National Partnership for Women & Families

In the News

Op-ed highlights how Hyde harms D.C. residents

"Since 1976, the Hyde Amendment has restricted the use of federal Medicaid funds for abortion services for low-income women in the District of Columbia except in cases of life endangerment, rape, or incest," Jamila Perritt writes in an opinion piece for Rewire.

Perritt explains that as a Washington D.C. resident and "front-line provider of health care for women," she has seen "what happens when patients cannot afford to pay for treatment from their primary physician." Not only do such patients go without preventive services and regular monitoring for chronic conditions, but they also face obstacles accessing abortion care, which is "no different from other forms of basic health services," Perritt writes.

As an example, Perritt outlines the obstacles a low-income rape victim might face when seeking abortion care in D.C. She writes, "You have Medicaid, which in D.C. means that your doctor only needs to write a note to attest to the fact that you were raped. But you're being told that in order to ensure Medicaid coverage for your abortion, you need a police report or some sort of 'evidence' to 'prove' you were raped." Moreover, if a rape victim instead tried to gather the necessary funds herself, she might have to delay her abortion care, Perritt writes, which means that she likely would "have to go to a neighboring state because there are few providers who do second-trimester abortions in Washington, D.C.," an endeavor that not only requires more money, but also time off work.

Perritt writes, "This is 2016. Roe v. Wade is more than four decades old. Where is your constitutional right to choose?" Yet, according to Perritt, "This is the reality that many women whom [she] take[s] care of face every day." She explains, "In a city where about one in five residents live at or below the federal poverty line, the Hyde Amendment unduly targets women who are already struggling to make ends meet" and exacerbates the trauma experienced by sexual-assault survivors.

Further, Perritt notes that in the District, "these attempts to control the reproductive lives of women have gone one step further than other regions," because Congress for all but two years since 1989 "has restricted the District's ability to use its own locally raised revenue for abortion services." In contrast, "all 50 states have the option of providing state funding for abortion care," she writes, although she notes that only 17 states currently permit the use of "state and local funding [for] abortion care for low-income women."

Perritt writes, "The Hyde Amendment creates and perpetuates a two-tiered system of health care: separated by income and often by race." Since Hyde's passage 40 years ago, Perritt writes that "we have seen worsening health disparities for women of color around the country." According to Perritt, the "health care disparities are manifested by lack of accessible and affordable health care in the form of contraception and other preventive health measures." In turn, the "disparities create differences in unintended pregnancy, maternal morbidity, and pregnancy outcomes for women of color while rates for other communities continue to fall," Perritt writes.

She explains that while "providers need to know more about why these disparities persist so we can change them, one thing is clear: Women and doctors don't want or need politicians deciding what we must do or say in our exam rooms." Reflecting on her own interactions with patients, Perritt states that "the women for whom I care are fully capable of making thoughtful decisions about their families and their futures without interference from individuals who presume to know better."

She continues, "This coverage restriction is not about the protection of taxpayers' money or an effort to protect religious freedom, but a systematic attempt to restrict access to reproductive health for our most vulnerable populations." Noting that women "who are affected the most are those who have the least," she concludes, "Reproductive autonomy, the right to control one's own body, should not be determined by or connected to socioeconomic status" (Perritt, Rewire, 9/29).