Abortion coverage bans severely restrict the ability of millions of women to obtain abortion care. The Hyde Amendment is the most infamous of such restrictions, barring about 7.5 million low-income women from using their Medicaid coverage to obtain an abortion, except in the most extreme circumstances. However, millions more women who receive their health insurance or care through the federal government face similarly severe restrictions, according to a new analysis in the Guttmacher Policy Review.

“The thinly veiled intent behind the Hyde Amendment and other abortion coverage restrictions is to put abortion out of reach for as many people as possible,” says Megan Donovan, author of the analysis. “These restrictions can pose an enormous financial obstacle, particularly for poor and low-income women and women of color who receive health care services or coverage through the federal government.”

Donovan offers new estimates for the number of women affected by federal abortion coverage restrictions and details how the various restrictions impact different groups:

  • Women enrolled in federal insurance programs, including low-income women enrolled in Medicaid and the Children’s Health Insurance Program and women with disabilities enrolled in Medicare.
  • Federal employees, including civilian employees and their dependents insured through the Federal Employee Health Benefits program, military personnel and their dependents insured through TRICARE and veterans who receive care through the Department of Veterans Affairs.
  • Women who receive health care or coverage through federal programs, including American Indians and Alaska Natives served by the Indian Health Service, women in federal correctional and immigration detention facilities, and Peace Corps volunteers.

Donovan discusses potential efforts by antiabortion policymakers in the Trump administration and Congress to codify current abortion coverage restrictions—in particular the Hyde Amendment—in permanent law and to expand the reach of coverage bans. The analysis further documents urgent efforts by supporters of abortion rights to restore abortion coverage for all U.S. women, including through the Equal Access to Abortion in Health Insurance (EACH Woman) Act, first introduced in 2015 by Rep. Barbara Lee (D-CA).

“In an increasingly hostile political climate, the fight to restore abortion coverage for all women is more important than ever, as is highlighting the real experiences of those women most impacted by coverage bans,” says Donovan. “Cutting off access to abortion care by making it unaffordable is not sound public health policy. All women should have access to abortion coverage, regardless of income, source of insurance or zip code.”

Full analysis: “In Real Life: Federal Restrictions on Abortion Coverage and the Women They Impact” by Megan Donovan