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Two articles in the latest edition of the Guttmacher Policy Review, a peer-reviewed publication of the Guttmacher Institute, conclude the Hyde and Helms Amendments that restrict abortion funding inside and outside the United States hurt women in several ways. The authors argue that those amendments should be be done away with. But, until that can be achieved, they write, partial measures could be taken now that don't require congressional action, which is, for the time being, simply not going to happen.

The Hyde Amendment bars federal funding for abortions except in the case of rape, incest and when a woman's life is at risk. Since it was first implemented in 1977—it is an appropriations bill "rider" that must be renewed each year—poor women have been the victims of those restrictions. Seventeen states—four voluntarily and 13 by court order—use their own revenues to fund all or most medically necessary abortions by individuals covered by Medicaid. The 1973 Helms Amendment bars payment for “abortion as a method of family planning” in U.S. foreign assistance programs.

The Hyde Amendment opened the door for additional provisions that hurt women who are dependent on the government for their health insurance or health care. These include federal employees, military personnel, federal prison inmates, poor residents of the District of Columbia and tribally enrolled American Indians covered by the Indian Health Service.

In the GPR article Insurance Coverage of Abortion: Beyond the Exceptions For Life Endangerment, Rape and Incest, Heather D. Boonstra wrote:

The poorest and most vulnerable women are usually hit hardest, leaving some of them unable to obtain a safe and legal abortion. This can have dire consequences for women and their families—for instance, forcing them to carry an unwanted pregnancy to term or, as is the case in many developing countries, compelling them to seek a clandestine abortion that can result in serious injury or death. [...]

Restrictions on insurance coverage of abortion fall hardest on poor women, who are already disadvantaged in a host of other ways, including in their access to the information and services necessary to prevent unplanned pregnancy in the first place. Compared with higher income women, poor women are five times as likely to have an unintended pregnancy, five times as likely to have an abortion and six times as likely to have an unplanned birth.21,22 Moreover, abortion has become increasingly concentrated among poor women: In 2008, 42% of women obtaining abortions had incomes below 100% of the poverty level—a large increase from 27% in 2000.

Sneha Barot wrote in Abortion Restrictions in U.S. Foreign Aid: The History and Harms of the Helms Amendment:
Another overarching impact of funding restrictions is that they single out and stigmatize abortion care. This stigma has a chilling effect, often leading various actors—from administrators to health service providers on the ground—to shy away even from abortion-related activities that are clearly permissible under these restrictions.
There is more below the fold.

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Ironically, the Hyde Amendment provided the underpinnings for a modest but important liberalization of abortion policy in 2012 when the military added cases of rape and incest to its coverage of abortion for U.S. servicewomen and military dependents. Previously, abortions were only covered when a woman's life was endangered. Huzzah to victory on a small scale in a matter that should never have been at issue in the first place.

Boonstra points out that pushing these incremental improvements is important. But the more ambitious goal, the original goal of the reproductive rights movements after Hyde and Helms were first passed, is to repeal them altogether:

The goal is that the federal government, in its role as insurer and employer, should ensure that coverage for abortion services is included in the health insurance it provides to women and arranges for its employees and their dependents. Moreover, there should be no government restrictions that prohibit or otherwise interfere with abortion coverage in private health insurance plans.
That goal, of course, is just one part of the struggle for reproductive rights. There is no getting around the fact that this is a fight we've been mostly losing at the state level, and badly, especially in the past two-and-a-half years. As we're all too well aware, not only safe and legal abortions are under attack, but so also are birth control and other aspects of women's health because of defunding efforts. Only one cure for this: replacing enough forced-birthers in state legislatures and governors' mansions to turn the tables. Obviously, no easy task. But it's one that is essential for reasons that extend far beyond abortion and birth control.
Extended (Optional)

Originally posted to Meteor Blades on Tue Sep 24, 2013 at 11:11 AM PDT.

Also republished by Pro Choice and Daily Kos.

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