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January 22, 2012, marks the 39th anniversary of Roe v. Wade, the US Supreme Court decision that recognized a woman’s constitutional right to have an abortion, if she so chooses. Reflecting on the anniversary of this landmark case, I am reminded of an interview with a woman from Florida who struggled to pay out-of-pocket for her abortion. When asked what she thought about the fact that Medicaid would not cover her care she said, “I wish women had a right [to Medicaid coverage of abortion]…. I think women should have that option…. There’s a lot of things to having a right to choose.”
One obstacle standing in the way of women’s right to have an abortion is the Hyde Amendment. Passed in 1976, the Hyde Amendment prohibits the use of federal Medicaid funding for abortion except when a woman is pregnant as a result of rape or incest, or when her pregnancy endangers her life. States have the option of using their own funds to cover abortion in broader circumstances, but few do.
Ibis Reproductive Health has conducted several research studies that evaluate how restrictions on public funding for abortion affect women. Our researchshows that women consistently encounter problems enrolling in Medicaid, trying to use Medicaid to cover qualifying abortion care, and finding a local health care provider that accepts Medicaid. We have also found that women have difficulty accessing accurate information about Medicaid coverage of abortion and that Medicaid staff frequently discourage women from seeking abortion coverage. Because of these difficulties, women are forced to raise their own money for care. They borrow money from friends and family, take out payday loans, delay bill payments, pawn jewelry, and take other drastic measures. This scramble to obtain funding can lead to delays in obtaining timely care or prevent women from obtaining an abortion altogether.
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The fight to restore public funding for abortion has been going on for over 35 years. In that time, women’s health advocates and abortion providers have endured an onslaught of policies aimed at restricting women’s abilities to access abortion. But they have also become adept at removing some of the obstacles in women’s paths. Our research shows that through a range of advocacy, policy, and practice-based strategies, women’s health advocates and abortion providers have developed a number of ways to ensure that eligible women secure timely access to Medicaid coverage of abortion.
We compiled these strategies in the Take Action series – a set of guides that outline actions that advocates and abortion providers can take to help expand women’s access to Medicaid coverage of abortion. The guides also highlight the real-life experiences of women and abortion providers trying to navigate the Medicaid system. In the coming months, Ibis will release two additional Take Action guides for women and policymakers.
It is our hope that documentation of the devastating impact of the Hyde Amendment, as well as evidenced-based strategies for improving the Medicaid system from the ground up, will help ensure that abortion is not only legal, but accessible to all women regardless of their income.