Why Lambda Legal Joins the Call to #BeBoldEndHyde

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September 24, 2016

On September 22, 2016, Lambda Legal joined thirteen other LGBT organizations in a letter urging Congress to reject the four-decade-old Hyde Amendment, a harmful and discriminatory prohibition on Medicaid assistance for low-income women in need of abortion care.

For the past 50 years, the Medicaid program and other federal health insurance programs have underwritten medically necessary health services for Americans living in severe poverty who meet specified criteria. The Hyde Amendment, first passed in 1976, created a special exception for abortion and does not even permit ending a pregnancy due to fatal fetal abnormalities or threats to a patient’s health unless the patient’s life is in danger.

Although this Amendment is not enacted into a permanent federal statute, each successive Congress has reauthorized it through federal appropriations (spending) bills. The Amendment’s prohibitions also have been adopted to block abortion care in other government-funded contexts, such as health insurance for federal employees, federally detained immigrants and Peace Corps workers.

In the 40 years in which it has been in force, the Hyde Amendment has imposed diverse dangers and severe harms upon low-income women through its restrictions on health care access.

Some women have been forced to carry pregnancies to term against their will. Others have been forced into later-term, much more difficult abortions.

Still others ultimately have resorted to dangerous, self-induced abortions or unsafe, illegal abortions from untrained practitioners.

By singling out low-income patients who need to end a pregnancy and interposing members of Congress between them and their doctors, the Hyde Amendment profoundly disrespects these patients’ decision-making abilities, and also stigmatizes and marginalizes them. This targeted exclusion of care denies that abortion is an essential component of basic health care. Denying low-income women the ability to make their own reproductive health decisions is discriminatory and harmful.

As Lambda Legal attorneys have previously explained, the stigmatization of abortion — one of the safest and most common surgical procedures in the United States — is interconnected with the struggles of LGBT people to be free from stigma and to live their lives with equal dignity. Religion-based judgments of some can lead to restrictions of individual liberty for others. And stereotypes about gender and sexuality can box any of us into roles that are simply wrong for who we are.

But many LGBT people also feel the direct effects of the Hyde Amendment. While the harmful impacts of the Hyde Amendment fall most potently on low-income young women, immigrants, women of color and women in rural communities, those communities, in turn, include lesbians, bisexual women, transgender men and intersex and gender-nonconforming people.

Indeed, LGBT individuals are disproportionately low-income and depend on Medicaid and many may find themselves in need of abortion services.

Those low-income members of the LGBT community who need abortion access may face additional dangers from being forced into later-term, more visible pregnancies due to the delay in accessing that care caused by the Hyde Amendment.

Bisexual women, for example, are at greater risk than gay or straight women of being victims of domestic violence, violence that may be aggravated if an abusive partner becomes aware of the woman’s pregnancy as a repercussion of Hyde Amendment-imposed delays.

Another troubling potential repercussion of the Hyde Amendment is that it can “out” pregnant transgender men by forcing them into more visible gestational stages of pregnancy than would have resulted had they been able to access an early trimester abortion. Denying abortion access to low-income transgender men facing unwanted pregnancy consequently increases the likelihood that they will be subjected to pervasive discrimination and harassment.

During a September 23 hearing before the House Judiciary Subcommittee on the Constitution and Civil Justice, members of the U.S. House of Representatives discussed two pieces of abortion legislation, including a bill with over 100 sponsors that would rescind the Hyde Amendment.

During the hearing, Congressman Cohen emphasized that the Hyde Amendment was, as recognized by former Supreme Court Justice Thurgood Marshall, “designed to deprive poor and minority women the constitutional right to choose,” and Cohen admonished, “politicians should not be allowed to deny women the right to health care services because they are poor. It is time to rescind the Hyde Amendment.”

Congresswoman Chu also spoke of the importance of full reproductive health care access for all women and stated firmly, “we must end the Hyde Amendment.”

Congressman Conyers added his voice of support to rescind the Hyde Amendment, noting that the Amendment disproportionately affects women of color, and causes low-income women to have to choose between paying utility bills and buying groceries or obtaining a safe and legal abortion. Some women, he described, have to sell personal possessions to pay for their abortion care, and at times are driven to self-induced abortion or unsafe abortions with unlicensed practitioners because of the Hyde Amendment.

Finally, a witness testifying about the dangers of the Hyde Amendment, Kierra Johnson, Executive Director of URGE (United for Reproductive & Gender Equity), attested to the disproportionate effect of the Hyde Amendment on women of color, testifying, “The Hyde Amendment prevents low-income women from being able to make a decision about their health care.”

Johnson’s testimony was interrupted at one point by Congressman King, who described abortion as genocide against Black people, and compared abortion to puppy-killing, but Johnson eloquently responded with a reminder about how it is the Hyde Amendment, not reproductive health options, that is harmful to people of color.

The singling out and denial of full reproductive health care access for low-income Medicaid recipients is part of a larger pattern of ideologues dangerously imposing their opposition to reproductive and sexual autonomy on heterosexual women and members of the LGBT community through health care restrictions.

As Lambda Legal has documented in comments to proposed federal regulations, and about potential changes to those regulations, LGBT community members frequently experience discrimination in reproductive health care contexts. This may include, for example, the denial of infertility treatment for lesbians or hysterectomies for transgender men based on medical providers’ religious objections. For such intentional imposition of ideology-based barriers to medically-appropriate care — that target many of society’s most vulnerable patients, specifically including members of the LGBT community — to continue well into the 21st Century is unacceptable.

Lambda Legal has historically been a strong supporter of the federal government’s work to ensure that all people can receive affordable, high quality health care. To that end, we join the cry to repeal the Hyde Amendment.

The time to end this unfair obstacle to full reproductive health care, along with the multitude of similar efforts to create barriers for heterosexual women and members of the LGBT community to access health care, is now.