Fulfilling the Promise of Roe v. Wade: Let's Start With the President's Budget

Every year, Congress uses the annual budget process to deny women access to a critical reproductive health service -- abortion. We must allow medical standards of care -- and not politics -- to dictate coverage once again.
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President Barack Obama talks about the ongoing budget ceiling negotiations, Friday, July 29, 2011, in the Diplomatic Reception Room of the White House in Washington. (AP Photo/Pablo Martinez Monsivais)
President Barack Obama talks about the ongoing budget ceiling negotiations, Friday, July 29, 2011, in the Diplomatic Reception Room of the White House in Washington. (AP Photo/Pablo Martinez Monsivais)

For good reason, the past few months have been dominated by talk of the federal budget, national debt and the illusive fiscal cliff. And here we are at the start of a new budget season, once again. Within the coming weeks, the president will present a budget proposal to Congress for the coming Fiscal Year. But the federal budget is more than a balance sheet -- it affects important aspects of our daily lives, specifically, women's reproductive health.

Here's the connection. Every year, Congress uses the annual budget process to deny women access to a critical reproductive health service -- abortion. The coverage ban known as the Hyde Amendment is an annual appropriations rider that denies abortion coverage for women who get their health care through the Medicaid program. Currently, federal funding for abortion is only permitted in the direst of circumstances: in cases of rape, incest, and life endangerment.

Women who are federal employees, women serving in the armed forces and spouses of those in the military, women in the Peace Corps, women in federal prisons, women in the District of Columbia, and women who receive health care through Indian Health Services are all affected by similarly restrictive coverage bans.

The Hyde amendment was first enacted in 1976 and Congress has renewed it every year since, with slight modifications. Before that, Medicaid covered abortion just as it covers the other necessary services that make up quality comprehensive health insurance.

We must allow medical standards of care -- and not politics -- to dictate coverage once again.

The National Health Law Program has been working to protect and advance the health rights of low-income individuals in the Medicaid program for more than 40 years and we've seen how this law hurts women and families. Research shows that the rate of unintended pregnancy for low-income women is five times the rate for the highest income women. Restrictions on coverage for abortion services rob low-income women of the opportunity to make the best decisions for themselves and their families.

Without Medicaid coverage, women often have to forgo food or heat or rent in order to pay out of pocket for an abortion, or to delay care while they gather the money. Delays in medical care, or living without basic necessities, all have dire consequences. Health insurance coverage for abortion care -- whether public or private -- ensures that a woman can access timely care. And that care should cover the full range of pregnancy care, including abortion, so that a woman can make the decision that's best for her and her family.

President Obama has recognized that women's access to family planning and other health care services "is not just a health issue; it's an economic issue for women." It's time to stop playing politics with women's reproductive health care. This year, Obama must send a budget to Congress that lifts restrictions on coverage for abortion care. This year, let's ensure that every woman has coverage for a full range of pregnancy related care, including abortion, whether she is enrolled in private or public health insurance.

The president's federal budget proposal will come on the heels of the 40th anniversary of Roe v. Wade. As we commemorate Roe's importance in America's legal and political history, we are reminded that the promise of Roe has not been realized. In order for reproductive rights to be meaningful, women and girls must have real access to the full range of reproductive health care of their choosing, including abortion.

The president's budget is a blueprint for his priorities. It's time to include women's reproductive health as one of those priorities. Removing bans that withhold coverage for the costs of abortion for women who get their health coverage through the federal government is a necessary first step.

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