The Economics of Abortion Access in the US: Restrictions on Government Funding for Abortion Is the Post-Roe Battleground
Fried, Marlene Gerber, Conscience
"SARAH" IS A 31-YEAR-OLD ALASKAN mother who works full time, making $1,000 a month. She has no health insurance. When she was 15 weeks pregnant and unable to get an abortion in Alaska (where there are only three abortion providers and none perform abortions after 14 weeks), she had to use her rent money to fly to Washington state to get one. (1)
In 2005, more than three decades after the Roe v. Wade decision legalizing abortion, there are thousands of "Sarahs" each year--women of all ages, races and ethnicities, religions, women in prison, in the military, women who are single and married. The only thing these women have in common is that they cannot afford to pay for the abortions they need and want. This "Sarah" was one of the fortunate women who, with financial assistance from grassroots abortion funds and a friend who provided a place to stay, was able to overcome the barriers and obtain an abortion. Too many others in her situation are not as fortunate. While this network of abortion funds helps thousands of women each year, it cannot meet the enormous need of all the women like Sarah.
This problem is getting worse--even though abortion rates are dropping, they continue to rise for poor and low-income women. (2) Abortions are economically out of reach for so many women--primarily because of restrictive laws and policies. In order to more fully understand the financial barriers to abortion access, we need to examine the restrictions placed on abortion funding, the cost of abortion and the history of advocacy for abortion funding.
RESTRICTIONS ON GOVERNMENT FUNDING FOR ABORTION
The major reason for the economic barriers to abortion is the restrictions on funding through laws and public policies that began soon after Roe v. Wade and continue today. Prohibiting abortion funding by the federal government and the states has been a key target of the antiabortion movement. While its ultimate goal is to make abortions illegal for all women and under all circumstances, the primary strategy has been curtailing access through laws, regulations, executive orders, violence and even murder.
In the first years of legal abortion, federal Medicaid paid for about one-third of all abortions--294,000 in 1977. (3) However, since 1976 when Congress passed the Hyde Amendment prohibiting the use of Medicaid funds for abortion except in cases where the life of the pregnant woman is at stake, the federal government pays for virtually no abortions--267 in 1992. (4) Thirty-three states have also banned the use of state funding for abortions. In those states less than one percent of abortions are paid for with state funds, in contrast to 27 percent of abortions paid for by states without such restrictions. (5)
Even during the Clinton administration, when it seemed that the basic constitutional right to abortion was safe, access was eroded. Although Clinton omitted the Hyde Amendment from his 1993 budget proposal, his aides stressed that he wouldn't object to congressional restrictions on abortion funding so long as rape and incest were exempt. And in 1993, the Hyde Amendment was passed by a large margin, 255-178, although the restrictions were slightly eased to allow funding for abortion in cases of rape and incest, as well as cases where the woman's life was in danger.
When the conservatives swept into Congress in the 1994 "Gingrich Revolution," the Republicans stepped up their attacks on abortion funding. They barred abortion coverage from federal employees' health insurance, outlawed the use of military hospitals for abortion, banned federal prisons from funding abortion and eliminated 35 percent of aid to family planning programs, all in the name of protecting taxpayers and family. (6) This gain was offset by new restrictions added in 1997, which tightened the life exception and an added provision extending the restrictions to other health care benefits packages receiving federal funding. …