Journal of Science Policy & Governance
Volume 21, Issue 01 | October 17, 2022

Policy Memo: Hyde and Seek: Searching for Solutions to The Hyde Amendment’s Financial Barriers to Abortion

Lauren Hutnik (1), Ashley Zimmermann (1), Lauren Naliboff (2), Kristyn M. Brandi (2)  
  1. Rutgers New Jersey Medical School, Newark, NJ
  2. Department of Obstetrics, Gynecology and Reproductive Health, Rutgers New Jersey Medical School, Newark, NJ​
​
Corresponding author: lah291@njms.rutgers.edu​
Keywords: abortion; reproductive rights; Hyde Amendment; EACH Act; medical policy; family planning
https://doi.org/10.38126/JSPG210105​

Executive Summary

The Hyde Amendment (Hyde) hinders abortion access to people who can become pregnant (we will refer to this cohort henceforth as “women” and recognize that not all people who can become pregnant identify as such) whose health insurance is funded by the federal government. In the forty-five years since its inception, the Hyde Amendment has disproportionately affected marginalized women. The conservative movement has augmented disparities in healthcare by passing incremental laws to restrict abortion access, including but not limited to, gestational age and specific procedure limitations, waiting periods, parental consent, and Targeted Regulation of Abortion Providers (TRAP) laws. With Roe V. Wade overturned with the Dobbs V. Jackson ruling (Dobbs), access to abortion is more restricted than it has been in the past 50 years. Eight states have completely banned abortion and many other states offer very limited exceptions to the ban. Now, more than ever, it is essential that funding is not a barrier to care in the states that continue to protect abortion rights. Our first recommendation calls for states to be held accountable to the minimal federal requirements set forth by Hyde and create a confidential forum for women to report informal barriers to care. Furthermore, we endorse the passing of the Equal Access to Abortion Coverage in Health Insurance Act (EACH Act), which would permanently end the renewal of Hyde. Our final recommendation calls on the government to create legislation that permanently institutes national mandatory guidelines for emergency obstetric care. These steps could counteract the increasingly restrictive encroachment on abortion rights. ​

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Background header image courtesy of The New York Times
Lauren Hutnik is a fourth year medical student at Rutgers New Jersey Medical School and a candidate for the global health distinction track. Lauren earned a B.A. in Biology at New Jersey Institute of Technology and was excited to continue her education in Newark and serve the Newark community.  She is passionate about advocating for equitable reproductive rights and engaging in discourse about the intersection of medical history and women’s health.  

​Ashley Zimmermann is a fourth year medical student at Rutgers New Jersey Medical School. In 2017, she graduated from Georgetown University where she earned a dual B.S. in Neurobiology and Mathematics. She is interested in high-risk pregnancies as well as reproductive rights advocacy. 

Dr. Lauren Naliboff is an assistant professor of Obstetrics and Gynecology at Rutgers, New Jersey Medical School in Newark, NJ where she serves as the director of the Ryan Residency Training program and the director of family planning services. She is a member of the Society of Family Planning and a Fellow of the American College of Obstetricians and Gynecologists. Her interests include complex contraception and abortion and training the next generation of physicians in these important skills.

Dr. Kristyn Brandi (she/her/ella) is an OBGYN, family planning specialist and steadfast advocate of reproductive autonomy for BIPOC people who dismantles oppressive structures in reproductive health to help every person achieve their own reproductive justice. She completed medical school and residency at Rutgers - New Jersey Medical School. She completed a Family Planning Fellowship and a Master’s in Public Health at Boston University. Her research interests are contraceptive coercion and racism in health care. She serves as Board Chair of Physicians for Reproductive Health, sits on sub-committees for the Society of Family Planning and is a founding member of CERCL-FP.

Acknowledgements
​The Authors would like to thank Science Policy and Advocacy at Rutgers (SPAR) and Rutgers-New Jersey Medical School for supporting this work. 

Disclaimer
The views expressed in this paper are the Authors’ opinions and are independent of Rutgers- New Jersey Medical School.

References

  1. ACLU. 2022. ”Access Denied: The Origins of the Hyde Amendment and Other Resitrctions on Public Funding for Abortion” https://www.aclu.org/other/access-denied-origins-hyde-amendment-and-other-restrictions-public-funding-abortion 
  2. Baker, Carrie N. 2021. “Abortion Restrictions Cost Women, Businesses, and States $105 Billion Each Year”. Institute for Women’s Policy Research. https://iwpr.org/media/press-hits/abortion-restrictions-cost-women-businesses-and-states-105-billion-each-year/?utm_source=rss&utm_medium=rss&utm_campaign=abortion-restrictions-cost-women-businesses-and-states-105-billion-each-year
  3. Finer, Lawrence. B., Mia R. Zolna.   2016. “Declines in Unintended Pregnancy in the United States, 2008-2011”. The New England journal of medicine, 374(9): 843–852. https://doi.org/10.1056/NEJMsa1506575
  4. Foster, Angel M., Grady Arnott, Simone Parniak, Kathyrn J. LaRoche, James Trussell.2015. “No Exceptions: Documenting the Abortion Experiences of US Peace Corps Volunteers.” American journal of public health 105(1):41-48. https://doi.org/10.2105/AJPH.2014.302358
  5. Grindlay, Kate., Susan Yanow, Kinga Jelinska, Rebecca Gomperts, Daniel Grossman. 2011. “Abortion Restrictions in the U.S. Military: Voices from Women Deployed Overseas”. Women's Health Issues, 21(4): 259-265. https://doi.org/10.1016/j.whi.2011.04.014
  6. Guttmacher Institute. 2021. “Medicaid Coverage of Abortion.” https://www.guttmacher.org/evidence-you-can-use/medicaid-coverage-abortion#:~:text=Under%20the%20Hyde%20Amendment%2C%20federal,rape%2C%20incest%20or%20life%20endangerment.
  7. Guttmacher Institute. 2022. “13 States Have Abortion Trigger Bans- Here’s What Happens When Roe is Overturned” https://www.guttmacher.org/article/2022/06/13-states-have-abortion-trigger-bans-heres-what-happens-when-roe-overturned
  8. Hayes, Jeff.,  Michelle Hawks Cuellar. 2021. “The Costs of Reproductive Health Restrictions: An Economic Case for Ending Harmful State Policies”. Institute for Women’s Policy Research. https://iwpr.org/wp-content/uploads/2021/05/Costs-of-Reproductive-Health-Restrictions_Research-Summary.pdf
  9. Jones, Rachel K., Jenna Jerman. 2017. “Characteristics and Circumstances of U.S. Women Who Obtain Very Early and Second-Trimester Abortions”. PLoS ONE. https://doi.org/10.1371/journal.pone.0169969
  10. Jones, Rachel K.,Meghan Ingerick, Jenna Jerman. 2018. “Differences in Abortion Service Delivery in Hostile, Middle-Ground, and Supportive States in 2014”. Women’s Health Issues. 28(3). https://www.whijournal.com/article/S1049-3867(17)30536-4/fulltext
  11. Miller, Sarah, Laura R. Wherry, Diane G. Foster. 2020. “What happens after an abortion denial? A Review of Results from the Turnaway Study.” AEA Papers and Proceedings, 110:1-6. http://www-personal.umich.edu/~mille/TurnawayPP.pdf
  12. Miller, Sarah, Laura R. Wherry, Diane G. Foster. 2022. “The Economic Consequences of Being Denied Abortion”. National Bureau of Economic Research. https://www.nber.org/system/files/working_papers/w26662/w26662.pdf
  13. Minton, Sarah., Linda Giannarelli. 2019. “Five Things You May Not Know About the US Social Safety Net”. Urban Institute. https://www.urban.org/sites/default/files/publication/99674/five_things_you_may_not_know_about_the_us_social_safety_net_1.pdf
  14. Morcelle, Madeline. 2021. “Fostering Equitable Access to Abortion Coverage: Reversing the Hyde Amendment.” https://healthlaw.org/resource/fostering-equitable-access-to-abortion-coverage-reversing-the-hyde-amendment/
  15. Myers, Caitlin K., Morgan Welch. 2021.“What can Economic Research Tell Us About the Effect of Abortion Access on Women’s Lives?”. Brookings. https://www.brookings.edu/research/what-can-economic-research-tell-us-about-the-effect-of-abortion-access-on-womens-lives/
  16. Roberts,  Sarah C.M., Heather Gould, Katrina Kimport, Tracy A Weitz, Diana Greene Foster. 2014. “Out-of-Pocket Costs and Insurance Coverage for Abortion in the United States.” Women's health issues.  24(2).  https://pubmed.ncbi.nlm.nih.gov/24630423/
  17. Salganicoff, Alina., Laurie Sobel, Amrutha Ramaswamy.“The Hyde Amendment and Coverage for Abortion Services”. KFF.org. March 2021. https://www.kff.org/womens-health-policy/issue-brief/he-hyde-amendment-and-coverage-for-abortion-services/
  18. Truven Health Analytics. 2013. “The Cost of Having a Baby in the United States”. https://www.nationalpartnership.org/our-work/resources/health-care/maternity/archive/the-cost-of-having-a-baby-in-the-us.pdf
  19. U.S. GAO 19-159. Government Accountability Office. 2019. “Medicaid: CMS Action Needed to Ensure Compliance with Abortion Coverage Requirements.” 
  20. The White House 2022. “Fact Sheet: President Biden to Sign Executive Order Protecting Access to Reproductive Health Care Services.
  21. https://www.whitehouse.gov/briefing-room/statements-releases/2022/07/08/fact-sheet-president-biden-to-sign-executive-order-protecting-access-to-reproductive-health-care-services/​
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