Ensuring Equal Access to Abortion Coverage in Health Insurance: Introducing the EACH Act of 2021

Ensuring Equal Access to Abortion Coverage in Health Insurance: Introducing the EACH Act of 2021

The future of access to abortion services is at a crossroads. The Biden-Harris administration and 117th Congress could commit to dismantling the injustices of the Trump-Pence years and long-standing systems of oppression, or they could retreat and maintain the status quo that so harms low-income and underserved communities.

The Trump-Pence administration spent four years relentlessly reshaping federal public policy and the federal judiciary, leaving a legacy of further-entrenched overlapping systems of oppression that obstruct health, well-being, and reproductive justice. That legacy is evident in the still-soaring COVID-19 pandemic, a historic economic recession, a deepening Black and Indigenous maternal health crisis, and state-sanctioned structural, institutional, and interpersonal white supremacist, xenophobic, sexist, and transphobic violence. We recognize it in anti-choice lawmakers’ efforts to exploit the pandemic to justify increasing barriers to abortion services.

The United States also grapples with longstanding reproductive injustices. For forty-five years, the Hyde Amendment has withheld federal funds from covering abortion services in nearly all circumstances. It has erected unconscionable barriers to access for low-income and underserved people who receive health coverage or care through Medicaid, the Children’s Health Insurance Program (CHIP), Medicare, the Indian Health Service (IHS), and other federal health care programs. It has pushed abortion access out of reach for millions, disproportionately harming the health, well-being, and economic security of Black, Indigenous, and other people of color, lesbian, gay, bisexual, transgender, queer, intersex, and gender-nonconforming people, people with disabilities, young people, and their families.

This constellation of reproductive injustices, new and old, has particularly harmed people who live and experience compounded discrimination at the intersection of multiple identities. In turn, these injustices have elevated the need for equitable, holistic, and community-driven solutions that ensure equitable access to sexual and reproductive health care services, including equal access to abortion coverage, for all.

The National Health Law Program (NHeLP) believes that the United States should ensure coverage of abortion services for all, no matter a person’s health insurance program or plan; location; race or ethnicity; sexual orientation; gender identity; age; language; or disability, immigration, or economic status. Today, United States Representatives Barbara Lee (D-CA), Ayanna Pressley (D-MA), Diana DeGette (D-CO), and Jan Schakowsky (D-IL), and United States Senators Tammy Duckworth (D-IL), Patty Murray (D-WA), and Mazie Hirono (D-HI) introduced the Equal Access to Abortion Coverage in Health Insurance (EACH) Act of 2021, groundbreaking legislation that would reverse the Hyde Amendment and related abortion coverage restrictions and promote equitable access to coverage.

The EACH Act is designed to restore or otherwise require coverage for abortion services for people who receive health coverage or care through enumerated federal programs and plans, including:

  • People who are enrolled in Medicaid, Medicare, and CHIP;
  • Indigenous people who receive their health care from IHS;
  • Refugees who receive medical assistance through federal programs for domestic resettlement and assistance to refugees;
  • People detained in federal prisons or detention centers, such as immigration detention;
  • Young people in the care or custody of the United States’ Department of Health and Human Services’ Office of Refugee Resettlement;
  • People who are enrolled in government-sponsored health insurance programs or plans due to a current or former employer relationship, including federal employees and their dependents, Peace Corps volunteers; military members, veterans, and their dependents;
  • People who receive other coverage, such as through a State health benefits risk pool; and
  • Government-sponsored programs established after the EACH Act’s enactment.

In addition to requiring that these programs and plans provide coverage, EACH would create a statutory right to that coverage. EACH also requires that the federal government ensure access to abortion services for individuals eligible to receive health care in its own facilities or in facilities with which it contacts to provide health care, such as people in federal prisons or detention centers. The EACH Act would also prohibit the federal government from restricting or interfering with abortion coverage in the private insurance market, including the health insurance marketplaces established by the Patient Protection and Affordable Care Act.

It is high time for the United States to recognize and comply with international human rights standards, which affirm that access to abortion and maternal mortality prevention are human rights. A myriad of reforms are needed to secure equitable access to abortion services for all. Decisively ending the Hyde Amendment and enacting the EACH Act of 2021 are crucial among them.

Introducing EACH brings us one step closer to ensuring comprehensive health coverage for all—but it will take a groundswell of support from our movement to get this bill moving. Please consider sending a message to your members of Congress and urging them to co-sponsor the bill. You can also learn more about the Hyde Amendment and the EACH Act of 2021 in NHeLP’s new issue brief, “Fostering Equitable Access to Abortion Coverage: Reversing the Hyde Amendment.” Read the House version here.

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