#hyde amendment

Carter Sherman at The Guardian:

Donald Trump on Friday signed an executive order reinstating a federal rule known as the “Mexico City policy” which halts US aid from flowing to groups that provide abortion services, counsel people about the procedure or advocate for abortion rights overseas. The policy, which was first instituted by Ronald Reagan in 1984, is typically implemented whenever a Republican president wins the White House and rescinded whenever a Democrat wins. But this whiplash has major implications for abortion and reproductive healthcare around the world. Historically, the revival of the Mexico City policy affects up to about $600m of international aid. During his first term, however, Trump dramatically expanded the scope of the Mexico city policy, which abortion rights supporters call a “global gag rule”. Rather than applying the policy only to family planning assistance, as was typical, the Trump administration applied to it to assistance for organizations that offer a range of health services around the globe – leading the policy to affect billions of dollars’ worth of aid. According to the Guttmacher Institute, which tracks abortion restrictions and their impact, the policy can cut off access to contraception, lead women to seek out unsafe abortions and cause tumult within the non-governmental groups that depend on US aid to keep their programs going. “Reinstating the Mexico City policy will have deadly consequences for people across the globe,” Rebecca Hart Holder, president of Reproductive Equity Now, said in a statement. “The United States is a vital partner to healthcare providers and organizations around the world, and robbing those frontline providers of their ability to provide the full spectrum of reproductive healthcare, and even information about people’s options, will result in people losing their lives to pregnancy complications.” Trump also signed a second executive order affirming a longstanding US policy that prohibits the use of federal funds to pay for abortions. That order also rolled back two executive orders penned by Joe Biden, which sought to protect abortion access in the wake of the 2022 overturning of Roe v Wade. The fall of Roe led a wave of states to ban the procedure. [...] Abortion rights supporters had anticipated the return of the Mexico City policy, but are still awaiting news on whether Trump will allow widespread enforcement of the Comstock Act, a 19th-century anti-vice law that could be used to effectively ban abortion nationwide.

Issued January 24, 2025.

One particularly maddening aspect of our current politics is that Democrats feel beholden to rules that Republicans feel entitled to burn. Democrats creatively interpret rules in ways that inevitably frustrate their ability to wield power, while Republicans creatively use their power to get around the rules. Democrats invent constraints on themselves, ostensibly to restrict Republicans, while these same Republicans long ago decided to use maximal power to achieve their goals.

Abortion services should be provided on federal lands; abortion providers should be deputized by the federal government to protect them from state bounty hunters; people seeking abortion services should be granted safe passage to these facilities, or out of state if need be.

But every time I or anybody else makes arguments for strong executive action to protect people from Republicans, somebody, often a liberal or Democrat, says that the Hyde Amendment prevents the federal government from funding abortions. Anybody who lived through the Trump administration should know that the law rarely outright “prevents” things, and “funding” is a matter of interpretation, but Twitter is awash in so many Hyde takes you’d think it was the 28th Amendment to the Constitution.

So let’s talk about the Hyde Amendment and what it says. Because when you really look at it, you’ll see it’s a paper tiger: While it is harrowingly effective at preventing poor and vulnerable people from getting the health care they need, it is easily shredded by a committed executive at the head of a massive administrative state.

The Hyde Amendment was proposed in 1976, three years after the landmark decision in Roe v. Wade, by Illinois Representative Henry Hyde, a white male Republican who didn’t like abortion rights. He proposed a rider to the funding bill for the Department of Health, Education, and Welfare (now called the Department of Health and Human Services) that prohibited federal Medicaid funds from being used to pay for women to get abortions.

The amendment passed both houses of Congress, and has been a feature of every budget bill since. The amendment and its modern versions prevent people enrolled in Medicaid or other government-run programs from using those insurance dollars for abortion procedures, except in the cases of rape or incest, or in cases where the life of the mother is at risk. Hyde Amendment–esque language has since been inserted into a number of health care bills, including the Affordable Care Act.

That’s it, that’s the whole thing.

This is not to say the Hyde Amendment isn’t a smoldering hunk of misogynist garbage that restricts access to abortion for millions of mostly poor women (often with the complicity of the Democratic Party, which is ostensibly elected to protect impoverished people). But, this boogey-man that Democrats argue constrains the commander in chief from providing health care to US citizens is not and has never been some insurmountable prohibition on federal government action.

The idea that the Hyde Amendment restricts all federal action for abortion services is a clear misreading of the amendment. The Hyde Amendment does not, for instance, prevent the government from allowing people in federal prisons to seek abortion services. It does not prevent people being held in immigration custody from being allowed to seek abortion services. And the astute reader will notice that exceptions in the case of rape and incest are written right into the regulation. It is simply inaccurate to say that the amendment, in its current form, prevents the federal government from doing anything that could lead to an abortion. The Hyde Amendment is about insurance coverage.

Those are just the facts. What one should do with the knowledge of those facts is open for interpretation. What one should do with knowledge of those facts while in charge of the executive branch of government is still another thing. I will stipulate that everything I am about to say will be disputed by Republicans. If that matters to you, I do not know how to help you. I do not allow my thinking to be cabled within the confines of “what Republicans agree with” because my desire to live in a pluralistic society built on justice and equality outweighs my desire to be liked by The New York Times. But in my opinion, this now-boilerplate budget amendment cannot prevent the might of the executive office from fighting for women’s rights. Here are four obvious workarounds.

The point of all of these suggestions is that Biden and the Democrats should use power maximally while they have it to prevent the atrocity of people being forced to give birth against their will. The argument that executive inaction is not only justified but required by a 1976 budget rider is intellectually dishonest, and literal evidence that one doesn’t perceive forced birth as a fundamentally illegitimate use of state power.

There is no law, yet, that prevents the federal government from helping rape survivors. There is no law, yet, that requires the federal government to throw up its hands every time it hits the borders of Texas.

There will be laws to do both of those things should Republicans take back Congress and the White House, because Republicans use power when they have it. Maybe Democrats should take a page out of the GOP playbook and try out the whole “using power” thing, before it’s too late for women, the LGBTQ community, and democracy.

Words are powerful. One heart-to-heart with your family could influence their perspective on the issues you care about — like abortion access. In turn, your family could share what they learn with their wider circles. That ripple effect is key to widespread social change.

Are abortion rights important to you? Do you feel safe talking about it with your family? Here are 8 tips for starting a conversation about abortion rights at a virtual dinner. 

At the end of your convo, remember the most important part: expressing gratitude.

Tip #1: Welcome your family into the conversation.

If your family members are taking turns to share what’s on their mind, use your turn to share that you’ve been thinking about abortion rights.

Note the values you and your family share, such as the core values of love, fairness, and compassion.

Say something like, “It’s because I care so much about others that I believe decisions on whether to choose adoption, end a pregnancy, or raise a child must be left to each individual — not to politicians, who can’t know each individual’s situation.”

Ask if it’s OK to start a discussion about the laws restricting access to safe, legal abortion. If people are up for it, proceed to Tip #2. 

Tip #2: Fire up some facts about abortion access.

The Supreme Court case Roe v. Wade affirmed the constitutional right to abortion in 1973. 

Today, the vast majority of Americans — 77% — support keeping abortion legal and don’t want Roe v. Wade overturned. 

ASK: “Do you believe everyone should be able to access the full range of reproductive health care, no matter how much money they make or where they live?”

Tip #3: Explain who gets hurt by bans and restrictions on abortion.

Restrictions on abortion have created costly barriers to care, such as forcing patients to travel long distances to the closest abortion provider, and to take time off work to comply with medically unnecessary waiting periods and multiple appointments.

Since nearly 6 out of 10 people who have abortions are already parents, obtaining an abortion requires many patients to arrange for child care.

Restrictions push safe, legal abortion out of reach for people who can’t afford these costs. It’s hardest on people who already face barriers to health care overall, including people with low incomes, people who live in rural areas, and Black and Brown people. 

Tip #4: Note challenges to abortion access in the states.

Since 1973, states have enacted over 1,000 abortion restrictions — and nearly 40% of those restrictions became law in just the past decade.

Because of abortion restrictions, five states — Mississippi, Missouri, North Dakota, South Dakota, and West Virginia — have only 1 abortion provider left.

11 state governments used COVID-19 as a pretense to temporarily ban abortion by labeling it “non-essential” health care during the pandemic.

Tip #5: Explain why abortion should be available to all, not just those who can afford it — and why the Hyde Amendment is both racist and discriminatory.

The Hyde Amendment is one of the longest-running federal restrictions on abortion access. Since 1976, Hyde has barred people from using Medicaid and other federal health coverage for abortion.

Nationwide, Medicaid covers 1 in 5 women of reproductive age. Of those 16.1 million Medicaid participants, 55% live in states where Hyde forces them to pay for abortion out of pocket.

Hyde is particularly harmful to people with low incomes, people of color, and young people — who, because of systemic discrimination and a history of economic barriers, disproportionately use Medicaid for their health care coverage.

ASK: “Do you believe abortion should be covered in health care plans, no matter who provides the insurance?”

Tip #6: Explain what’s happening in the courts.

Right now, there are at least 19 abortion-related cases one step away from the U.S. Supreme Court. It’s possible that safe and legal abortion access could go back to where it was before Roe v. Wade.

If Roe v. Wade is overturned, individual states will decide whether abortion is legal. That means 1 in 3 women of reproductive age — more than 25 million women — would be living in states without legal abortion.

Banning abortion won’t stop abortion. But it will stop people from accessing safe, legal abortion. The cost: pregnant people’s health, and even their lives.

Tip #7: Advocate for policies that the federal government should support in order to protect and expand abortion access, such as:

Ending the Hyde Amendment

Changing rules and regulations to protect people from discrimination by health care providers and insurers

Lifting restrictions on private insurance for abortion so that fewer people are forced to pay out-of-pocket for safe, legal abortion

Tip #8: Say ‘Thank You’

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A grassroots organization raises money for an abortion fund entirely for Indigenous people while also raising awareness.

An Albuquerque film screening that served as a fundraiser for Indigenous Women Rising raised $300 late last month. The money goes to support an abortion fund for Native people in the U.S. and Canada. Since the beginning of this year alone, the IWR abortion fund has helped 18 people get an abortion. The fund can help with the cost of the abortion itself. IWR’s abortion fund also helps with other practical support such as gas, food and childcare expenses related to an abortion.

But Rachel Lorenzo, co-founder of IWR and who is of Laguna Pueblo and Mescalero Apache, said that in addition to raising money, the organization’s staff wanted to raise consciousness by getting new people, especially white people, to the IWR event because abortion care is “more nuanced for Native people.”

“Join us in dismantling those barriers,” Lorenzo said.

Although health care is a Native American right through treaties with the federal government, the National Congress of American Indians reported that in fiscal year 2017, the Indian Health Service spent $3,332 per capita expenditures for patient health services while national spending on healthcare is $9,207 per person.

The Hyde Amendment, a legislative provision that has been reenacted every year since the 1970s, prevents the use of federal dollars for abortion except in instances of rape, incest or to save the life of the mother. Because of it, Indian Health Service cannot provide abortions for Indigenous people.

Much of the state’s reservation land is far from New Mexico’s major cities where the few abortion clinics exist, further complicating abortion care when time matters.

“The abortion debate isn’t just about Roe v. Wade. We want people to understand that the big thing is Roe already hasn’t fulfilled its promise to Native people,” Lorenzo said.