Sec. 5401. Findings; sense of Congress on urgent barriers to abortion access and vital solutions
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Congress finds the following: Affordable, comprehensive health insurance that includes coverage for a full range of pregnancy-related care, including abortion, is critical to the health of every person regardless of actual or perceived race, color, national origin, immigration status, sex (including sexual orientation, gender identity, pregnancy, childbirth, a medical condition relating to pregnancy or childbirth, or sex stereotyping), age, or disability status. Abortion services are essential to health care and access to those services is central to people’s ability to participate equally in the economic and social life of the United States.
Abortion access allows people who are pregnant to make their own decisions about their pregnancies, their families, and their lives. Reproductive justice seeks to address restrictions on reproductive health, including abortion, that perpetuate systems of oppression, lack of bodily autonomy, White supremacy, and anti-Black racism. The violent legacy of these systems of oppression has manifested in policies including enslavement, rape, and experimentation on Black people, forced sterilizations, medical experimentation on low-income people’s reproductive systems, and the forcible removal of Indigenous children.
Access to equitable reproductive health care, including abortion services, has always been deficient in the United States for Black, Indigenous, and other People of Color (BIPOC) and their families. Transgender, nonbinary, and gender expansive individuals, and specifically those who are Black, disabled, and at the intersections of multiple forms of oppression, also experience inequitable access to abortion services due to systemic violence. Centering abortion rights and access as a women’s health issue restricts access to those with reproductive needs who do not identify as cisgender women.
In order to work towards reproductive justice for all communities, transgender, nonbinary, and gender expansive individuals must be centered in conversations of abortion access. Improving abortion access for this community requires a gender-neutral approach to abortion care, rights, and justice policy. The legacy of restrictions on reproductive health, rights, and justice is not a dated vestige of a dark history. Access to abortion services is obstructed across the United States in various ways, including blockades of health care facilities and associated violence, prohibitions of, and restrictions on, insurance coverage, parental involvement laws (notification and consent), restrictions that shame and stigmatize people seeking abortion services, and medically unnecessary regulations that neither confer any health benefit nor further the safety of abortion services, but which harm people by delaying, complicating access to, and reducing the availability of, abortion services.
As of December 2, 2021, 19 States have enacted 106 restrictions, including 12 new abortion bans, making 2021 the year with the highest number of restrictions passed since Roe v. Wade was decided in 1973. Additionally, 21 States are poised to immediately ban or significantly restrict access to abortion services if the Supreme Court chooses to overturn or weaken Roe v. Wade. These unprecedented attacks on abortion rights and access fall especially heavily on people with low incomes, BIPOC, immigrants, young people, people with disabilities, those living in rural and other medically underserved areas, and transgender, nonbinary, and gender expansive individuals.
Since 1976, the Federal Government has withheld funds for abortion coverage in most circumstances through the Hyde amendment and similar coverage restrictions, affecting individuals of reproductive age in the United States who are insured through the Medicaid program, as well as individuals who receive insurance or care through other Federal health plans and programs. Of women aged 15 to 44 enrolled in Medicaid in 2017, 55 percent lived in the 35 States and the District of Columbia that do not cover abortion, except in limited circumstances.
This amounts to roughly 7,300,000 women of reproductive age, including 3,100,000 women living below the Federal poverty level. Women of color are disproportionately likely to be insured by the Medicaid program, and nationwide, 32 percent of Black women and 27 percent of Hispanic women aged 15 to 44 were enrolled in Medicaid in 2017, compared with 16 percent of White women. Abortion-specific restrictions are even more compounded by the ongoing criminalization of people who are pregnant, including those who are incarcerated, living with HIV, or with substance use disorders.
These communities already experience health inequities due to social, political, and environmental inequities, and restrictions on abortion services exacerbate these harms. Removing medically unjustified restrictions on abortion services would constitute one important step on the path toward realizing reproductive justice by ensuring that the full range of reproductive health care is accessible to all who need it. Abortion-specific restrictions are a tool of gender oppression, as they target health care services that are used primarily by individuals with reproductive needs.
These paternalistic restrictions rely on and reinforce harmful stereotypes about gender roles, people’s decision making, and people’s need for protection instead of support, undermining their ability to control their own lives and well-being. These restrictions harm the basic autonomy, dignity, and equality of individuals with reproductive health needs, and their ability to participate in the social and economic life of the Nation. Many abortion-specific restrictions do not confer any health or safety benefits on the patient.
Instead, these restrictions have the purpose and effect of unduly burdening people’s personal and private medical decisions to end their pregnancies by making access to abortion services more difficult, invasive, and costly, often forcing people to travel significant distances and make multiple unnecessary visits to the provider, and in some cases, foreclosing the option altogether. Congress has used its authority in the past to protect access to abortion services and health care providers’ ability to provide abortion services.
In the early 1990s, protests and blockades at health care facilities where abortion services were provided, and associated violence, increased dramatically and reached crisis level, requiring congressional action. Congress passed the Freedom of Access to Clinic Entrances Act ( Public Law 103–259 ; 108 Stat. 694) to address that situation and protect physical access to abortion services. Congressional action is necessary to put an end to harmful restrictions, to federally protect access to abortion services for everyone regardless of where they live, and to protect the ability of health care providers to provide these services in a safe and accessible manner.
The Equal Access to Abortion Coverage in Health Insurance Act of 2021 or the EACH Act of 2021 (H.R. 2234, S. 1021) introduced in the 117th Congress, would reverse the Hyde amendment and related abortion coverage restrictions. It would create an enforceable statutory right for people who receive health coverage or care through enumerated Federal programs (including Medicaid, the Children’s Health Insurance Program, Medicare, and the Indian Health Service, among others) and plans (including government-sponsored health insurance due to a current or former employment relationship) to receive abortion coverage.
It would require the Federal Government to facilitate abortion access for individuals eligible to receive health care in Federal facilities or in facilities with which it contracts to provide health care, such as immigration detention centers. It also prohibits the Federal Government from prohibiting, restricting, or otherwise inhibiting State or local governments or private health insurance issuers from providing abortion coverage. The Women’s Health Protection Act of 2021 (H.R. 3755, S. 1975) introduced in the 117th Congress, would establish an enforceable statutory right for health care providers to provide, and abortion patients to receive, abortions free from medically unnecessary restrictions, limitations, and bans that delay, and at times, completely obstruct, access to abortion.
It is the sense of Congress that eliminating the Hyde amendment, enacting the Equal Access to Abortion Coverage in Health Insurance Act of 2021, and enacting the Women’s Health Protection Act of 2021, are critical to— promoting equitable abortion access, including coverage, for all who seek care; creating enforceable rights to receive, and receive coverage for, such care; advancing equitable access to comprehensive health coverage, which cannot be achieved without abortion coverage; and alleviating urgent racial, gender, and other inequities in health and health care and corresponding reproductive injustices.
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- Pub. L. 103-259
- 108 Stat. 694
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Sec. 5401
Findings; sense of Congress on urgent barriers to abortion access and vital solutions
Pub. L.Pub. L. 103-259
Stat.108 Stat. 694
Cites 2Cited by 0 across 0 sources