the four decades of legal, safe abortion, it has remained unaffordable and unavailable for far too many, particularly women of color.

Karen Law is the executive director of Pro-Choice Resources.
National Journal
Sept. 12, 2014, 1 a.m.

Kar­en Law has served as the ex­ec­ut­ive dir­ect­or of Pro-Choice Re­sources since Ju­ly 2008. Law has ded­ic­ated the ma­jor­ity of her ca­reer to an­ti­poverty and so­cial-justice work, help­ing fam­il­ies ac­cess the ba­sic re­sources and ser­vices they re­quire and de­serve. Law earned a bach­el­or’s de­gree in polit­ic­al sci­ence from the Uni­versity of Den­ver and lives in Min­nesota.

Law has spent the last few weeks fol­low­ing the Be Bold Road Trip across the coun­try with oth­er ad­voc­ates. The Be Bold Road Trip is co­ordin­ated by All* Above All, a co­ali­tion of more than 60 na­tion­al, state, and loc­al or­gan­iz­a­tions work­ing to re­store pub­lic in­sur­ance cov­er­age for abor­tion so that every wo­man, however much money she makes, can ac­cess af­ford­able, safe abor­tion care when needed.

Law shared her take on the state of abor­tion ac­cess with Na­tion­al Journ­al‘s Next Amer­ica pro­ject.

In the four dec­ades of leg­al, safe abor­tion, it has re­mained un­af­ford­able and un­avail­able for far too many. His­tor­ic­ally, wo­men who are strug­gling fin­an­cially have had a par­tic­u­larly dif­fi­cult time ac­cess­ing abor­tion care, mostly due to the ban on Medi­caid cov­er­age im­posed by the Hyde Amend­ment since 1976.

That was the ex­act in­ten­tion of law­makers when the ban was put in place.

“I cer­tainly would like to pre­vent, if I could leg­ally, any­body hav­ing an abor­tion, a rich wo­man, a middle-class wo­man, or a poor wo­man,” said Rep. Henry Hyde, R-Ill., at the time. “Un­for­tu­nately, the only vehicle avail­able is the [Medi­caid] bill.”

Hyde was par­tially suc­cess­ful in his mis­sion.

Ac­cord­ing to the Guttmach­er In­sti­tute, a re­pro­duct­ive-health policy and re­search or­gan­iz­a­tion, re­strict­ing Medi­caid cov­er­age of abor­tion forces one in four poor wo­men to carry an un­wanted preg­nancy to term. And their stud­ies show that low-in­come wo­men of­ten must get abor­tions later in preg­nancy and, as a res­ult, face great­er risk to their fin­an­cial well-be­ing.

“Re­search shows that poor wo­men who are able to raise the money needed for an abor­tion of­ten do so at great sac­ri­fice to them­selves and their fam­il­ies,” the Guttmach­er In­sti­tute found in a 2007 re­port. “Stud­ies in­dic­ate that many such wo­men are forced to di­vert money meant for rent, util­ity bills, food, or cloth­ing for them­selves and their chil­dren.”

Laws such as the Hyde Amend­ment do not simply cre­ate more bur­dens for low-in­come wo­men. They ap­pear to con­trib­ute to the cycle of poverty. A wo­man who seeks an abor­tion but is un­able to get one is three times more likely to fall in­to poverty than a wo­man who does, a 2012 study pub­lished by the Amer­ic­an Pub­lic Health As­so­ci­ation found.

Be­cause of the con­nec­tion between ra­cial dis­crim­in­a­tion and eco­nom­ic dis­ad­vant­age, this bur­den falls dis­pro­por­tion­ately on wo­men of col­or and young wo­men. Those with lower so­cioeco­nom­ic status—spe­cific­ally those who are least able to af­ford out-of-pock­et med­ic­al ex­penses—already ex­per­i­ence dis­pro­por­tion­ately high rates of ad­verse health. What I have heard on the Be Bold tour and what I have wit­nessed over the course of my ca­reer con­vinces me that cur­rent policies help to add to these bur­dens and un­justly in­crease the health and eco­nom­ic dis­par­it­ies wo­men of col­or face.

Ac­cord­ing to a 2012 re­port pro­duced by the Wo­men’s Found­a­tion of Min­nesota on the status of wo­men in Min­nesota—the state where I live and where my or­gan­iz­a­tion, Pro-Choice Re­sources, is loc­ated—there is a re­pro­duct­ive-rights crisis that dis­pro­por­tion­ately af­fects people of col­or. Teen preg­nancy in Min­nesota sits at a far high­er rate for teens of col­or than for white teens. House­holds headed by a wo­man of col­or are from 40 to 74 per­cent more likely to live un­der the poverty line and wo­men of col­or are un­in­sured at far high­er rates than their white peers.

Deny­ing ac­cess to abor­tion care only ex­acer­bates each of these prob­lems.

Part of our work at Pro-Choice Re­sources in­cludes as­sist­ing wo­men who want and need an abor­tion but that are un­able to af­ford this health care. Min­nesota law en­sures the leg­al right to abor­tion, and Min­nesota Med­ic­al As­sist­ance cov­ers abor­tion care. Yet, even with fa­vor­able laws in place, thou­sands of people in Min­nesota still find it nearly im­possible to ac­cess abor­tion care without a struggle.

The prob­lems as­so­ci­ated with ac­cess­ing abor­tion care grow even great­er out­side the Min­neapol­is/St. Paul metro area. More than 1.2 mil­lion people live in rur­al areas of the state. Yet, all but one of our state’s abor­tion pro­viders are loc­ated in the Twin Cit­ies. That situ­ation adds to the cost of an abor­tion. Rur­al wo­men have to shoulder any med­ic­al costs as­so­ci­ated with an abor­tion plus hous­ing, travel, time away from work, or child care for oth­er chil­dren, along with oth­er ex­penses.

All it takes is just one part of that net to un­ravel and the en­tire pro­cess falls apart. As one caller to the Pro-Choice Re­sources’ abor­tion fund re­cently ex­plained to one of my col­leagues, “It was scary think­ing I wouldn’t be able to get my abor­tion done be­cause I couldn’t af­ford a motel, then my rides to and from can­celed.”

Still, wo­men in Min­nesota rank among the more for­tu­nate. In more re­strict­ive states, laws pro­hib­it Medi­caid and in­sur­ance pur­chased through the Af­ford­able Care Act ex­changes from cov­er­ing abor­tion care. Ad­di­tion­ally, med­ic­ally un­ne­ces­sary clin­ic reg­u­la­tions have been passed de­signed spe­cific­ally to lim­it the num­ber of abor­tion pro­viders and abor­tion clin­ics avail­able.

Put this all to­geth­er and we have a situ­ation that has be­come dire.

For ex­ample, my or­gan­iz­a­tion in Min­nesota of­ten helps wo­men com­ing from South Dakota, where there is only one clin­ic loc­ated at the most south­east­ern corner of the state. Even if a wo­man is able to get there, South Dakota law re­quires a wo­man to wait 72 hours after an ini­tial ap­point­ment to have an abor­tion. This forces people to drive hun­dreds of miles on mul­tiple oc­ca­sions or go out­side the state for their abor­tion care.

At Pro-Choice Re­sources, we know firsthand that these re­stric­tions are mak­ing abor­tion more un­avail­able and un­af­ford­able. Every day, we hear from people who need abor­tion care and are strug­gling fin­an­cially. Some qual­i­fy for med­ic­al as­sist­ance but can­not get their in­come veri­fied be­cause the doc­u­ments they need are in a home they have fled be­cause of do­mest­ic vi­ol­ence. Oth­ers are young wo­men who are afraid to use their own in­sur­ance be­cause their par­ents will kick them out. We help wo­men who have no homes, and no one else to turn to in or­der to en­sure they have the same rights as any oth­er wo­man with more money or private, un­sub­sid­ized health in­sur­ance.

As one wo­man we as­sisted stated, “It’s im­port­ant to have these rights. It’s hard be­ing home­less, go­ing to school full-time and work­ing. Not hav­ing this op­tion is ludicrous, it should be every wo­man’s right.”

That’s why we are stand­ing up for all people and fam­il­ies, as part of the All* Above All Be Bold Road Trip. We be­lieve that wherever a wo­man lives, and however much she makes, every wo­man must be able to make her own de­cisions about preg­nancy. That should be true even if, and per­haps es­pe­cially if, a wo­man is already strug­gling.

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