When Stephanie Loraine Piñeiro was 17, she found out she was pregnant. Loraine Piñeiro decided to have an abortion, but because she was Medicaid recipient — like more than 72 million other Americans — her insurance wouldn’t cover the costs of the procedure. So, Loraine Piñeiro picked up extra shifts at her restaurant job, earning $2.17 per hour in base pay, to earn the necessary $450. She was still in high school.
She was in that position thanks to the Hyde Amendment, a policy dating back to 1976 that prohibits the use of federal funds to pay for abortion, except in the case of rape, incest, or if the pregnant person’s life is in danger. “When I learned about the Hyde Amendment, I realized how much it affected my life,” Loraine Piñeiro tells Mic. “I had no idea how I would figure out how to pay for an abortion. Those types of resources aren't easily available.”
A group of women of color in Congress — led by Sen. Tammy Duckworth (D-Ill.) and Rep. Barbara Lee (D-Calif.) — hope to change that, with the Equal Access to Abortion Coverage in Health Insurance (EACH Woman) Act. The bill, introduced in March 2021, would reverse the Hyde Amendment and prohibit the federal government from meddling in insurance companies’ coverage of abortion care. It’s a crucial step in making abortion legal and accessible for everyone, but it’s perhaps most urgent for people of color, who are disproportionately impacted by the Hyde Amendment.
“Let's call this amendment what it is: It’s anti-choice and it's blatantly racist.”
“Let's call this amendment what it is: It’s anti-choice and it's blatantly racist,” Lee said about Hyde during a press conference ahead of the EACH Act’s introduction. Of the millions of non-elderly Americans on Medicaid, 20% are Black, according to a Kaiser Family Foundation estimate using Census Bureau data. Just over 29% are Hispanic, while 4.3% are AAPI and 1.1% are Native. Moreover, 2.6 million Native American and Indigenous people in the U.S. receive medical care through the federally-funded Indian Health Services, which means abortion coverage is also out of their reach as long as the Hyde Amendment is in place.
This isn’t the first time lawmakers have tried to get rid of Hyde. Lee, along with other Democratic members of Congress, introduced a version of the EACH Woman Act first in 2017 and again in 2019. Both times, it was DOA in the Republican-led House. But the power has shifted now, with Democrats in control of both the House and Senate. In addition to Lee, the bill has 127 co-sponsors in the House, and Duckworth has 22 fellow supporters in the Senate.
Lee, who worked as a staffer for former California Rep. Ron Dellums (D) when the Hyde Amendment first passed in the 1970s, said support for reversing Hyde is at an all-time high right now. The bill has the support of House leadership, she says, as well as the House Appropriations Committee — which is crucial because the Hyde Amendment is actually just a provision that is added to congressional spending bills, which the Appropriations Committee oversees. It’s not actually a law on its own, which means it doesn’t have to be formally repealed.
For his part, President Biden has gone back and forth on the Hyde Amendment, though he’s most recently expressed support for repeal. So it seems likely he would sign the EACH Act if it crosses his desk. But even with backing from Democratic congressional leadership and Biden, it’s unclear whether the bill can pass the Senate, where even one conservative Democrat could keep the bill from passing.
If the EACH Act does pass, it will certainly be cause for celebration, as reproductive rights advocates agree it is a crucial step forward. More than 130 national and state organizations support the bill under the coalition All* Above All. The public, too, supports ending the Hyde Amendment: Polls from 2019 show 62% of voters support Medicaid covering abortion.
Loraine Piñeiro, who is now 29 and the co-executive director of Florida Access Network, an organization that advocates for abortion access and helps fund abortion care, knows from experience how much good the bill could do. “People turn to us and other abortion funds for support, because they are unable to afford their abortions and are forced to navigate unnecessary restrictions” Loraine Piñeiro says. “The EACH Act will remove a huge financial hurdle.”
Even so, this bill isn’t a magic bullet when it comes to reproductive justice. Oriaku Njoku, co-founder and co-director of Access Reproductive Care-Southeast, which helps Southerners seeking abortions, agrees that the EACH Act “will definitely open up possibilities,” but stresses that removing the Hyde Amendment is only one of many necessary changes to guarantee the comprehensive care people need.
For example, Njoku tells Mic, state-level restrictions like mandatory waiting periods and the shrinking number of clinics would still exist even if the EACH Act passes. “How are people going to get to the clinics? How are they going to make these multiple-day trips? Who's going to take care of their kids? How are they going to eat while they make those trips?” Njoku asks, rattling off several practical hurdles to abortion access. “Logistically, there's still going to be things that need to happen.”
Consider how even if the EACH Act allows pregnant people to use federal money for abortions, it won’t address the cost of actually getting to the procedure — a trip to one of the few remaining clinics, possibly having to stay overnight, and finding child care for any existing kids all add up. So will taking time off of a job to make the trip, if you’re not entitled to paid time off. Meanwhile, persistent racial and gender pay gaps mean most women of color will be less likely to have savings to cover the extra costs.
Additionally, according to a 2016 study, providers in states that did not use state funds for abortion coverage often also did not accept Medicaid for the procedure, even when the pregnancy met the conditions for coverage under the Hyde Amendment. Providers claimed the billing process was difficult and reimbursement irregular.
“Our folks deserve better.”
If and when the Hyde Amendment is gone, “there's still going to be a need for us,” Njoku says. Abortion funds like hers help pregnant people meet the costs that Medicaid cannot cover, but that low-income people must pay due to increasingly restrictive state laws.
“Our folks deserve better,” says Njoku.
Democrats have the majority in the Senate — although the slimmest possible one — thanks to Vice President Kamala Harris’s tie-breaking vote. But for Harris to even have the opportunity to give the thumbs-up to the EACH Act, it would require all 50 Democratic votes to come in support of the bill — and that is not guaranteed.
In 2019, conservative Democratic Sen. Joe Manchin (W.Va.) voted yes in a procedural vote that allowed Republicans to make the language of the Hyde Amendment permanent. The No Taxpayer Funding for Abortion Act was ultimately referred to subcommittee by the House, but Manchin’s break with party lines is an indication the EACH Act might not have his support this time around. He, along with Democratic Sens. Bob Casey (Pa.) and Tim Kaine (Va.), also voted in support of Oklahoma Republican Sen. James Lankford’s attempted introduction of Hyde-like language to the coronavirus relief bill earlier this year.
Manchin ultimately voted for the relief bill without restrictions on money for abortion, but it seems clear that he does not support removing Hyde for good. He’s also generally proved himself comfortable stymying Democratic priorities. If one white man stops the EACH Act from passing, it’ll be a dark irony considering the racial inequities the bill is seeking to address. (And that doesn’t even count the 50 Republicans in the Senate, 47 of whom are white.)
But if and when the EACH Act enshrines insurance coverage for abortions into law, Loraine Piñeiro will turn her full attention to the next goal: “pushing back on abortion stigma, informing the community, [and] dispelling myths that folks have about reproductive health care.” In the end, funding is just one piece of the puzzle. But once it falls into place, the rest of the picture can start to come together.