Fractured: Stories From a Post-Roe America
A new series coming June 24, 2023 chronicles the experiences of state legislators from across the country as they fight to defend abortion rights and expand access for all Americans.
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Medication abortion care is a safe and effective method of abortion care that has been studied extensively since it was approved by the FDA 20 years ago this month.
Still, many Americans are unfamiliar with medication abortion care -- what it is, how it can increase access to care during a pandemic and beyond, and the state and federal level policy barriers that stand in the way.
To assist state legislators' work in this area SiX Reproductive Rights teamed up with Dr. Ushma Upadhyay, an expert in medication abortion care from the University of California San Francisco, and Innovating Education in Reproductive Health to make this short instructive video.
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Click here to read video transcript.
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For additional resources, messaging guidance, or to be connected with a research expert on reproductive health topics, please reach out to fran@stateinnovation.org.
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Crisis does not erase inequality. It lays it bare.
We've seen how low-income communities of color, have been hardest hit by the COVID-19 crisis. And we've seen how anti-abortion officials are pulling out all the stops to use this crisis as an excuse to ban abortion.
During this unprecedented pandemic, our elected officials should be focused on our families’ health and safety. It’s unconscionable that politicians would use a national crisis to try to deny critical health care to anyone. Now more than ever we should be coming together as communities to make sure everyone can safely get the healthcare they need, not actively working to deny our neighbors care--including and especially abortion care.
That's why SiX Repro Team worked with legal, medical, and legislative experts to release a 19-minute video on abortion as essential healthcare.
In this urgent global health pandemic, anti-abortion lawmakers are once again playing politics with people's lives and health, and there are very real reproductive health impacts and needs this moment presents.
Important: Here are some issues that you should talk to your repro coalition and abortion and family planning providers about. In some states, they may want public support and in other places, it may be harmful to raise these issues at all, even within the administration or with other, less friendly, legislators or officials. Your support of reproductive health care is crucial at this time. Please check in with the state coalition organizations and reproductive health care providers to see how best you can support them during this difficult time, and we encourage you to reach out to us to connect you if you don’t already have an existing relationship.
By: Rep. Sheryl Cole, MPT Delia Garza, Rep. Joyce McCreight, CM Carlina Rivera
Representative Sheryl Cole represents Texas District 46.
Mayor Pro Tem Delia Garza represents District 2 in Southeast Austin.
Representative Joyce “Jay” McCreight represents Maine District 51.
Council member Carlina Rivera represents the 2nd Council District of New York City Council.
The national conversation about reproductive rights has been dominated this year by the spate of abortion bans passed across the country as well as the Trump administration’s gag rule affecting Title X funding. But banning abortion isn’t the only avenue to making it hard to get. Since the Hyde Amendment was passed by Congress 43 years ago, it has done exactly what it was set up to do: deny low-income people the right to an abortion, forcing them to carry unintended pregnancies to term.
The Hyde Amendment is a federal restriction that withholds insurance coverage for abortion from those enrolled in the Medicaid health insurance program, except in the limited cases of rape, incest, and life endangerment. As elected officials and members of the Reproductive Freedom Leadership Council, we honor the personal decision of whether, when, and how to become a parent and condemn the Hyde Amendment for what it is: political interference with decisions about pregnancy and parenting. When a person has decided to end their pregnancy, they should be able to get safe, timely, affordable care in their community, regardless of income.
As Trump and Pence continue to push their agenda of punishment and shame, it is up to the states and cities to protect people who are already failed by our health system--women of color, young people, transgender and non-binary people, immigrants, and people who live in rural areas.
The Hyde Amendment stands in large part not because of public support, but because of political inertia. A national poll recently released found that:
While this new polling demonstrates overwhelming support for providing insurance coverage for abortions, many state legislatures have acted against the will of the people and raced to ban abortion. According to the Guttmacher Institute, in 2019, states enacted 58 abortion restrictions, 26 of which would ban all, most, or some abortions. With the balance of the Supreme Court now turned against abortion rights, the threat of abortion care being further dismantled or pushed out of reach entirely is real.
Although for over four decades the Hyde Amendment has denied federal Medicaid coverage of abortion, we must remember Hyde is not permanent. Every year Congress has an opportunity to pass a budget without the Hyde Amendment. In the meantime, there are actions that states and cities have taken that our colleagues could follow to ensure a person can access the care they need.
This year Maine became the 16th state to guarantee Medicaid coverage for abortion by passing LD 820, a bill that expands public and private insurance coverage of abortion care.
In Maine we saw the combination of restrictions and coverage bans across the country forcing people to delay care or stop them from getting abortions altogether. Restricting Medicaid coverage of abortion forces one in four poor women seeking an abortion to carry an unwanted pregnancy to term. When a woman wants to get an abortion but is denied, she is more likely to fall into poverty, less likely to have a full-time job, and twice as likely to experience domestic violence.
In Texas we worked to introduce Rosie's Law, which would have restored Texas Medicaid coverage for abortion care services for low-income Texans.
This bill was named in honor of Rosie Jiménez, a beloved mother, student, and young Chicana, who was the first victim of the Hyde Amendment in 1977. When Rosie realized she was pregnant and was too poor to pay for a safe and legal procedure at a clinic, she sought out a cheaper, unsafe abortion. She suffered a painful death from an infection that ravaged her body and led to her preventable death at the age of 27.
While this bill did not pass into law, the conversations started by lawmakers and young activists alike have paved the way for the fight for Medicaid coverage to continue into the next legislative session.
Cities like Austin and New York City are already taking steps to fill the gap that Hyde has created. Austin City Council has set aside $150,000 and New York City Council $250,000 to lessen financial and logistical barriers that make it difficult and sometimes impossible for low-income individuals to access abortion.
This isn’t just an issue for Washington, DC. As state and local leaders, we encourage our colleagues everywhere to fight back against restrictions that hit hardest at low-income people and widen inequalities even further. In the end, it will take us all -- state legislators, individual advocates, city council members, and members of Congress -- to ensure that abortion is accessible, affordable, and safe for all, no matter their economic situation.
Published in The State September 14, 2018. See the original post here.
As Brett Kavanaugh’s confirmation hearings wrap up and Roe v. Wade remains at risk, my colleagues and I in state legislatures across the country have our work cut out for us in defending the rights and reproductive health care for women and families. In states supportive of abortion access, it’s time to repeal bad laws that threaten abortion access if Roe is overturned.
Unfortunately, some of us working in states like South Carolina may not hold enough votes to defeat bad bills. But we do have the resolve to exercise our rights and the responsibility to defend our constituents.
That’s why I joined my colleagues last session on the floor of the state Senate for an 11-hour filibuster against a bill that would have banned the majority of safe and legal abortions. Ultimately, the bill died, and we never tired in our fight to stop South Carolina from becoming the latest state to enact bogus legislation at the expense of women.
We can’t standby and watch more state legislatures undo the progress we’ve made in this country. The Reproductive Freedom Leadership Council — a coalition of more than 300 legislators lead by the State Innovation Exchange is one group fighting back, and I was proud to join them in opposing Kavanaugh’s Supreme Court nomination.
I am heartened by people in South Carolina and nationwide who have voiced opposition to attacks on abortion. The people of this country believe in women’s rights. And we’ll fight with everything we have to protect them.
By: Sen. Margie Bright Matthew
Senate District 45
By Agata Pelka
The ability to plan, time, and space children is inextricably linked with economic opportunity, stability, and security for women and families. This is no surprise to the majority of women who report using contraception as a means to complete their education, keep or get a job, and to support themselves and their families financially. In addition, voters intuitively recognize the connection between control over one’s reproductive decision-making, financial stability, and equal access to opportunities.
Access to contraception is widely documented as an important factor in increasing female engagement in the work force and for narrowing the gender wage gap. Today, working mothers are the breadwinners in four out of 10 American families, and working women’s income is integral to the economic security of most families. The impact of one's ability to decide whether and when to have a child on women’s economic outcomes is even more stark when examining long-term outcomes for women who were denied a wanted abortion: they were almost three times more likely to be unemployed and almost four times more likely to be below the Federal Poverty Level than women who were able to successfully access the abortion care they wanted.
It is important to note that the economic benefits of contraceptive use have not been distributed equally: low-income women and women of color have not benefited as much as their higher-income and white counterparts. We still have a lot of work to do to ensure that all women have meaningful access to comprehensive reproductive health care. One of the major barriers to consistent contraceptive use is high out-of-pocket cost, and women in particular are likely to defer medical care because of cost. Even with insurance, cost-sharing in the form of co-pays can be prohibitive to accessing the most effective – and in turn often the most expensive – contraceptive methods. Cost-sharing for health services is specifically intended to discourage the use of non-essential services, which is inappropriate when applied to ongoing contraceptive use.
The Affordable Care Act (ACA) acknowledged this fact and removed this obstacle by extending a no co-pay requirement to contraceptive coverage. As a result, women saved approximately $483 million on contraception in 2013. State legislators have also increasingly taken steps to protect and expand coverage for contraceptives and abortion care in their states. Six states currently prohibit cost-sharing for contraception and three have provisions that will be effective in 2018 and 2019 – most of which cover even more methods than under the ACA. California and New York require certain plans to cover abortion care. Last session, Oregon passed ground-breaking legislation requiring health insurers to cover the full spectrum of reproductive health services – including contraception, abortion, prenatal and postpartum care – without co-pay. Since state legislative sessions kicked off in January, legislators have continued the momentum to improve coverage for reproductive health care by introducing bills in several states:
All of these measures would make contraception and abortion care more accessible to women. Ensuring that everyone has access to comprehensive reproductive health care coverage – which includes contraception, abortion, prenatal and postnatal care – allows a woman to make the best decisions for her circumstances and her family. As threats to these vital services continue to loom at the federal level, more and more state legislators have been turning their attention to this issue as part of their family economic security agendas. Reproductive health advocates and their constituents around the country eagerly await more bill introductions pushing these protections forward this session and beyond.
Agata Pelka is a State Legislative Counsel at the Center for Reproductive Rights, where she works to advance proactive policy strategies in the states.