It's Time to End the Federal Ban Preventing Some Poor Women From Accessing Abortions

In the four decades of legal, safe abortion, it has remained unaffordable and unavailable for far too many, particularly women of color.

Karen Law has served as the executive director of Pro-Choice Resources since July 2008. Law has dedicated the majority of her career to antipoverty and social-justice work, helping families access the basic resources and services they require and deserve. Law earned a bachelor's degree in political science from the University of Denver and lives in Minnesota.

Law has spent the last few weeks following the Be Bold Road Trip across the country with other advocates. The Be Bold Road Trip is coordinated by All* Above All, a coalition of more than 60 national, state, and local organizations working to restore public insurance coverage for abortion so that every woman, however much money she makes, can access affordable, safe abortion care when needed.

Law shared her take on the state of abortion access with National Journal's Next America project.

In the four decades of legal, safe abortion, it has remained unaffordable and unavailable for far too many. Historically, women who are struggling financially have had a particularly difficult time accessing abortion care, mostly due to the ban on Medicaid coverage imposed by the Hyde Amendment since 1976.

That was the exact intention of lawmakers when the ban was put in place.

"I certainly would like to prevent, if I could legally, anybody having an abortion, a rich woman, a middle-class woman, or a poor woman," said Rep. Henry Hyde, R-Ill., at the time. "Unfortunately, the only vehicle available is the [Medicaid] bill."

Hyde was partially successful in his mission.

According to the Guttmacher Institute, a reproductive-health policy and research organization, restricting Medicaid coverage of abortion forces one in four poor women to carry an unwanted pregnancy to term. And their studies show that low-income women often must get abortions later in pregnancy and, as a result, face greater risk to their financial well-being.

"Research shows that poor women who are able to raise the money needed for an abortion often do so at great sacrifice to themselves and their families," the Guttmacher Institute found in a 2007 report. "Studies indicate that many such women are forced to divert money meant for rent, utility bills, food, or clothing for themselves and their children."

Laws such as the Hyde Amendment do not simply create more burdens for low-income women. They appear to contribute to the cycle of poverty. A woman who seeks an abortion but is unable to get one is three times more likely to fall into poverty than a woman who does, a 2012 study published by the American Public Health Association found.

Because of the connection between racial discrimination and economic disadvantage, this burden falls disproportionately on women of color and young women. Those with lower socioeconomic status—specifically those who are least able to afford out-of-pocket medical expenses—already experience disproportionately high rates of adverse health. What I have heard on the Be Bold tour and what I have witnessed over the course of my career convinces me that current policies help to add to these burdens and unjustly increase the health and economic disparities women of color face.

According to a 2012 report produced by the Women's Foundation of Minnesota on the status of women in Minnesota—the state where I live and where my organization, Pro-Choice Resources, is located—there is a reproductive-rights crisis that disproportionately affects people of color. Teen pregnancy in Minnesota sits at a far higher rate for teens of color than for white teens. Households headed by a woman of color are from 40 to 74 percent more likely to live under the poverty line and women of color are uninsured at far higher rates than their white peers.

Denying access to abortion care only exacerbates each of these problems.

Part of our work at Pro-Choice Resources includes assisting women who want and need an abortion but that are unable to afford this health care. Minnesota law ensures the legal right to abortion, and Minnesota Medical Assistance covers abortion care. Yet, even with favorable laws in place, thousands of people in Minnesota still find it nearly impossible to access abortion care without a struggle.

The problems associated with accessing abortion care grow even greater outside the Minneapolis/St. Paul metro area. More than 1.2 million people live in rural areas of the state. Yet, all but one of our state's abortion providers are located in the Twin Cities. That situation adds to the cost of an abortion. Rural women have to shoulder any medical costs associated with an abortion plus housing, travel, time away from work, or child care for other children, along with other expenses.

All it takes is just one part of that net to unravel and the entire process falls apart. As one caller to the Pro-Choice Resources' abortion fund recently explained to one of my colleagues, "It was scary thinking I wouldn't be able to get my abortion done because I couldn't afford a motel, then my rides to and from canceled."

Still, women in Minnesota rank among the more fortunate. In more restrictive states, laws prohibit Medicaid and insurance purchased through the Affordable Care Act exchanges from covering abortion care. Additionally, medically unnecessary clinic regulations have been passed designed specifically to limit the number of abortion providers and abortion clinics available.

Put this all together and we have a situation that has become dire.

For example, my organization in Minnesota often helps women coming from South Dakota, where there is only one clinic located at the most southeastern corner of the state. Even if a woman is able to get there, South Dakota law requires a woman to wait 72 hours after an initial appointment to have an abortion. This forces people to drive hundreds of miles on multiple occasions or go outside the state for their abortion care.

At Pro-Choice Resources, we know firsthand that these restrictions are making abortion more unavailable and unaffordable. Every day, we hear from people who need abortion care and are struggling financially. Some qualify for medical assistance but cannot get their income verified because the documents they need are in a home they have fled because of domestic violence. Others are young women who are afraid to use their own insurance because their parents will kick them out. We help women who have no homes, and no one else to turn to in order to ensure they have the same rights as any other woman with more money or private, unsubsidized health insurance.

As one woman we assisted stated, "It's important to have these rights. It's hard being homeless, going to school full-time and working. Not having this option is ludicrous, it should be every woman's right."

That's why we are standing up for all people and families, as part of the All* Above All Be Bold Road Trip. We believe that wherever a woman lives, and however much she makes, every woman must be able to make her own decisions about pregnancy. That should be true even if, and perhaps especially if, a woman is already struggling.