If passed, it will ban women from using federal funding for abortion.
The House of Representatives has voted to ban American women from receiving any financial government assistance for abortions, including if they have Medicaid or private health insurance as part of the Affordable Care Act. The bill, known as H.R. 7, would make permanent the existing Hyde Amendment, a legislative provision that bars the use of federal money to pay for abortion.
Abortion has been making headlines every day this week after Donald Trump reinstated a global gag rule, which removes all U.S. funding from international health organizations that counsel patients on abortion. Like the global gag rule policy, this H. R. 7 news is pretty in-depth, which is why we’re breaking it down for you. Here, eight things you should know about the Hyde Amendment and H.R. 7.
1. The Hyde Amendment was passed in 1976, and it has always prevented people from using Medicaid to pay for abortions except in cases of rape, incest, or life endangerment.
The Hyde Amendment is a bill rider, meaning it's attached to other annual bills, and it's been passed every year since it was first approved. According to the American Civil Liberties Union, the Hyde Amendment excludes abortion from the health care services provided to low-income people by the government through Medicaid.
The ACLU reports that these restrictions have left some women forced to use money they need for food, rent, clothes, or other necessities to pay for an abortion, which isn’t covered by their insurance. Planned Parenthood calls the Hyde Amendment a “dangerous and unfair policy that lets politicians interfere in a woman’s personal health care decisions.”
2. The Hyde Amendment has an outsize effect on certain segments of the population, many of which are already marginalized.
“Among women subject to the Hyde Amendment who seek an abortion, one in four are unable to obtain one because of lack of coverage. And restrictions on abortion coverage disproportionately impact low-income families, women of color, immigrants, and young people," Megan K. Donovan, senior policy manager at the Guttmacher Institute, tells SELF.
3. If it becomes a law, H.R. 7 would make the Hyde Amendment permanent, cementing existing abortion restrictions for women using Medicaid.
H.R. 7 bills itself as the potential law “to prohibit taxpayer-funded abortions.” Although taxpayer and government money does not currently fund abortions (again, except for rape, incest, or a pregnant person's life being in danger), because the Hyde Amendment expressly forbids it, H.R. 7 would solidify the Hyde Amendment into law if passed through the Senate and signed by the president.
“H.R. 7 is a sweeping piece of legislation, the sole purpose of which is to put constitutionally protected abortion care out of reach of as many women as possible by making it unaffordable,” Donovan says.
Sarah O'Leary, founder of Exhale Healthcare Advocates, a national consumer health care advocacy group, agrees. “This is an obvious attempt to discriminate against women by denying them access based on socioeconomic status,” she tells SELF.
Under this law, low-income people using Medicaid who want to terminate a pregnancy will continue to have to pay for abortion out of pocket, Sherry A. Ross, M.D., a women's health expert and author of She-ology: The Definitive Guide to Women's Intimate Health. Period, tells SELF. "Statistically, these are the groups who need this health care service the most," she says. "The federal government will be doing them an unforgivable disservice. This sets a horrible precedent for a woman’s right to choose through insurance restrictions."
4. If passed, H.R. 7 would also affect women's ability to use private health insurance to cover abortion.
The majority of women who receive their health insurance through the Affordable Care Act insurance marketplace do so through government subsidies, and H.R. 7 would prevent them from receiving coverage for abortions as well, O’Leary says.
In addition, section 302 of the bill specifically addresses prohibiting funding for health insurance plans that cover abortion. So, if H.R. 7 becomes law, private insurance companies may stop covering abortions altogether, Planned Parenthood reports, making abortions unaffordable for millions of people.
Georgeanne M. Usova, legislative counsel for the American Civil Liberties Union, tells SELF that H.R. 7 places tight restrictions on private insurance. “Beyond codifying the Hyde Amendment, which is terrible itself, this would put restrictions on women’s ability to buy private insurance that includes abortion coverage," she says. It would also deny small businesses tax credits if they tried to provide health insurance including abortion access to employees, and it would deny premium tax credits (refundable tax credits to help low- to moderate-income people afford insurance) to those who choose comprehensive health insurance plans including abortion. “It’s a really broad, wide-ranging piece of legislation," Usova says.
5. Under H.R. 7, the only exceptions allowing someone to use federal funding to get an abortion will continue to be limited.
Under the Hyde Amendment, and under H.R. 7 if it passes, a person can use federally-provided funds to get an abortion in three situations: rape, incest, and life endangerment. But it's notoriously difficult to prove rape and incest claims in court, O’Leary points out—and so emotionally draining that many people feel as though trying to do so would just inflict more damage. And by the time the level of proof required is reached, it’s often legally too late for an abortion, especially since many states have enacted 20-week abortion bans.
Under these extreme restrictions, getting an abortion due to fetal abnormalities or serious maternal health issues that aren’t deemed life-threatening at that moment wouldn't qualify for coverage. Ross says that it's "torturous" and "mentally devastating" to make someone deliver a baby with fetal abnormalities that are incompatible with life. "It’s absolutely inhumane and has potential medical dangers to the mother," she says. "It’s senseless to think this is acceptable."
“[These restrictions] effectively ban abortion coverage in all but the most extreme circumstances,” Donovan says. “Once a woman has made the decision to have an abortion, politicians should not stand in the way of constitutionally protected care.”
6. These limited exceptions also mean the government wouldn't see serious mental health conditions as enough of a reason to provide financial assistance for someone's abortion.
According to section 308, abortion funding restrictions can be lifted if “a woman suffers from a physical disorder, physical injury, or physical illness that would, as certified by a physician, place the woman in danger of death unless an abortion is performed, including a life-endangering physical condition caused by or arising from the pregnancy itself.” That means if someone is deemed have severe depression or even be suicidal due to the pregnancy, she could not receive financial assistance through Medicaid or private health insurance for an abortion.
7. H.R. 7 is part of a greater attack on women’s reproductive health.
The current administration has said they plan to repeal the Affordable Care Act, which O’Leary points out will deny millions of people access to free contraception, the morning after pill, and a host of preventive women’s wellness tests. “History tells us that taking away access to birth control drives up abortion rates,” she says. “When legal abortions aren’t available, illegal and highly dangerous ones are performed.”
8. It also takes away a woman's—and her doctor’s—ability to decide what is best for her.
Jessica Shepherd, M.D., an assistant professor of clinical obstetrics and gynecology and director of minimally invasive gynecology at The University of Illinois College of Medicine at Chicago, tells SELF that she’s concerned about H. R. 7's potential effect on a patient’s ability to have control over her body—and to receive proper guidance from her doctor. “You lose patient autonomy, and that’s not good for health care in general,” she says. “A woman’s right to decide her health care and how she treats her body should be a discussion between [her] and her doctor, and should not be decided between politicians and legislation.”
Ross agrees, noting that people will continue to have abortions, even if they're cost-prohibitive. "Supporting this ban encourages discrimination against women’s rights, especially for the poor and underserved. It’s plain and simply shameful," she says. "Women will end up in back alleys getting coat hanger abortions, making them at risk for dangerous complications including death."
H.R. 7 is now headed for the Senate. If you oppose the bill, call your state senator and voice your concerns. There are also tons of other ways to get involved, like finding activist opportunities. And if you're invested in women's access to reproductive health care in particular, you can also consider: donating to the Center for Reproductive Rights, volunteering for NARAL Pro-Choice America, donating to the Reproductive Health Access Project, or volunteering for Planned Parenthood.
This content appears as it was originally published on the SELF Magazine website.