THE EQUAL ACCESS TO ABORTION COVERAGE
IN HEALTH INSURANCE (EACH) ACT:
Groundbreaking Legislation for Abortion Justice
The EACH Act is bold legislation to reverse the Hyde Amendment and related abortion coverage restrictions. The bill has been introduced by Representatives Barbara Lee (D-CA), Ayanna Pressley (D-MA), Diana DeGette (D-CO), and Jan Schakowsky (D-IL) in the U.S. House and Senators Tammy Duckworth (D-IL), Patty Murray (D-WA), and Mazie Hirono (D-HI) in the U.S. Senate.
The EACH Act would have a significant impact on abortion care for people and families who are working to make ends meet, creating two important standards for reproductive health:
First, it sets up the federal government as a standard-bearer, ensuring that every person who receives care or insurance through the federal government will have coverage for abortion services. The EACH Act restores abortion coverage to those:
- enrolled in a government health insurance plan (i.e., Medicaid, Medicare), including those who live in the District of Columbia;
- enrolled in a government-managed health insurance program (i.e., FEHBP, TRICARE) due to an employment relationship; or
- receiving health care from a government provider or program (i.e., Indian Health Services, the Federal Bureau of Prisons, the Veterans Administration).
Second, it prohibits political interference with decisions by private health insurance companies to offer coverage for abortion care. The federal government cannot interfere with the private insurance market, including the insurance marketplaces established by the Affordable Care Act, to prevent insurance companies from providing abortion coverage.
Since the Hyde Amendment was passed in 1976, anti-abortion federal politicians have added abortion coverage and funding bans to programs affecting:
- Medicaid, Medicare and Children’s Health Insurance Program enrollees;
- Federal employees and their dependents;
- Peace Corps volunteers;
- Native Americans and Indigenous peoples who get their care through Indian Health Services;
- People in federal prisons and detention centers, including those detained for immigration purposes;
- Military members, veterans and their dependents; and
- Low-income people in the District of Columbia.
Currently, 34 states and the District of Columbia do not cover abortion within their state Medicaid programs, except for limited exceptions. Additionally, anti-abortion politicians in 26 states have enacted restrictions that interfere with abortion as a covered health service in health plans offered by health insurance exchanges, 22 states restrict abortion coverage in insurance plans available for public employees, and 11 states have laws restricting insurance coverage of abortion in all private insurance plans written in the state.
THE IMPACT OF ABORTION COVERAGE BANS
When policymakers deny people insurance coverage for abortion, they either are forced to carry the pregnancy to term or pay for care out of their own pockets. Consequently, cutting off access to or placing strict limitations on abortion can have profoundly harmful effects on public health, particularly for those who already face significant barriers to receiving quality care, such as people working to make ends meet, immigrants, young people, and women of color.
- Fifty-five (55%) of reproductive-age women enrolled in Medicaid live in states that withhold insurance coverage for abortion except in limited circumstances.
- Fifty-one percent (51%) of reproductive-age women who are enrolled in Medicaid and subject to abortion coverage restrictions are women of color.
- Studies show that when policymakers place severe restrictions on Medicaid coverage of abortion, it forces one in four poor women seeking an abortion to carry an unwanted pregnancy to ter
- When a someone is living paycheck to paycheck, denying coverage for an abortion can push them deeper into poverty. Indeed, studies show that a woman who seeks an abortion but is denied is more likely to fall into poverty than one who is able to get an abortion.
- Women with lower socioeconomic status – specifically those who are least able to afford out-of-pocket medical expenses – already experience disproportionately high rates of adverse health conditions. Denying access to abortion care only exacerbates existing health disparities.
- In some cases, women need to delay their abortions to take time to raise funds for the procedure. According to the Federal Reserve Board, 40% of Americans do not have enough savings to pay for a $400 emergency expense like an abortion.
- Due to inequities in health care and systemic racism, women of color are more likely to qualify for government insurance programs that restrict abortion coverage and are more likely to experience higher rates of unintended pregnancy.