Abortion has emerged as a major issue in the 2020 presidential campaign, and with it has come renewed scrutiny on the Hyde Amendment, a legislative provision that restrict federal funds from covering abortions.
Many Democratic presidential hopefuls have called for a repeal of the amendment and lined up with abortion rights groups, who say the policy turns poor women into second-class citizens, unable to exercise their constitutionally protected right to abortion.
Now, new research is offering a fresh look at exactly how many poor women are denied abortions and go on to have children because the procedure is not covered under Medicaid.
Researchers at Advancing New Standards in Reproductive Health (ANSIRH), a team at the University of California, San Francisco, asked pregnant women in Louisiana if they had considered having an abortion. If the women had, they asked them if lack of Medicaid coverage for abortion was a reason why they did not have one.
Based on their findings, published in the journal BMC Women’s Health on Wednesday, researchers estimate that 29% of low-income Louisiana women who would have had an abortion if it were covered under Medicaid instead decided to give birth.
The Hyde Amendment “essentially bans abortion for a substantial proportion of low income women in the U.S.,” said Sarah Roberts, one of the authors of the study.
“It’s not just some potential future if Roe is overturned, or if some states ban abortion outright,” she said. “Women are already unable to obtain abortions because of policies in place.”
The results of the study come on the heels of a busy legislative season in which state lawmakers across the country have passed extreme anti-abortion bills. Planned Parenthood, which is hosting a forum for Democratic presidential candidates on Saturday, has declared a state of emergency for reproductive rights.
The Hyde Amendment was passed in 1976 and has been renewed every year since. It bars the use of federal funds to pay for abortion services, except in cases of rape, incest or to save the life of the mother. Seventeen states use their own funds to provide abortion coverage for women on Medicaid. Louisiana is not one of them.
“It’s not just some potential future if Roe is overturned. ... Women are already unable to obtain abortions because of policies in place.”
A 2009 literature review, based on research done in the 1980s and ’90s, estimated that about a quarter of Medicaid-eligible pregnant women give birth instead of having an abortion because federal funds do not cover the procedure.
ANSIRH’s study aimed to see if that number was still accurate. According to their findings, it is.
“To some extent, it’s not terribly surprising,” Roberts said. “Lack of Medicaid funding for abortion continues to be an insurmountable barrier.”
For poor women, the inability to access abortion services can result in a wide range of negative consequences, she said.
Another research initiative from ANSIRH, the “Turnaway Study,” has found that women who are unable to obtain wanted abortions are more likely to remain tethered to violent partners, experience economic insecurity, and suffer from short and long-term physical health complications.
“When we ask women why they want to have an abortion, they have lots of reasons and those reasons are clearly well thought out,” said Diana Greene Foster, the principal investigator for the “Turnaway Study.”
They are concerned about money or their ability to care for their existing children, or their chances of becoming a single mother, for example.
“When we compare the outcomes of people who receive an abortion to people who are denied one, the people who are denied abortions live out all their fears,” Foster said.
“They are worried for their children and their children do worse. They’re worried for their economic well being, and sure enough, they become poorer.”