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Sanders’ ‘Medicare for All’ Covers Abortion Care, Ends Hyde Amendment

Christine Grimaldi

“This bill recognizes what people across the country already know: that health insurance plans should cover the full range of pregnancy-related care, including abortion.”

Sen. Bernie Sanders’ (I-VT) newly unveiled “Medicare for All” bill lives up to promises that his vision for universal health coverage includes—and prioritizes—abortion care.

Rewire in August first reported that the Sanders bill would proactively cover abortion care and preempt the Hyde Amendment, which bans any federal insurance program from covering abortion. Under a Medicare for All proposal that didn’t address Hyde, the discriminatory ban, which burdens people with low incomes and people of color, could apply to every person who moves off their private insurance into a public option that’s supposed to be more equitable.

Under Title VII, “Universal Medicare Trust Fund,” the text of Sanders’ bill appears to reference Hyde as one of the “restrictions that shall not apply.”

Specifically, “any other provision of law in effect on the date of enactment of this Act restricting the use of Federal funds for any reproductive health service shall not apply to monies in the Trust Fund”—meaning that Hyde couldn’t apply to Medicare funds.

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Another section of the bill includes “comprehensive reproductive, maternity, and newborn care” within the scope of Medicare for All’s coverage. Reproductive rights and justice advocates in August told Rewire that it’s just as important for universal health care proposals to spell out abortion care within the scope of covered services as it is to end Hyde. Their consensus now is that the bill’s “comprehensive reproductive care” includes abortion care, and they praised Sanders for it.

Insurance coverage of abortion is critical to ensuring women can access the services they need, helping to protect women’s health and economic security,” Rachel Easter, the National Women’s Law Center’s counsel for reproductive rights and health, said in an email.

That recognition emerged during the drafting of the bill, which was “written to cover abortion, explicitly,” a Sanders staffer told Rewire Editor-in-Chief Jodi Jacobson.

Democrats on Capitol Hill have increasingly signaled their support for a “single-payer” system in which the federal government covers health-care costs, regardless of income, job status, or health status, bucking party leaders who have distanced themselves from the idea. A Medicare for All bill in the U.S. House of Representatives counts the support of more than half of the chamber’s Democrats. (As Rewire reported, Illinois Democrat John Conyers’ House version doesn’t deal with abortion coverage and the Hyde Amendment, though he’s part of a concurrent effort to end Hyde.)

The single-payer landscape looks different across the Capitol. Politico reported that vulnerable incumbents, such as Sen. Claire McCaskill (D-MO), have been loath to sign onto Sanders’ U.S. Senate version.

Single-payer health care will remain out of reach for the foreseeable future under a GOP-controlled Congress and a White House committed to undermining health coverage. But Sanders, Conyers, and others offering “vision bills” can set the benchmarks for health care if and when Democrats return to power.

Sanders is an independent who ran a progressive campaign for president under the Democratic Party ticket. High-profile Democrats, including Sens. Kamala Harris (CA), Elizabeth Warren (MA), Kirsten Gillibrand (NY), and others who may have their eyes on a 2020 bid for the White House, flanked Sanders during a Wednesday press conference in the Senate unveiling the measure—and publicly pushing the party toward an embrace of universal health care. 

Advocates applauded Sanders for not only embracing health care as a human right, but also recognizing that abortion care is health care.

“We applaud Senator Sanders and the bill’s co-sponsors for this BOLD vision for health coverage,” All* Above All Co-Director Destiny Lopez told Rewire via email. “This bill recognizes what people across the country already know: that health insurance plans should cover the full range of pregnancy-related care, including abortion.”

NARAL Pro-Choice America President Ilyse Hogue echoed that sentiment.

“Senator Sanders’ healthcare bill ends the debate and makes clear that reproductive healthcare, including abortion services, is a fundamental right—not just a privilege for the wealthy,” she said in a statement. “The introduction of this bill is the culmination of significant work led by women of color, who suffer the most when contraception and abortion care are offered on a pay-to-play basis.”

Sanders’ coverage for maternity and newborn care aligns with that of the Affordable Care Act, commonly called Obamacare. Still the law of the land, Obamacare requires health insurance plans in the individual and small-group markets to cover “pregnancy, maternity, and newborn care (both before and after birth)” as one of ten essential health benefits.

Congressional Republicans have tried, unsuccessfully, to repeal Obamacare while voicing disdain for the health of cisgender women, as well as transgender and gender nonconforming people. Rep. John Shimkus (R-IL) questioned why men should have to buy prenatal care, and House Speaker Paul Ryan (R-WI) sacrificed maternity care and the other essential health benefits in a failed initial attempt to bring an Obamacare repeal bill to the House floor. Ryan later railroaded through a bill that would have allowed states to waive essential health benefits and, in some cases, charge higher premiums for pre-existing conditions.

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