I deliver my patients’ babies when needed, and perform their abortions when needed. Thankfully, my state treats all health care like health care.

I walk into the room and greet my patient with a smile. Six months earlier, I delivered her first baby by cesarean section after a long labor.

“How are you?” I ask. She assures me that she is doing fine, her daughter is thriving. She quickly takes out her phone and flips through a few recent photos. She smiles at me and tells me that she is just not ready for another baby. My patient is pregnant again and has made the decision to have an abortion. Just as I did when I delivered her daughter, I strive to hold a space of dignity and respect. I hold space for her and her emotions. I recognize that for her, she is making a difficult decision, but is doing so out of love and compassion.

She is insured through Medi-Cal, California’s state Medicaid program. California is one of only 16 states that cover abortion for patients who are publicly insured. That means my patient can easily access this medical care, and she was able access that care with me, the same provider who delivered her daughter. 

This shouldn’t be a privilege just for the patients I see in California. It’s a right everyone should be able to access. We can’t get there unless the Biden administration and Congress do away with the discriminatory Hyde Amendment.

Boxing the poor out of health care

The Hyde Amendment’s prohibition on the use of federal funds to pay for most abortion care has been in the budget since the late 1970s. The amendment’s sponsor, Rep. Henry Hyde, R-Ill., made it clear that he was punishing poor people in service of his anti-abortion agenda, saying, ‘I would certainly like to prevent, if I could legally, anybody having an abortion, a rich woman, a middle class woman, or a poor woman. Unfortunately, the only vehicle available is the … Medicaid bill.”

No one should be denied abortion coverage because of where they live or how much money they make. Having their abortions covered by Medi-Cal makes abortion an option for my patients. They schedule an appointment and access this care as they would any other medical care. They don’t have to worry how they will have to pay for it. That means most of my patients don’t have to delay until they can scrape together enough money to afford their abortion.

While the risks are minimal, complications from abortion increase with each week of pregnancy. The burden of paying for the procedure often makes it so my patients who don’t have insurance coverage for abortion (their private insurance doesn’t cover it and those coming from out of state) don’t make it in for abortion care until later in pregnancy. 

Abortion should be covered for all

Abortion should be covered for all. But the Hyde Amendment assures a gross level of inaccessibility to those who are least likely to afford it. Longstanding systemic racism and racialized systems of oppression led to people of color being disproportionately insured through public insurance or lacking insurance altogether. Hyde Amendment restrictions thus disproportionately limit choice and access for people of color. 

Even with the assurance that her abortion would be paid for, my patient had to take time away from work, secure child care for her daughter, and find transportation — all things that cost money. She lives in the same city where I provide care, which made this more manageable. However, many of my patients come from farther away, and even with coverage for their abortion, they must manage travel, gas money, bus or train fare, child care, time away from work, hotel room costs. Those costs, for many, make abortion barely accessible. 

Abortion rights demonstrators including Jaylene Solache, of Dallas, Texas, right, rally outside the Supreme Court in Washington, D.C., on March 4, 2020.

Abortion rights demonstrators including Jaylene Solache, of Dallas, Texas, right, rally outside the Supreme Court in Washington, D.C., on March 4, 2020.  JACQUELYN MARTIN, AP

Imagine adding on thousands of dollars for actually paying for the abortion. It’s a cruel twist that having to delay an abortion to save up enough money to pay for it means you need even more money for an even more expensive procedure. This is what the Hyde Amendment does for publicly insured people in the vast majority of states. Ending the Hyde amendment is a necessary — though still insufficient — step toward allowing people the human right to decide if and when they will continue a pregnancy. 

President Joe Biden and Vice President Kamala Harris declared their opposition to the Hyde Amendment on the campaign trail. But they have been largely quiet so far on how they plan to follow through on that commitment.

I’ve seen how hard my patients fight to get the basic care that should be their right. The Biden administration owes it to them to fight just as hard to end this discriminatory policy. I’m honored to be able to provide the compassionate care my patients deserve in a state where it’s treated like all other health care. It’s well past time for everyone to have that experience.     

Source: https://eu.usatoday.com/story/opinion/voices/2021/03/07/pro-choice-abortion-hyde-amendment-obgyn-biden-harris-column/4592699001/