The Hyde Amendment: where the fight for economic equality and reproductive access collide
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It has been forty years since the Hyde Amendment was passed. The amendment discriminates against millions of low-income women by banning coverage of abortion under Medicaid, denying them much needed reproductive care. Hyde is an example of how reproductive and economic injustices affect one individual in intersecting ways. Too often, they show up in disastrous circumstances in the lives of low-income women, like those in the restaurant industry.

Take for example, the experience of Sylvia from Kentucky. In her first job out of school waiting tables she was paid $2.13 an hour plus tips at a local café. Living almost entirely off her tips, there were no benefits, no job security, and no paid time off – but at 23 years old, Sylvia wasn’t particularly worried. She and her boyfriend decided to take two months off to teach English overseas, knowing she could return to work at the cafe when she got back. After only a few weeks abroad, she became pregnant. They knew they weren’t ready to be parents, so they returned home earlier than expected to get an abortion. They quickly learned just how costly and difficult abortion can be to obtain.


Sylvia returned to her job at the café, but had some tough decisions to make. The $1,200 a month she earned, on average, was the same as the cost of the abortion. At the same time, they needed to save up $1,300 for the deposit on an apartment. Meanwhile, time was ticking. At 12 weeks, the cost of the abortion plus expenses would have gone up to $1,950 and at 14 weeks up to nearly $3,000. They decided to go into debt and put the cost of the procedure on their credit cards.

The medical costs, food, and the three-hour travel back and forth to the nearest clinic in Nashville ate into her meager savings. With no sick leave, she lost two more days in pay for follow up care. A week after the abortion, Sylvia returned to work. She tried to make up for the lost income but business was unpredictable at the café. In Kentucky, as in 17 other states, the minimum wage for restaurant workers is $2.13 per hour. When you make $2.13 an hour, your wages usually go entirely to taxes and your paycheck is $0. On a good day, Sylvia could leave with $80 in tips, but on a bad day she could take home as little as $15 after a full days’ work.

In spite of these difficulties, she still considers herself lucky: that she had a supportive partner, access to credit, a friend who provided her a place to stay, and no judgment at the clinic in Nashville while she had the abortion. She wonders though, “If this is lucky, what’s unlucky?”

Sylvia is just one of many stories of restaurant workers trapped between a rock and a hard place when it comes to getting the reproductive care they need. That’s why the Restaurant Opportunities Centers United joined forces with Forward Together and more than 50 partners in the All* Above All Coalition. We share the belief that our economic and reproductive health policies must work for every facet of a woman’s life.

In forty-three states, the restaurant industry gets away with paying employees as little as $2.13 an hour, forcing workers to live off tips. As a result, seven of the 10 lowest paying jobs in the country are restaurant jobs. These poverty wages make it impossible for many workers to afford housing, pay for food for their families. Because nearly 70% of servers are women, too many restaurant workers cannot pay for reproductive health care like birth control, prenatal care, or abortion.

The Hyde Amendment penalizes poor women by denying them vital health care. There are 5.9 million tipped workers in the U.S. and 15% of them are on Medicaid. Seventy-seven percent of those are women who are affected by the Hyde Amendment. Since 1976, the Hyde Amendment has prohibited the Medicaid health insurance program from covering abortion care, except in cases of rape, incest or life endangerment. It is unconscionable that people who work full-time in the restaurant industry can still qualify for Medicaid—and that injustice is compounded by low wages that make it impossible for many to pay for an abortion out-of-pocket because insurance coverage is denied by politicians.

The impact of politicians interfering with a woman’s personal health decisions around pregnancy by restricting abortion coverage are clear: low-income women, women of color, immigrant women and young women often have reduced ability to pay for safe and legal abortions. Restricting Medicaid coverage of abortion forces one in four poor women seeking an abortion to carry an unwanted pregnancy to term, and women who are denied abortion access are more likely to fall into poverty.

We must repeal the Hyde Amendment and secure reproductive care for all women. That’s why Congress must pass the EACH Woman Act, which ensures that lack of health coverage will not stand in the way of a woman making the decision that is best for her and her family. The EACH Woman Act repeals the Hyde Amendment and creates two important standards for reproductive health. First, if a woman gets her care or insurance through the federal government, she will be covered for all pregnancy-related care, including abortion. Second, the EACH Woman Act prohibits political interference with decisions of private health insurance companies to offer coverage for abortion care. American women deserve no less.

*Sylvia is a pseudonym. Her story comes from the National Network of Abortion Funds.

Saru Jayaraman is Co-Director of Restaurant Opportunities Center United and Kalpana Krishnamurthy is Policy Director at Forward Together and staffs the Movement Building Taskforce of the All* Above All, a coalition seeking to repeal the Hyde Amendment.

The views expressed by authors are their own and not the views of The Hill.