The Hyde Amendment — What to Know

Abortion is a basic health care service, and therefore, should be accessible and covered by health insurance. Yet the cost of an abortion can serve as a barrier to that care for many low-income folks, particularly because not all insurance policies cover abortion. In fact, there are some outright bans on health insurance coverage for abortion that hinder access for millions of low-income folks, particularly Black and brown women. The most far-reaching is the Hyde Amendment.

What is the Hyde Amendment?

The Hyde Amendment bans the use of federal funds for abortion care. This means that folks who rely on Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or any other federal health insurance, must pay out of pocket for their abortion. Federal funds may only be used for abortion care to save the life of the pregnant person. The Hyde Amendment has been in effect since 1977 and has been approved every year by Congress.

Who does the Hyde Amendment affect?

The Hyde Amendment currently affects people in 34 states and the District of Columbia. The remaining 16 states provide their own funding for abortion coverage for people enrolled in Medicaid.

The combination of post-Roe abortion bans and the Hyde Amendment has meant that abortion is inaccessible for millions of people. The Kaiser Family Foundation estimates that more than half of all folks who can get pregnant that rely on Medicaid live in a state that is either impacted by the Hyde Amendment or bans abortion.

How did the Hyde Amendment come to be?

In 1976, three years after Roe v. Wade legalized abortion nationwide, anti-choice Representative Henry J. Hyde figured out a way to, if not ban abortion, then seriously hinder access. He introduced the Hyde Amendment (named for him, of course), which bars the use of federal funds for abortion care, which was approved as part of the annual Congressional budget. 

Abortion rights organizations sued, blocking the Hyde amendment from taking effect for nearly a year. By August of 1977, however, the Hyde amendment was in effect. It has been approved by Congress to the annual budget every year since. The Hyde Amendment is currently in effect.
How does the Hyde Amendment impact abortion access?

The Hyde Amendment was intentionally created to make accessing abortion more difficult for low-income folks, who are more likely to rely on Medicaid for health insurance coverage.

The Hyde Amendment isn’t just classist, however. Systemic racism and the ongoing erosion of the social safety net in America mean that Black and brown women are disproportionately likely to be insured by Medicaid. According to the Guttmacher Institute, among women aged 15–49, 29% of Black women and 25% of Hispanic women were enrolled in Medicaid in 2019, compared with 15% of White women and 12% of Asian women.

What about other insurance coverage for abortion care?

Abortion opponents have found many ways to restrict access to abortion through health care insurance coverage, and those attacks aren’t limited to publicly-funded health insurance.  

Currently, 25 states ban coverage of abortion through Affordable Care Act state marketplaces. If someone relies on health insurance they purchased on the ACA marketplace in one of these states, they will still be forced to pay out of pocket for an abortion.  

Ten states go even further, banning private insurance coverage of abortion care. This means that a privately-held insurance company cannot legally cover the cost of abortion care in these states, whether they want to or not.

How can we get rid of the Hyde Amendment and other bans on insurance coverage for abortion care?

Eradicating the Hyde Amendment isn’t difficult in terms of political procedure, but more a challenge of political will. The pervasive stigma around abortion means that members of Congress, even those who are supposedly supportive of abortion rights, often go along with the Hyde Amendment because it’s seen as a “reasonable” restriction on abortion, even though there is no such thing.

But there is a growing movement to end bans on insurance coverage for abortion, both public and private. A coalition of 163 members of Congress have introduced the Equal Access to Abortion Coverage in Healthcare (EACH) Act, which would guarantee abortion coverage, no matter how someone gets their insurance. The EACH Act has not yet become law, which means that bans on abortion coverage, including the Hyde Amendment, can still be in effect.

For now, putting your money towards abortion access is key. Abortion funds exist to bridge the growing gap that the Hyde Amendment first created in 1977. Supporting your local abortion fund and/or practical support organization (PSO) can help someone who is denied coverage of their abortion, either through the Hyde Amendment or other insurance coverage bans, access the care they need. You can find a list of PSOs here.

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