After 48 years, Roe v. Wade appears to be on the brink of being overturned, with a 6-3 conservative-liberal majority on the U.S. Supreme Court, which would free states to decide when, where and whether safe, legal abortion is available. Twenty-one states have laws that could restrict abortions.
When and if this happens, many women of color may not notice much difference. That’s because, for too many, access to abortion is a legal right that cannot be exercised. Black women, in particular, have been left with the false promise of “rights” that we cannot always exercise.
For 44 years, the Hyde Amendment has barred federal funding for abortion under Medicaid and numerous other federal programs. Even the Affordable Care Act includes language applying similar limitations on abortion coverage to plans for women who receive income-based health care subsidies. Forcing women who access health care coverage through the government to pay out of pocket disparately impacts Black women, who are more likely to experience pay discrimination and inequity, making us more likely to need Medicaid coverage for health care.
Nationally, 31 percent of Black women of reproductive age are enrolled in Medicaid, compared to 16 percent of white women. The Hyde Amendment’s ban on abortion care coverage under Medicaid means that Black women and girls who need abortion care are either prevented from accessing it entirely, or forced to delay care while raising money to cover costs. Either scenario is inhumane and threatens both their personal and economic well-being. Research suggests that individuals who are denied access to needed abortion care are more likely to fall into poverty or long-term economic insecurity.
Forcing anyone into prolonged pregnancy and childbirth against their will is not only an attack on a basic human right, it is also an especially callous act of violence against Black women who are already targeted by a deadly maternal health crisis. Black women in the U.S. are three to five times more likely to experience a pregnancy-related death than white women. This is true across all socioeconomic and geographic lines.
While these disparities appear most strongly linked to the systemic racism that all Black women experience, the risks are compounded for those who need publicly-funded health care. Further, while low-income people who rely on Medicaid for health care are more likely to experience gaps in contraception, which directly puts them at increased risk of unintended pregnancy, Black women and girls are disparately likely to experience contraception gaps, regardless of income level.
The legal protections that Roe v. Wade offers are the floor, not the ceiling, of what’s needed to enshrine universal reproductive rights. It never will be enough to fight to preserve the rights promised under Roe without fighting just as hard to remove barriers preventing that promise from ever reaching all women. The Hyde Amendment and the systemic racism it espouses remain among the greatest of these barriers. Forty-four years of a two-tiered system of rights that relegate low-income women — many of whom are people of color — to second-class status, is 44 years too long.
Change is overdue. The Biden-Harris administration and the new Congress must deliver on their promises to protect women’s reproductive rights by protecting the rights of all women. House Speaker Nancy Pelosi (D-Calif.), Senate Majority Leader Chuck Schumer (D-N.Y.) and President Biden must abolish the Hyde Amendment and expand access to quality reproductive health care for all women — especially the Black women who helped put them in office.
Marcela Howell is president and CEO of In Our Own Voice: National Black Women’s Reproductive Justice Agenda. Follow her work on Twitter at @BlackWomensRJ.