Five hundred dollars. That’s about what it costs for a woman to exercise her constitutional right to end a pregnancy in the United States—not including associated expenses such as travel, child care, and lost wages.
For some women, that’s a deep breath—but doable. For others, it will wipe out a savings account or send them into debt.
But for millions of low-income women—for whom every single cent available is already earmarked for rent and food and kids—$500 is an un-climbable mountain. It may as well be $500,000. As a result of current restrictions that deny abortion coverage to Medicaid recipients, one in four women receiving Medicaid seeking abortion care will be forced to carry an unwanted pregnancy to term.
One of these women is Laurie. A young mother of three working at Pizza Hut and trying to go back to school, Laurie was devastated when she found out she was pregnant again. She knew she could not afford it—financially or emotionally.
But due to a lack of Medicaid coverage, she found herself unable to obtain a legal abortion. The fact that Laurie had a constitutional right to end her pregnancy meant nothing without the ability to afford it.
“I was heartbroken. I cried and cried,” Laurie recalls. “And I think it’s an extra layer to have a unwanted pregnancy when you are poor and a woman of color. You know what it means to walk into the welfare office and add another child to your case—everyone thinking it’s your fault. You know you’re going to be ‘that girl.’ You feel the stigma. And you know that the moment your child comes in to this world, she will feel it, too.”
A historic piece of legislation introduced this month in Congress by Representatives Barbara Lee (D-CA), Jan Schakowsky (D-IL), and Diana DeGette (D-CO) would ensure that a lack of coverage no longer stands in the way of a woman making the best decision for herself and her family. The EACH Woman Act gives all women access to health coverage for abortion services—no matter how much money they make, what insurance plan they have, or where they live.
“This is visionary lawmaking,” says Megan Donovan, federal policy counsel at the Center for Reproductive Rights. “For too long, discriminatory policies such as the Hyde Amendment have taken a disproportionate toll on low-income women, immigrant women, young women, and women of color by banning insurance coverage for abortion care.”
Since 1976, the Hyde Amendment has barred Medicaid coverage of abortion except very limited circumstances. Numerous states also impose unfair and harmful limitations on insurance coverage– whether a woman’s insurance is provided by her employer or the government, or purchased individually.
In addition to restoring coverage to Medicaid recipients, the EACH Woman Act would protect federal employees and their dependents, Peace Corps members, Native Americans, low-income residents of Washington, D.C., and federal prisoners—all of whom are currently denied abortion coverage. The bill would also prohibit political interference with decisions by private health insurance companies to cover abortion care.
Studies have shown that when a woman seeks an abortion but is denied, she is far more likely to fall into poverty than a woman who is able to get an abortion. When asked how a woman affords to have a baby if she can’t afford an abortion, Laurie responds without a pause: “You don’t.”
“You’re not living—you are existing. You’re in survival mode. I dropped out of school—it just wasn’t doable—and went back to waitressing after only four weeks,” Laurie remembers. “We had some shockingly lean months. The baby slept with me because I couldn’t afford a crib. I had to negotiate for everything we had—food, clothes. No one budgets better than a poor, single woman, but I still couldn’t make ends meet.”
Of course, not all barriers are financial. Over the last few years, hundreds of new state laws have imposed restrictions on abortion care including mandatory delays, sham health regulations, and outright bans.
That is why in January of this year, Representatives Judy Chu (D-CA), Marcia Fudge (D-OH) and Lois Frankel (D-FL) reintroduced the Women’s Health Protection Act. That bill would prohibit states from imposing unconstitutional restrictions on reproductive health providers that apply to no similar medical care, interfering with women’s personal decision-making, and blocking access to abortion services.
“Right now, we are working to secure an environment where a woman’s right to make one of the most important decisions of her life—when and if to become a parent—is not dependent on where she lives or what’s in her pocketbook,” says Donovan. “These two complementary measures are essential components of that environment.”
The idea that a government has an obligation to ensure that women have access to safe health services—and that no woman is denied a legal abortion just because she cannot pay for it—is hardly groundbreaking. At the Center, we know from our global involvement in international human rights bodies and courts around the world—from France to Uruguay to Nepal—that coverage of abortion services is commonplace in countries that respect women’s rights to health and self-determination.
We are committed to advancing the compassionate vision of the EACH Woman Act and the Women’s Health Protection Act—and joining the ranks of nations that understand that a right without the ability to access it is not a right at all.