A Punitive Double Bind: Families Suffer When States Deny Abortion Coverage and Fail to Support Expecting and New Parents

Analysis Identifies Worst States for Low-Income Women, Marks 40 Years of Hyde Amendment

Lawmakers in nearly every state are undermining instead of fostering economic security for women and families by denying them the abortion coverage and workplace supports they need, according to an analysis released today by the National Partnership for Women & Families. Women of color are disproportionately affected, the analysis concludes.

Released to mark the 40th year under the Hyde Amendment, A Double Bind: When States Deny Abortion Coverage and Fail to Support Expecting and New Parents is an issue brief and map that identify obstacles faced by low-income women across the country, many of whom struggle without insurance coverage for abortion care, paid family and medical leave, paid sick days and pregnancy accommodation laws. The Hyde Amendment, which denies Medicaid funding for abortion care, is in place in 35 states and the District of Columbia; just 15 states use state-only Medicaid funds to cover abortion care.

“Every one of those 35 states is failing women. Forty years of the Hyde Amendment is 40 years of a shameful, callous public policy that pushes women deeper into poverty and exacerbates health disparities,” said National Partnership for Women & Families President Debra L. Ness. “When a woman who was denied abortion coverage cannot keep her job because her employer refuses to make reasonable accommodations for her pregnancy – when she has no paid sick days for prenatal appointments or well-baby care – no paid family and medical leave to use after giving birth – the deck is truly stacked against her. The failure of so many states to provide abortion coverage and workplace supports conspires to put and keep women in poverty. We urgently need federal and state policies that support women and families, instead of deepening their struggles. Not enough lawmakers are answering that call.”

The new analysis finds that many states further restrict women’s access to abortion coverage, even beyond the Hyde Amendment: 25 states restrict abortion coverage in plans in state health insurance marketplaces; 10 states restrict abortion coverage in all private health insurance plans; and 21 states restrict abortion coverage in insurance plans offered to state public employees. At the same time, few states have passed laws that improve upon inadequate federal law by providing paid family and medical leave, paid sick days and strong pregnancy accommodations. As a result, in most states women are denied both abortion coverage and access to public policies that support expecting and new parents in the workplace.

Conversely, the states with the fewest restrictions on abortion coverage tend to offer stronger workplace protections and supports. California and New York have the most expansive workplace protections for expecting and new parents, and both provide state Medicaid coverage for abortion care.

The analysis identifies 12 states – Alabama, Arizona, Georgia, Idaho, Michigan, Mississippi, Missouri, Nevada, Oklahoma, South Carolina, South Dakota and Wyoming – that have especially failed to foster women’s economic security:

  • Idaho, Michigan, Missouri and Oklahoma do not have a single workplace protection for expecting and new parents beyond what inadequate federal law provides, and have all four abortion coverage restrictions addressed in this analysis.
  • Arizona, Georgia, Mississippi and South Carolina are also without a single workplace protection to support expecting and new parents, and each has three of the four abortion coverage restrictions assessed in this analysis.
  • Similarly, Nevada and Wyoming withhold abortion coverage from women enrolled in Medicaid and fail to provide a single workplace protection beyond inadequate federal law.
  • Alabama and South Dakota have no workplace protections for expecting and new parents and two abortion coverage restrictions. South Dakota has failed to comply with even the limited Hyde exceptions, barring Medicaid coverage for abortion except when continuing a pregnancy will endanger the life of the woman.

“The well-being and economic security of families depends, in many ways, on their freedom to plan if and when to have children and on the supports they can access during pregnancy and after children are born,” said National Partnership Vice President Sarah Lipton-Lubet. “For too long, lawmakers have been playing politics with women’s health and ignoring the urgent need for family friendly workplace policies. The consequences are very clear and very harmful. A woman who wants an abortion but is denied is more likely to fall into poverty than a woman who is able to obtain care. Having a baby is the most expensive health event that families face during their childbearing years, and the failure to provide workplace supports during this critical time undermines the economic security of families, sometimes for years. Women of color are disproportionately impacted; they are at higher risk for unintended pregnancy, more likely to be enrolled in Medicaid, and are disproportionately without access to paid time off to address health needs. Lawmakers in Congress and the states must do better.”

The new issue brief recommends swift adoption of:

The data on workplace supports in the issue brief is from the National Partnership’s report, Expecting Better: A State-by-State Analysis of Laws That Help Expecting and New Parents, released in August.

About the National Partnership

The National Partnership for Women & Families is a nonprofit, nonpartisan advocacy group dedicated to promoting fairness in the workplace, reproductive health and rights, access to quality, affordable health care and policies that help all people meet the dual demands of work and family. More information is available at NationalPartnership.org.


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