Forty Years of Restrictions on the Health-Care Rights of Low-Income Women

By Kate Vlach

September 30 marks the fortieth anniversary of the passage of the Hyde Amendment, a provision that has drawn a line between rich and poor when it comes to the constitutionally protected right to abortion.[1] Named after its main proponent, Rep. Henry Hyde, the Hyde Amendment bans federal Medicaid dollars from paying for abortion services in almost all cases.[2] The law’s practical effect means that women with financial resources have the right to choose when and whether to become parents, while women in poverty are left with a right in name only. If a low-income woman cannot afford the cost of an abortion procedure, she is denied a meaningful choice about whether to carry a pregnancy to term.

Medicaid is a publicly funded insurance program designed to meet the health needs of those who cannot afford medical care.[3] Yet, in Harris v. McRae, the Supreme Court held that Congress could exclude medically necessary abortion services from the Medicaid program under the Hyde Amendment.[4]According to the Court, this categorical denial of health services did not violate the Constitution because the freedom to choose does not come with “a constitutional entitlement to the financial resources to avail [one]self of the full range of protected choices.”[5]  It reasoned that “although government may not place obstacles in the path of a woman’s exercise of her freedom of choice, it need not remove those not of its own creation. Indigency falls in the latter category.”[6]

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