Abortion as a race issue: How the Hyde Amendment keeps people of color in poverty

If you’re a living, breathing woman in America, you’re probably aware of all the restrictions and barriers placed on abortion since Roe v. Wade. One of the biggest, the Hyde Amendment, has prevented women on Medicaid from using their government-funded insurance to pay for the procedure since 1977, except in cases of rape, incest, or when the mother’s life is in danger. Obviously, Hyde is seen as a class barrier preventing poor women from accessing abortion, but it’s also important to look at how the Hyde Amendment is a race issue. Because however you approach the topic, it unavoidably is.

Let’s start here: People of color are more likely to be poor in the U.S.: 26 percent of African-Americans and 24 percent of Hispanics were living below the poverty line in 2014, compared to 10 percent of non-Hispanic whites. On top of that, women are more likely to live in poverty than men, so women of color are at the highest risk of being on Medicaid. According to data from the Guttmacher Institute, 30 percent of black women and 24 percent of Hispanic women ages 15–44 are enrolled in Medicaid, while only 14 percent of white women in the same age group are. It’s not hard to see how inability to use Medicaid to pay for abortions is a hindrance felt substantially more by women of color.

On top of being more likely to need Medicaid, women of color also disproportionately seek abortions. According to data from the Centers for Disease Control and Prevention (CDC), black women sought 36 percent of all abortions from 1997 to 2006, despite black people consistently making up about 12 percent of the population.

So, we know women of color are far more likely to be on Medicaid and to need/want an abortion, meaning just on the surface, Hyde disproportionately limits their reproductive rights, which is egregious enough on its own, but limited access to abortions for the people who are most likely to need not only an abortion but also help subsidizing their medical costs is not a situation that exists in a vacuum. All of these conditions are, indeed, profoundly connected to the overall economic mobility of women (and families and communities) of color — or rather, lack thereof.

An abortion costs about $500 on average, which must be paid out of pocket if your insurance (i.e., Medicaid) won’t cover it. Most people don’t just have a full $500 lying around they don’t need for rent, bills, or, food, but for someone making $1,000 a month, that’s literally half the money they have to survive. Actually, after all their normal expenses, the poor have an “extra” $367 dollars on average for the year, according The Atlantic.

“When I get hurt or sick, the first thing I think about isn’t how can I pay for this or who can I borrow money from, but that’s the first thing [women seeking an abortion] think about,” said Renee Bracey Sherman, a NARAL Pro-Choice America board member and the senior public affairs manager at the National Network of Abortion Funds (NNAF). “I think that’s just a sad state of affairs in this nation because we have great health care but people have to sit and think about their finances first.”

For women who have to save up to pay to end a pregnancy, the cost often goes up as time passes. Tiffany, a 30-year-old Latina woman from Flint, Texas shared her experience in the amicus brief the NNAF submitted to the Supreme Court while fighting Texas’ restrictive HB2 law. The brief read:

“After Tiffany became aware of her pregnancy at 11 weeks gestation, she obtained an estimate of the cost of an abortion and learned that she would need time to save money to afford the procedure because she was uninsured. After she saved $300, she sought to schedule an appointment in Dallas, encountering another delay in obtaining an appointment due to congestion at the clinic. By the time Tiffany had raised $300 and obtained an appointment in Dallas, she had reached 18 weeks gestation and the cost of the abortion had risen to $1,700, well beyond the sum she could afford or raise.”

Another little-known fact is that most women who get abortions are already mothers. According to data from the Guttmacher Institute, 61 percent of those who terminate a pregnancy already have at least one child and 34 percent have more than one. This means they’re having to try to save money for an abortion while also trying to feed their kids.

Yamani Hernandez, executive director of the NNAF, told The Frisky:

“When people call us, we hear about the struggles they go through when insurance won’t cover abortion. People are forced to choose between their abortion and rent, childcare, groceries, and more. Often, they’re struggling to make ends meet for the children they are already parenting. They may also feel more pressure to get an abortion because of economic situations.”

Of course, TRAP laws — all the seemingly small restrictions placed on abortion clinics and providers at the state level — only make the situation worse. When a woman has to travel to an abortion clinic because there isn’t one in her area and is forced to attend multiple appointments or wait a certain number of hours before having the procedure, she has to come up with travel and lodging funds on top of the initial hundreds of dollars. She also has to take off work to do that, and since women of color are more likely to hold low-wage jobs with no paid time off, they lose income as well as the money they have to spend. It’s a system that disproportionately affects women of color at every turn.

Let’s get back to the Hyde Amendment. It’s the first monetary obstacle and the only one universal across state lines. The poor women who come up with the money and have an abortion are set back financially, while the women who aren’t able to come up with the money are forced to carry the pregnancy to term and continue spending money to raise a child. Having a baby is obviously a major expense (or hadn’t you heard?), making it more difficult to save money and climb out of poverty.

Either way, Hyde creates an additional financial strain on poor women of color already struggling, which inevitably effects those around them as well. “This punishment doesn’t just affect the person having an abortion. There are ripple effects throughout families and communities for people of color,” Hernandez said. Maybe the children she already has suffer because the family’s money had to go toward an abortion. Maybe the woman is forced to ask others for money to pay for the abortion or to help raise the child she had because she couldn’t afford an abortion. Maybe multiple women in a community go through the same thing, creating an even bigger financial burden.

Dr. Willie Parker, an ob-gyn who performs abortions in Georgia, Alabama, and Mississippi’s only abortion clinic, has trouble seeing how the easily drawn connections between Hyde and already economically disadvantaged populations doesn’t elicit more pressing urgency to change: “To me, it would seem that the immorality of creating two tiers and devaluing the lives of poor women who are mostly women of color should have been transparent and problematic for all policymakers.”

Despite the Hyde Amendment’s clear role in keeping women in poverty, lawmakers continue to ignore its detrimental effects on people of color, which unfortunately, is very much typical of the pattern of the routine creation and upholding of legislation that reinforces economic inequalities across racial lines.