What is the Hyde Amendment?

The Hyde Amendment is a legislative provision barring the use of federal funds to pay for abortion unless the person’s life is in danger or the pregnancy results from incest or rape. The Hyde Amendment was introduced by Congressman Henry J. Hyde of Illinois as part of the appropriations bill for what is now the Department of Health and Human Services. It was first passed by Congress in 1976, three years after Roe vs. Wade legalized abortion, and was implemented in 1977. It has been renewed every year since then. In many ways, the Hyde Amendment is the grandfather of all abortion restrictions and has made abortion a privilege rather than a right.

The Hyde Amendment significantly impacts those insured by Medicaid, the nation’s main public health insurance program for low-income Americans, as well as federal workers, Peace Corps volunteers, women in federal prisons, Native Americans, and members of the military, by preventing them from using their insurance to end an unintended pregnancy.

TO LEARN MORE about the Hyde Amendment and its impact on families across the U.S., read this from the Kaiser Family Foundation. Also read this account about Rosie Jimenez, the first victim of the Hyde Amendment, and how the law continues to target low income families.

Are Medicaid recipients in all 50 states affected by the Hyde Amendment?

No. The Hyde Amendment only restricts the use of federal dollars. Medicaid is a joint federal and state program and states can cover abortions with their share of Medicaid funds. But most states don’t. In 2019, only 16 states extend abortion coverage to people enrolled in Medicaid through state budgets, and 6 additional states cover abortion only when a person's health is at risk.

It is difficult to assess exactly how many women can’t access abortion because of the Hyde Amendment, but supporters and opponents agree that the number is substantial. According to the Guttmacher Institute, “among women with Medicaid coverage subject to the Hyde Amendment who seek an abortion, one in four are unable to obtain one because of lack of abortion coverage.”

What does an abortion cost?

Nationwide, the cost at health centers ranges from about $350 to $950 for abortion in the first trimester. The cost is usually greater for a second-trimester abortion. Hospital costs are even higher. By 24 weeks gestation, the cost can be upwards of $3,000. Costs vary depending on how long a person has been pregnant and where they go, and do not include incidental costs like child care, transportation, and lost income.

Time is of the essence in being able to obtain an abortion: as a person struggles to raise funds and the pregnancy advances, the cost of the procedure goes up. Note that the Federal Reserve released research in 2019 showing that roughly 4 in 10 Americans do not have the means to cover a $400 emergency expense.

Don’t abortion clinics have sliding scales?

Yes, and many patients who are struggling financially qualify for a discount. But most callers to funds still have to raise at least $350 in a very short period of time.

What is an abortion fund and how does it work?

The Women’s Medical Fund, where Abortion Helpline, This is Lisa was filmed, is one of many abortion funds. According to the National Network of Abortion Funds, there are more than 70 abortion funds across the country. There are many models and sizes of funds, but the funds’ mission is to fill the financial gap for individuals who cannot afford the cost of an abortion. Many funds are staffed by volunteers and rely on individual donations to sustain their work. Some, like the fund in Philadelphia featured in Abortion Helpline, This is Lisa, rely on a combination of professional staff, volunteers, and work-study students. Some funds are run by a health facility itself. Some funds transfer money directly to the abortion provider, some to the patient; some funds make loans but most give outright support. Some cover the entire cost of the procedure, some—in order to help more people —only cover a portion. When funds receive large requests, to cover procedures later in pregnancy or medically complicated procedures, they often turn to several national organizations that have emergency funds available.

What are some other barriers to equal access to abortion for all?

The majority of people seeking abortions already have at least one child they are caring for. So besides the cost, there are the logistics: transportation, child care, work, and sometimes an uncooperative or unsupportive partner or family. Residents of many states have to travel great distances to reach an abortion provider. Many states have a waiting period, or mandatory informed consent sessions, requiring patients to make not one but two trips to the provider’s office. And of course there is the stigma; many patients struggling with all the logistics to get themselves to an abortion provider are confronted by protestors who often present misinformation and question and criticize their decision-making.

What can I do to help close the gap?

Give to your local fund, or to any fund. Here’s a list of funds. The Women’s Medical Fund, featured in Abortion Helpline, This is Lisa, is just one of many funds doing this important work. But, because abortion funds mayl never have enough funds to fill the gap, you can join in the work of the organizations that are fighting to change unjust policies. [Go to our ADVOCACY page for more information.]

What is the impact of unequal access to abortion?

The number of women potentially affected by the Hyde Amendment is substantial, according to the Gutttmacher Institute. Of women aged 15–44 who are enrolled in Medicaid, 60% live in the 35 states and the District of Columbia that do not cover abortion, except in limited circumstances. This amounts to roughly seven million women of reproductive age, including 3.4 million who are living below the federal poverty level.

The Hyde Amendment falls particularly hard on women of color. Because of social and economic inequality linked to racism and discrimination, women of color are disproportionately likely to be insured by the Medicaid program: Thirty percent of black women and 24% of Hispanic women aged 15–44 are enrolled in Medicaid, compared with 14% of white women.