We trust pepople to make the best decisions about their health care for their own lives.
Politicians should trust them, too. But far too many anti-choice extremists at all levels of government continue to propose laws that restrict the ability to access safe and legal abortion.
Anti-choice legislators at the state and national levels have passed laws that limit access to abortion care by banning federal and state funding for the procedure in most cases, prohibiting insurance coverage for abortion care, and placing unnecessary, harmful restrictions on health-care clinics.
Access to abortion shouldn’t depend on ZIP code, health insurance or income. Every person should have the autonomy to make decisions that impact their bodies and their lives.
Bans on Public and Private Health Insurance Coverage in North Carolina
Anti-choice politicians in North Carolina have enacted laws that prohibit both public and private insurers from including abortion coverage in their health plans, preventing many people from using health insurance to cover abortion care. Without insurance coverage, patients who choose an abortion are forced to bear the cost entirely on their own, despite having paid for health insurance—and for low-income North Carolinians, this may put the procedure financially out of reach, or force them into unsafe situations (skipping rent/bill payments, asking abusive partners for money, etc).
In North Carolina, the following funding restrictions apply:
- No state funds can be used to pay for abortion care, except in very limited circumstances (1980’s). A state abortion fund was established, but over the years not funded. The fund was finally repealed in 2006.
- In 2011, the NC General Assembly voted to remove abortion coverage from state employee health plans, except in limited cases. This means no state employees, including public school teachers, can access abortion through their state benefits.
- In 2013, the NC General Assembly voted to bar private insurance offered on the Affordable Care Act marketplace from offering abortion coverage.
- Also in 2013, the NC General Assembly voted to bar local or county governments from offering abortion coverage to their employees, even if that is what the local municipality wants to do.
The Hyde Amendment
The Hyde amendment (and related restrictions) is a discriminatory federal policy that restricts access to abortion for women who receive their health care through the government. The reach of this policy is long, affecting many programs and resulting in millions of women being denied insurance coverage for abortion care. They include:
- Anyone enrolled in Medicaid and Medicare
- Native Americans
- U.S. servicewomen and veterans
- Peace Corps volunteers
- Federal employees
- Residents of Washington, D.C.
- People in immigration detention facilities and prisons
There have been recent federal efforts to also restrict people in immigration detention facilities from accessing abortion with their own funds as well.
As Supreme Court Justice Thurgood Marshall wrote, the Hyde amendment was “designed to deprive poor and minority women of the constitutional right to choose abortion.” And that’s exactly what this policy does.
By forcing low-income people to carry unintended pregnancies to term or spend a large portion of their income to pay for abortion care, Congress creates more barriers to women lifting themselves out of poverty. Women without abortion coverage are forced to use funds they would spend on necessities such as food and rent to pay for an abortion. In many cases, finding the money to pay for the abortion results in a delay in care, which means the procedure becomes even more expensive.
The Hyde Amendment is incorporated into the federal budget every year; it currently must be renewed with each federal budget. NARAL Pro-Choice North Carolina is working with national and local partners to bring an end to this economic injustice, one that exacerbates our country’s health care inequality, and robs low-income people of the opportunity to make dignified and personal choices for themselves.
The Helms Amendment
Enacted in 1973, the Helms amendment has prevented U.S. foreign aid from helping some of the world’s poorest women access abortion care as well as comprehensive reproductive health care. Because the language of the policy has been wrongly interpreted and implemented over the years, the Helms amendment has resulted in a near-total ban on U.S. assistance to some of the world’s poorest women who need abortion care, even when a woman’s life is in danger or she is a survivor of rape or incest. In 2016, this ban was expanded to impact organizations who receive funding for any global health programs, not just ones associated with family planning programs.
This is nothing but playing politics on the backs of poor people across the globe, who have little power to impact the United States’ political system that allows these ideological policies to come into place.
U.S. government can and should issue guidance to U.S.-funded health centers overseas clarifying that these exceptions—when consistent with local law—are permissible, and that U.S. funds may pay for abortion care in these cases. While this would fall far short of a full repeal, it would be a step in the right direction.
Abortion Bans Throughout Pregnancy
Anti-choice politicians in many states have used a variety of tactics to enact abortion bans earlier and earlier in pregnancy. The most common type of abortion ban in recent years is a ban on abortion after 20 weeks, with Congress, again, trying to pass a federal ban as recently as early 2018. These laws interfere with a patient’s ability to make the decision that is best for themselves and their families, and often come into play under difficult circumstances surrounding a pregnancy or when the pregnant person’s health is at risk. These bans also criminalize doctors for the care they provide. In North Carolina:
A few states have gone even further, passing laws to ban abortion as early as six weeks—before many women even realize they’re pregnant. These laws are effectively outright bans on abortion.
Abortion Procedure Bans
In 2003, President George W. Bush signed into law the Federal Abortion Ban. The first federal law to criminalize a safe medical procedure, this ban means doctors may not be able to use the abortion procedure they believe is best for a patient. The ban has no exception to protect a woman’s health and is widely opposed by leading medical groups.
In North Carolina, only a physician may provide an abortion, and only in a hospital or a licensed clinic. These restrictions are not based on medical evidence, and are used in more recent times by anti-abortion lawmakers to further restrict access to abortion.
In North Carolina, a law was passed in 2013 that barred the use of telemedicine to provide abortion care, requiring a physician be physically present during a medication abortion when the first medication is administered. Again, this is not based on medical best practices, but rather a desire to make it more difficult to access abortion.
“Personhood” measures seek to outlaw abortion by redefining the term “person” to include a fertilized egg or embryo—with the intent of outlawing abortion.
In addition, “personhood” measures often sweep in bans on stem cell research and in vitro fertilization, as well as many common forms of birth control. Ultimately, these measures have no exceptions to protect a pregnant person’s life or health, and likely will eventually criminalize people for having abortions. There is a trend of increasing criminalization of self-administered abortion and poor birth outcomes, based on current child abuse/neglect laws, and outdated abortion laws still on the books. There is every reason to believe “personhood” measures would result in re-criminalization of abortion.
Voters have repeatedly rejected “personhood” ballot initiatives as too extreme and harmful to women and their health. However, anti-choice groups and politicians continue to introduce them in the hopes of mounting a legal challenge to Roe v. Wade.