History was made last week.
At a New Hampshire campaign rally, presidential candidate Hillary Clinton delivered the most complete, full-throated defense of abortion access I’ve ever heard cross the lips of a public figure. And she ended it by coming out for federally-funded abortion care. Seriously, you have to see and hear it to believe it:
“I believe we need to protect access to safe and legal abortion—not just in principle, but in practice. Any right that requires you to take extraordinary measures to access it is no right at all. Not when patients and providers have to endure harassment and intimidation just to walk in to a health center. Not when making an appointment means taking time off from work, finding childcare, and driving halfway across your state. Not when providers are required by state law to recite misleading information to women in order to shame and scare them. And not as long as we have laws on the book like the Hyde Amendment making it harder for low-income women to exercise their full rights.”
A few days later, her official Twitter account posted a follow-up to make her position clear in case people inexplicably thought the above statement was a fluke:
A right without the opportunity to exercise it isn't a right. Low-income women deserve health care. The Hyde Amendment should be overturned.
— Hillary Clinton (@HillaryClinton) January 15, 2016
I burst into tears of joy and relief. Again.
I never thought in my lifetime I would see a presidential candidate without prompting declare that the Hyde Amendment should be overturned. As we over-celebrate Roe v. Wade this week, reproductive justice organizations and activists around the country are using the hashtag #ReclaimRoe for exactly the reason Hillary gave to explain her position: a right without the opportunity to exercise it isn’t a right.
“A right without the opportunity to exercise it isn’t a right.”
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Here’s the best part about Hillary taking on Hyde: it’s a campaign promise she can keep IN HER FIRST YEAR because it isn’t a stand-alone law that Congress would have to overturn. She can do it practically on her own because it’s embedded in the very complicated, nearly year-long annual process of creating a national budget. (The Washington Post has a solid infographic if you’re so inclined: “A guide to the federal budget process.”) The budget has to be put together every single year—along with all the amendments that get attached in the process. Since 1976, Hyde has been reinstated over and over again, signed into law by democratic and republican presidents alike.
It’s all thanks to former Rep. Henry Hyde (R-IL), whose motivation couldn’t have been clearer:
“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.”
Thanks, Henry. Quite the lasting legacy.
As president, Hillary would have the power to veto any budget with Hyde attached and dare a Congress in full view of a very conflict-weary electorate to shut down the government over an issue where polling says 86% of us agree with her. Legislators couldn’t feign shock over her unwillingness to perpetuate the status quo because they’d have notice about her intent to veto—and not just because of campaign statements. The White House sends a budget plan to Congress on or before the first Monday in February and the deadline to send it back to the president’s desk isn’t until right before the fiscal year starts October 1. No one is going to see eight months as insufficient time for Congress to submit a budget that will come back signed.
And it gets better.
I’m not just excited because a candidate said the word abortion or because it was a woman candidate or because this is a promise she could keep without creating new legislation—although that is historic on its own. I’m excited because Hyde is literally the worst kind of “social issue” policy. With the words of its creator long forgotten outside reproductive justice circles, Hyde pretends to be about keeping people from seeing their tax dollars designated for a thing they find offensive, but it’s really about punishing people rich white guys have, for centuries, given far less than a fuck about. Since we don’t make laws or form budgets with exemptions for any other slice of the budget pie (still waiting for my refund on the tax dollars that went to Iraq, the millionaire tax cuts, and President George W. Bush’s salary), this talking point needs to stop already. Hyde is about legislators dictating what I can do with my uterus because our patriarchal culture and two generations of their colleagues being comfortable trading away the lives of the poor and communities of color have told them that they can do so without consequences.
For four decades, Hyde denied abortion coverage to any person whose insurance comes from the federal government: residents of the District of Columbia, Peace Corps volunteers, Native Americans, federal prisoners and detainees (including those detained for immigration purposes), and Children’s Health Insurance Program (CHIP) enrollees. Communities of color and the poor have been disproportionately affected as per usual. Two full generations of Americans have lived under this prohibition; there are only a handful of people of reproductive age who were alive before Hyde. Currently, one in four people insured by Medicaid who experiences an unwanted pregnancy is forced against their will to carry that pregnancy to term.
“Communities of color and the poor have been disproportionately affected as per usual.”
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I was only pregnant for nine weeks and every moment of every day I felt like I might come out of my skin. I felt as though my body had been invaded, and had I not had the resources to get to my local Planned Parenthood, I would most certainly not have survived the pregnancy. I have watched as the supposed pro-choice party has ignored the erosion of access to the procedure that saved my life. We don’t have to look very far to find to see evidence of this catastrophic apathy.
Just a few days ago, House Minority Leader Nancy Pelosi (D-CA)—the highest ranking democrat in the House as well as the former Speaker—told the nonpartisan politics/election coverage site Roll Call: “I don’t believe in abortion on demand.” And she’s from one of two states in the country with a top record on reproductive rights and sexual health for 2015; if anything, she should be pandering to the pro-choice left, not hedging her bets by courting the fabled “middle voter” or the right-wing. She’s simply towing the well-entrenched party line that regularly expresses discomfort with full autonomy for pregnant people.
While we readily think of the GOP as anti-woman, anti-reproductive rights, and anti-just-about-every-other-human-right-imaginable, the “left wing” is largely a Pelosi-style check-the-box style of “pro-choice.” Ask them if they are for “a woman’s right to choose” and they will respond with a hearty “of course!” But ask them about policies that discriminate or expand access and they clam up, folding into knots hoping you’ll just move on already from this very inconvenient topic. Even if candidates and legislators are pledging to vote against or veto bad legislation, they are hardly being pro-active. Our country just received a D+ from the Population Institute in overall reproductive rights and health—a two-notch slip down from 2014’s C grade.
It gets worse.
As a party, not only have the democrats not sought to enshrine an affirmative right to abortion into law so as to at least protect the in-name-only aspect of my constitutional right, but every federal budget they have voted to approve and sign since 1976 had Hyde attached to it. Legislators and presidents have reinstated Hyde’s punishment of the poor damn near annually with hardly a word. The exception, of course, is Rep. Barbara Lee, whose Equal Access to Abortion Coverage in Health Insurance Act also made history this year. Co-sponsorship has reached 110 members of the House, all of whom have put their names on a bill that, again, polling suggests the vast majority of voters support, but which historically elected officials would have shied away from because it prohibits the denial of abortion care to anyone with any insurance, private or government-funded.
Here’s the thing: Lee’s bill was introduced with hardly a whisper in the corporate media. Virtually no one covered the press conference and the coalition of young people of color whose organizations banded together to make it happen. Which means Hillary didn’t have to comment on Hyde; she never would have been asked about it on the record. I say that with the confidence of someone who shook my head through a democratic primary debate a week after her position declaration and just five days before the anniversary of Roe—with ZERO QUESTIONS about abortion. Not even a veiled reference! Hell, they didn’t even ask about the safe lady issues:
No questions at #DemDebate, but we'll say it now: The women of America deserve a champion in the White House. pic.twitter.com/HnEOtjn8jd
— Hillary Clinton (@HillaryClinton) January 18, 2016
Hillary could have gone through the entire primary and—should she secure the nomination—the entire general election without having to address the landscape of inequality in our country with respect to abortion care. She could have euphemised and Planned Parenthood-praised her way around the word abortion and relied on her gender to build support in the reproductive rights community. There will be enough sexism circulating through the campaign coverage courtesy of talking heads and the GOP for her to be the better repro candidate by default.
But she was bolder than she had to be.
Hillary’s Surprising Abortion Record
“Abortion should be safe, legal and rare.” — Arkansas Governor, Bill Clinton accepting the democratic presidential nomination on July 23, 1992
The “safe, legal and rare” reinforced abortion stigma further shushed the 3 in 10 women who have the procedure, and created a framework within the democratic party that still exists nearly 25 years later. The “good abortions” vs. “bad abortions” culture where we must spin our stories so we are worthy of a medical procedure and jump through hoops to pay an appropriate penance was solidified. For eight years, we had a president who had told the country we, of course, all agree that nobody likes abortion; the follow-up act was President George W. Bush, who thought the Declaration of Independence applied to “unborn children.” President Obama, like most politicians, doesn’t like the word abortion. Even his statements on the anniversary of Roe almost manage to not actually say “abortion”—until the President Clinton throwback near the end:
“Forty-two years ago today, the U.S. Supreme Court issued its ruling in Roe v. Wade, a decision that protects a woman’s freedom to make her own choices about her body and her health, and reaffirms a fundamental American value: that government should not intrude in our most private and personal family matters . . .”
. . . yadda yadda yadda . . . “core constitutional right” . . . yadda yadda yadda . . . “government should not be injecting itself into decisions best made between women, their families, and their doctors” . . .
Ah! Here it is: “I am also deeply committed to continuing our work to reduce unintended pregnancies, support maternal and child health, promote adoptions, and minimize the need for abortion.” [emphasis mine]
Oh. That explains the dwindling access to abortion care during this administration despite the much-touted Affordable Care Act (ACA) mandates on annual visits and contraceptive coverage (for most people; well, almost most people).
Hillary is not new to the politics of abortion. She spent a lot of time in the Capitol during the course of those three administrations. She was an involved First Lady from 1993-2000, a senator from 2001-2009, and Secretary of State from 2009-2013. To say she is in touch with the pulse of the political sphere since the days of safe, legal, and rare is an understatement. You don’t have to agree with any of her platform to consider her a savvy politician; if there’s one thing both Clintons have always been good at, it’s knowing which way the winds are blowing. She understands the risk and still didn’t cross reproductive rights off her to-do list following NARAL’s perfect abortion rights voting record, thanks to her “yea” on extending abortion care to military personnel serving overseas and her “nays” on restricting types of abortion procedures and aiding minors traveling out of state to access abortion care.
“Hillary is not new to the politics of abortion.”
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When I dug into her less public history—again, because corporate media ignores comments about abortion the majority of the time—I discovered her stance on Hyde may not be much of a shift at all. Typically, I find attack pieces by anti-choice sites to be overly alarmist in title and content, but LifeNews tends to get the underlying facts right if you brush off the inaccurate adjectives intended to cause mass pro-life hysteria. Their piece “10 Times Hillary Clinton Revealed How Extreme She is on Abortion” lists some moments I wasn’t aware of that have me feeling pretty good about Hillary’s overall abortion cred.
Perhaps I equated her too much with her husband and should remember that she, yanno, wasn’t the president in the 90’s—a time when abortion doctors and other staff were being murdered. Along with the eight clinic workers and volunteers who have been murdered since 1993, there have been 17 attempted murders. (This excludes the Colorado Springs Planned Parenthood attack.) If Hillary wasn’t vocal then, maybe it was her husband’s administration making a calculated decision on the topic or on saving her public advocacy for health care; we can’t know, but her moves since stepping into her own public service space have been clear and consistent.
Last spring, when the House passed an abortion restriction based on the faux-science of roundly debunked “fetal pain,” Hillary tweeted:
When it comes to women's health, there are two kinds of experts: women and their doctors. True 40+ years ago, true today. -H
— Hillary Clinton (@HillaryClinton) May 13, 2015
She has regularly and quickly defended Planned Parenthood—even while mainstream news outlets were referring to heavily doctored videos from anti-choice group Center for Medical Progress as “undercover exposés.” Anti-choicers are so worried about her, they regularly spin anything they can to, for example, claim she’s forcing abortion on people against their religious beliefs. Mainstream publications like USA Today even publish take-down pieces on her supposed extremist stance on abortion.
By the time my vision had blurred from scanning Google results on Hillary’s abortion-related content, I was upset at myself for being so shocked at her willingness to make history. I had underestimated her based on, well, the “common knowledge” that she’s a corporate, middle-of-the-road democrat. Hillary, allow me to say on the record: I’m sorry for judging you ahead of hearing your words on the rights I have committed the majority of my life to. I’m a little emotional and jaded when it comes to reproductive justice; I expected you to be the next candidate to disappoint me. I couldn’t be happier.
A Ripple Effect
I can now see flashes of the ripples that flow from the end of Hyde. Obviously, the first is the immediate life-saving expansion of insurance coverage for abortion care. Medicaid covers more than 10 million women of reproductive age a year (a hard number to accurately pin down currently, thanks to GOP governor vacillations on accepting expanded federal funding and fluctuations in the economy). Ten million is SO MANY PEOPLE. Not to mention the side benefit — for those feigning fiscal conservatism when denying coverage of abortion care—the multiple millions saved by not forcing anyone to carry an unwanted pregnancy to term. Medicaid funds prenatal care at an average of $20,716 per live birth; the average cost of a first trimester termination is around $450. That amounts to a savings of $20,266 per person who we don’t turn into a walking incubator.
“Multiple millions will be saved by not forcing anyone to carry an unwanted pregnancy to term.”
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That alone would be win-win-win.
But there’s more.
Clinics are currently losing money on that $450 procedure. Most full-spectrum reproductive health-care clinics have a solvency issue because they exist to help people and doing that is expensive when insurance companies— Medicaid as well as the25 states with laws severely restricting ACA plans and even privately purchased insurance from covering abortion—are prohibited from extending this service to their customers. Independent clinics have closed en masse over the past few decades—certainly because of restrictions like those being challenged at the Supreme Court by Whole Woman’s Health in Texas, but also for purely financial reasons. Despite the right-wing fascination with “abortionists” (their made up word for imaginary money-hungry, predatory health care providers), reproductive health care physicians and clinic owners aren’t getting rich off of desperate patients with nowhere to turn; quite the opposite.
As Molly Redden so thoroughly covered at The Guardian, “clinics have kept the price of abortion the same for decades, even as costs throughout the rest of the healthcare industry have exponentially grown”—causing independent clinics without a national fundraising profile to lose money on essentially every abortion procedure. Even in states where clinics can bill Medicaid for some abortion care, they struggle to keep the lights on. The rampant restrictions on abortion care—1,075 of them since Roe—are much more well-known than the day-to-day operational challenges. It may sound callous to call an abortion clinic a business, but any facility that has staff and bills to pay must at the very least break even somehow.
Well. What if the federal funding ban on abortion were suddenly gone? What if clinics could bill Medicaid and other insurers for the actual cost of the procedure? When we throw out Hyde, we throw out the precedent for punishing low income women as well as the people who provide their care. This new Hyde-free landscape opens up countless ways for advocates to pursue funding and negotiate for fair reimbursement—maybe even lobby their legislators for increased resources through Title X and any other avenue they can dream up. The reproductive justice movement has seasoned citizen lobbyists ready to mobilize, and wow have I watched them get things done with my own eyes.
With independent clinics able—finally—to stay afloat while fending off and potentially even being able to challenge some of the 1,075 state-level restrictions on the books, we could even see new clinics opening. Picture it: clinic owners and providers who have wanted to expand their services to other corners of their communities—and new communities!—could do so without perpetually worrying that they’ll have to lay off staff and make calls cancelling appointments knowing those patients have nowhere else to go.
Just dismissing Hyde could open the doors to a trend reversal with the potential to exponentially elevate access to the entire slate of reproductive health services around the country. Since 1991, we’ve lost 75% of surgical abortion clinics; even with a handful of new medication-only facilities, we have only been able to keep 739 total facilities operational. Even if just the 73 clinics (just! ugh) that closed in 2014 were able to reopen, we would increase the total number of providers by 10%.
A 10% increase in provider availability could save thousands for patients who time-out on the less expensive procedure at 13.5 weeks while trying to raise the money for the appointments, travel, and, often, child care. At that mark, the price spikes drastically—by 200-300%—and patients risk hitting a hard legal deadline between 14 and 24 weeks. The legislators who impose these faux science-based limits also make early access when the procedure is cheaper impossible through other anti-abortion laws—TRAP laws—that close clinics. Patients even time out in some areas just waiting to get an appointment. Patients in Dallas are waiting up to 20 days to be seen by a physician. In Austin, the wait time for either of the two remaining clinics hovers around 23 days.
“Dismissing Hyde could elevate access to the entire slate of reproductive health services.”
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What if we could start rebuilding by strengthening the existing clinics through more adequate funding and then expand? We could begin turning Roe into more than a theoretical right for the residents of the 89% of U.S. counties without a provider. One community at a time, one victory at a time.
But wait—there’s still more.
Imagine, just for a moment, what a Supreme Court with four justices appointed by the first presidential candidate to advocate for federally funded abortion might look like. As constitutional, feminist law professor and author David Cohen pointed out to me recently, four SCOTUS justices—Breyer, Ginsburg, Kennedy, and Scalia—will be 78 or older when we inaugurate the next president. Two of them are conservative (Kennedy and Scalia) and two are the most liberal currently on the court (Breyer and Ginsburg). With hundreds of anti-choice laws available for challenge or working their way through lower courts, any shift to the left from this SCOTUS makeup of four conservative, four liberal, and one fabled swinging undecided vote could set off a domino effect. A six-three liberal court handing down just a few precedent-setting pro-choice victories at the highest court in the land would cascade quickly down to the lower courts. Well, as quickly as courts move, anyway.
And in my wildest dreams, Justice Ruth Bader Ginsburg gets the chance to write the majority decision that does away with the “undue burden” test and—through her characteristically carefully chosen rhetoric—closes the loopholes she has been long frustrated by in Roe. The Notorious RBG could get the chance to define our constitutional right to abortion care through a gender equality lens, making the era of a trimester framework and the ZIP code lottery a distant, painful memory.
The Fight Ahead
Why am I so optimistic? How even could I think such extravagant things in an era of restrictions from the right and wishy-washy-ness at best from the majority of the legislators on “my side?” In short: I believe Hillary is for real on Hyde.
None of these statements she’s made make any sense unless she simply feels strongly about this issue and her chance to right a wrong that has been punishing people in this country since she was a young woman barely out of law school. There are no financial upsides and no allies to be gained in the media by proclaiming her aggressively pro-choice—no, pro-abortion stance. This far left position declaration didn’t earn her any big dollar donations or secure her any endorsements. She already had NARAL Pro-Choice America, and Planned Parenthood doesn’t have a “Hooray, abortion!” litmus test on endorsing “pro-choice” candidates. Yes, many in the reproductive justice movement will now consider her their candidate—volunteering, canvassing, and even donating. But we are not a monied group of people. Hillary didn’t declare Hyde to be a human rights violation because she thinks she can fundraise off of it. The only people fundraising off of this will be the GOP nominee once the general election starts. And he’s going to turn this into MILLIONS.
My optimism extends beyond abortion access. I’m now considering what else we could push Hillary on. If we show up for an issue, who knows how much a lot of noise from her base could radicalize her platform? My personal request is to give some thought to how ridiculous our bankruptcy law is. I’m filing the simplest bankruptcy possible next month—I own nothing and therefore have nothing to protect and there are just six accounts to discharge—and it’s costing upwards of $2,000. Reforming bankruptcy law could help tens of thousands of people a year and over a million people a year in rough economic times.
I’m sure you have a personal issue or two and the primary season is the perfect time to demand our candidates shape their platforms with our input. #MyPrimaryIssues are ending the Hyde Amendment and reforming bankruptcy law and I’m letting Hillary know. If she can break with cultural and political tradition, own her history while tacking all the way to the left, and march along the third rail like a seasoned tight-rope walker on abortion—let’s test out what other “off limits” issues she’s veteran enough and savvy enough to move on. At the very least, this is an opportunity to make our body politic and national conversation better.
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Lead image: flickr/Marc Nozell
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