Analysis Abortion

From the Ground Up: Restoring Insurance Coverage for Abortion Care

Tara E. Sweeney

What if elected officials strongly and unequivocally spoke out in support of insurance coverage for abortion?

By now the mantras are familiar: The Hyde Amendment is settled law. Current Hyde Amendment restrictions governing abortion policy will always be the law of the land. No elected official is willing to stick their neck out for this issue.

The Hyde Amendment was first passed in 1976, and with each passing year, as it gets routinely attached to the annual appropriations bill without even a floor vote, the mantras reinforcing the ban on public insurance coverage for abortion care grow more deterministic. 

But what if elected officials strongly and unequivocally spoke out in support of insurance coverage for abortion? What if they went on record declaring that a woman needs access to a range of safe, affordable reproductive health care services throughout her life, including abortion care? And that all women, regardless of income, need insurance coverage to access these services so that economic barriers do not dictate critical health care decisions? What if they called on Congress to stop withholding coverage for abortion care for qualified women?

On January 23, 2013, the New York City Council took this step by adopting Resolution 1635-A, which commemorated the 40th anniversary of Roe v. Wade and called on the United States Congress to support funding for comprehensive reproductive health care.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

This resolution is an example of the kind of proactive move that elected officials can take to break the mold of defensive responses that have characterized the movement, especially the attitude toward insurance coverage for abortion.

Back in 2007, the National Institute for Reproductive Health saw that the tendency of Congress and state legislatures to attack access to reproductive health care—especially abortion care—created a real opportunity for cities and municipalities to step in to pick up the slack.

Urban areas are often ground zero for some of our nation’s most pressing reproductive health challenges, including high rates of unintended pregnancy, sexually transmitted infections, and maternal and infant mortality and morbidity. The data is especially stark for particular groups of women who often have the least access to health care, including young women, lower-income women, and women of color. At the same time, city governments and agencies are comprised of people who see firsthand how state or federal policies that restrict reproductive rights can have a devastating effect on the ground. 

The Institute launched the Urban Initiative for Reproductive Health specifically to demonstrate that there is a place and a need for local elected and public health officials to advocate for improved access to reproductive health care. And furthermore, we knew that elected officials working on the local level could advance the kind of proactive policies and programs on reproductive health that might be seen as nonstarters at the state and federal levels.

The Urban Initiative’s city-level strategy has been in play in 30 cities across the country since 2007. From Austin to Baltimore, Denver to Pittsburgh, Memphis to San Francisco, the Urban Initiative has helped local advocates to pass proactive legislation, enact effective and innovative reproductive health programming, and build support for reproductive health, rights, and justice. It has countered the deceptive practices of crisis pregnancy centers, directed teens to youth-friendly reproductive health care, minimized the dangerous effects of environmental toxins on women’s fertility, trained local legislative champions, and more. Most importantly, it has started to create a change in the minds of partners and allies about the meaning of local work—both its importance to the community and its impact on the national conversation.

In 2012, the Urban Initiative aligned our local partnerships to help create a critical mass of public support for abortion coverage from local elected and public health leaders and advocates, all working in tandem to repeal laws that currently withhold this coverage from low-income women. The 40th anniversary of Roe v. Wade was a perfect opportunity to underscore that the legal right to decide to have an abortion means nothing if abortion isn’t accessible. We believed that an elected official at the local level—who feels the immediate ramifications when her constituency’s needs aren’t being met – understands how a longstanding federal policy like the Hyde Amendment leads to fundamental inequities in access to health care, creates confusing and inefficient bureaucracy, and ultimately harms women and families.

On January 18, 2013, the Committee on Women’s Issues of the New York City Council held a hearing on Resolution 1635-A commemorating the 40th anniversary of Roe v. Wade and calling on the United States Congress to support funding for comprehensive reproductive health care. This resolution recognizes that “budgetary actions taken by the federal government have increased barriers to accessing such services by restricting abortion coverage for those enrolled in public insurance programs” and that “when a woman needs to end her pregnancy it is important that she have access to safe medical care, and insurance coverage can help ensure such care is available.” Advocates who testified at this hearing highlighted the importance of insurance coverage for abortion; on January 22, the full Council adopted the resolution.

And New York City is just one example. Urban Initiative partner cities throughout the country are laying the groundwork to take this conversation higher and farther.

For example, in Austin, TX, advocates worked with the Travis County Commissioners Court to adopt a resolution commemorating Roe that speaks to the challenges facing women in Travis County and Texas as a whole and reflects the local political climate. Ultimately, on January 22, the Court adopted a resolution that “affirms the importance of full spectrum women’s reproductive rights” and “urges Congress and the State of Texas to pursue a positive agenda that reaffirms the fundamental right of women to make decisions about their health in concert with their doctor and improves women’s access to safe and comprehensive reproductive health care.” 

As our partners at NARAL Pro-Choice Texas noted, “the Texas Women’s Health Program is in shambles and family planning clinics have closed their doors around the state,” and this resolution represents a step forward for elected officials in publicly recognizing the dire need for funding and coverage for reproductive health care, including abortion care.

This is just the beginning. Throughout 2013, additional cities will take actions to publicly declare that it is unfair for politicians to withhold insurance coverage or try to influence a woman’s decision about whether to end a pregnancy just because of the type of insurance she uses. 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. Withholding insurance coverage for abortion to a woman who qualifies for these benefits for political reasons is unconscionable. 

With more actions like these from brave and prominent leaders in our cities, the quiet acquiescence that reinforces the Hyde Amendment’s ban on coverage just might start to disintegrate.

Commentary Human Rights

The Democratic National Convention Was a Remarkable Victory for Disabled People

s.e. smith

This year's convention included disabled people every evening, as part of a larger inclusive policy that made 2016 a banner year for disability rights activists.

Read more of our coverage of the Democratic National Convention here.

On Thursday night, Hillary Clinton formally accepted the Democratic Party’s nomination for president. Her speech included many of the elements one expects from a nominee, but there were some standout moments—like when she mentioned disability rights, which she did repeatedly.

Clinton integrated disability into her discussion of her record, talking about her work to ensure that disabled children have the right to go to school and bringing up the health-care needs of disabled youth. Her commentary reinforced the fact that she has always cared about disability issues, particularly in the context of children’s rights.

But she did more than that. She referenced shortages of mental health beds. She explicitly called out disability rights as necessary to defend. And at one point, she did not mention disability, which in itself was radical. When she outlined her plans for gun reform and clearly stated that she wanted to keep guns out of the hands of people who shouldn’t have them, she referenced people with criminal histories and terrorists, but not mentally ill people, who have been fighting a surge in stigma thanks to perennial (and wildly incorrect) assertions that mental illness causes violence. That omission was clearly deliberate, given the meticulous level of crafting that goes into writing one of the most important speeches of a presidential candidate’s career.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

The nominee’s speech would have been remarkable on its own, but what made it truly outstanding is that it was far from the first appearance of disability at this year’s Democratic National Convention (DNC). The convention included disabled people every evening as part of a larger inclusive policy that made 2016 a banner year for disability rights activists, who are used to being invisible. These kinds of appearances normalized disability, presenting it as a part of some people’s lives and a source of pride, not shame or misery.

On Monday, for example, disability rights activist Anastasia Somoza rolled out to give a sharp, compelling speech that didn’t cast disability in a tragic or exceptional light. She wasn’t the only wheelchair user to appear on the DNC stage—Paralympic athlete Mallory Weggemann led the pledge of allegiance on a different evening. Dynah Haubert, an attorney for Disability Rights Pennsylvania, took the stage on Tuesday. Nor were wheelchair users the only disabled people represented. Ryan Moore, a longtime friend of Clinton’s, spoke about health care and his experiences as a man with spondyloepiphyseal dysplasia congenital syndrome, a form of dwarfism. Connecticut Gov. Dannel Malloy talked about his learning disabilities. Musician Demi Lovato, who has bipolar disorder, took on mental health.

Former Iowa Democratic Sen. Tom Harkin, a nondisabled man who played an instrumental role in the push to pass the Americans with Disabilities Act (ADA) in 1990, taught the crowd sign language during a lively speech about the fight for disability rights on Tuesday, the 26th anniversary of the landmark legislation.

On Wednesday night, former Rep. Gabby Giffords (D-AZ) strode out onto the DNC stage in Philadelphia, smiling and waving at the crowd, to make a few short remarks. “Speaking is difficult for me,” she concluded, “but come January 2017 I want to say these two words: ‘Madam President.'” Her speech was about gun violence—a subject with which she’s intimately familiar after being shot in the head in 2011.

This level of representation is unprecedented. Some speakers, like Somoza, explicitly talked about disability rights, putting the subject in the spotlight in a way it’s never been at previous conventions. Others, like Giffords, came up on stage to talk about something else entirely—and happened to represent disability while they were at it. Similarly, Rep. Tammy Duckworth (D-IL), a decorated combat veteran and double amputee, talked about military policy.

This is a striking contrast from the treatment of disability at previous Democratic National Conventions: When disabled people have appeared, it’s often been in the form of a lackluster performance that objectifies disability, rather than celebrating it, as in 1996 when former actor Christopher Reeve framed disability as a medical tragedy.

Disability rights activists have spent decades fighting for this kind of representation. In 1992, two years after the passage of the ADA, the platform included just three mentions of disability. This year, the subject comes up in 36 instances, woven throughout the platform for an integrated approach to disability as a part of society, rather than as something that needs to be walled off into a tiny section of the platform, tokenized, and then dismissed.

In the intervening years, disabled people in the United States have fought for the enforcement of the ADA, and taken the right to independent living to court in 1999’s Olmsted v. L.C., which was namechecked in the 2000 platform and then forgotten. Disabled people advocated to have their rights in school codified with the Individuals with Disabilities Education Act (IDEA) in 2004, pushed for inclusion in 2010’s Affordable Care Act, and are fighting to pass the Community Choice Act and Disability Integration Act (DIA). Disability rights in the United States has come a long way since 1990’s infamous Capitol Crawl, in which disability rights activists dragged themselves up the steps of the U.S. Capitol, pleading with Congress to pass the ADA.

And as activists have pushed for progress in the courts and in Congress, disability rights have slowly become more prominent in the Democratic party platform. The ADA has been a consistent theme, appearing in every platform since 1992 alongside brief references to civil rights; historically, however, the focus has been on disability as a medical issue. The 1996 platform introduced Medicare, and health care in general, as issues important to the disability community, a refrain that was reiterated in years to come. In numerous years, Democrats addressed concerns about long-term care, in some cases positioning disabled people as objects of care rather than independent people. Disabled veterans have also played a recurring role in the platform’s discussion of military issues. But beyond these topics—again, often approached from a dehumanizing angle—and the occasional lip service to concerns about discrimination and equal rights, until the 2000s, education was the only really consistent disability issue.

In 2000, however, the Democrats went big, building on eight years under President Bill Clinton, and the influence of his then-first lady. For the first time, disability wasn’t simply lumped under “civil rights.” The platform explicitly called out the need for protection from disability hate crimes, but it also began to introduce the idea that there were other issues of relevance to the disability with a discussion of the digital divide and the obstacles that held disabled people back. Almost 30 years after the passage of the Rehabilitation Act of 1973, which barred disability discrimination by government agencies and contractors, the Democrats were starting to embrace issues like accessibility and independent living, which also played a prominent role in 2000.

It was a hint that the party was starting to think about disability issues in a serious way, especially when in 2008, the Democrats discussed the shameful delay on ratification of the United Nations’ Convention of the Rights of Persons with Disabilities, took on the Community Choice Act, talked about the need to enforce IDEA, and, again for the first time, explicitly addressed voting rights issues. By 2012, they were also calling out discriminatory voter ID laws and their disproportionate effect on the disabled community.

That’s tremendous, though incremental, progress.

And this week, the efforts of a generation of disability rights activists are on display everywhere in Philadelphia, where Daily News columnist Ronnie Polaneczky observed that accessibility is a top priority across the city. The DNC is providing expanded accessible seating, wheelchair charging stations, service dog relief areas, Braille materials, closed captioning, American Sign Language interpreters, medication refrigerators, and more. That’s radical inclusion at work, and the result of incredible efforts by disability rights organizers—including the 400 delegates who disclosed disabilities.

Those same organizers have been hounding the presidential candidates, holding them accountable on disability over and over again. They’ve brought up concerns about independent living, wage disparities, education, access to services, accessibility, hate crimes, reproductive rights, the “marriage penalty” and government benefits, and casual disablism in campaign rhetoric and practices. Advocates leaned on the Clinton campaign until it began captioning its content, for example. RespectAbility sent journalists out on the trail, #CriptheVote organized Twitter, and Rev Up encouraged people to register to vote and get involved. The disability community may be more explicitly politically active this year than ever before, and the DNC has been responding accordingly.

Clearly in consultation with disability rights activists, the Democrats have brought a host of new issues into this year’s platform, acknowledging that disabled people are part of U.S. society. Some of the many issues unique to this year’s platform include: abolition of the subminimum wage, concerns about economic opportunities with an explicitly intersectional discussion of the racial wealth gap, affordable housing, accessibility at the polls, the role of disability in the school-to-prison pipeline, and the need for more accurate Census data.

Notably, in a platform that has loudly called for a Hyde Amendment repeal and pushed for other abortion rights, the Democrats have also reinforced the need for access to reproductive health for disabled people, a revolutionary clause that’s gone virtually unnoticed.

This is a platform—and convention—of aggressive inclusion, and it reflects a victory for disabled people in the United States. It does still lack some components the disability community would like to see, like a shoutout to the DIA, which Clinton supports. This is, however, the start of what looks like a robust and real relationship between the Democrats and the disability rights community.

News Politics

Tim Kaine Clarifies Position on Federal Funding for Abortion, Is ‘for the Hyde Amendment’

Ally Boguhn

The Democratic Party voiced its support for rolling back the restriction on federal funding for abortion care in its platform, which was voted through this week.

Sen. Tim Kaine (D-VA), Hillary Clinton’s running mate, clarified during an interview with CNN on Friday that he still supports the Hyde Amendment’s ban on federal funding for abortion care.

During Kaine’s appearance on New Day, host Alisyn Camerota asked the Democrat’s vice presidential nominee whether he was “for or against” the ban on funding for abortion. Kaine replied that he had “been for the Hyde Amendment,” adding “I haven’t changed my position on that.”

Robby Mook, Clinton’s campaign manager, told CNN on Sunday that Kaine had “said that he will stand with Secretary Clinton to defend a woman’s right to choose, to repeal the Hyde amendment.” Another Clinton spokesperson later clarified to the network that Kaine’s commitment had been “made privately.”

The Democratic Party voiced its support for rolling back the restriction on federal funding for abortion care in its platform, which was voted through this week.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

“We will continue to oppose—and seek to overturn—federal and state laws and policies that impede a woman’s access to abortion, including by repealing the Hyde Amendment,” reads the platform.

Kaine this month told the Weekly Standard that he was not aware that the party had put language outlining support for repealing Hyde into the platform, noting that he had “traditionally been a supporter of the Hyde amendment.”

Clinton has repeatedly said that she supports Hyde’s repeal, calling the abortion care restriction “hard to justify.”

Abortion rights advocates say that Hyde presents a major obstacle to abortion access in the United States.

“The Hyde amendment is a violent piece of legislation that keeps anyone on Medicaid from accessing healthcare and denies them full control over their lives,” Yamani Hernandez, executive director of the National Network of Abortion Funds, said in a statement. “Whether or not folks believe in the broken U.S. political system, we are all impacted by the policies that it produces. … Abortion access issues go well beyond insurance and the ability to pay, but removing the Hyde Amendment will take us light years closer to where we need to be.”