As the third largest source of health insurance in the U.S. , Medicaid's guidelines regarding what is 'essential health care' limits millions of poor women to services only covered by Medicare. Thus, the Hyde Amendment ensures that abortion is not an option for these women who lack the financial resources to pay for out-of-pocket expenses.
The Hyde Amendment states that funds appropriated by the Department of Health and Human Service cannot be used to cover abortion services. In the current version of the Hyde amendment, the federal Medicaid program permits abortion coverage only in the case of rape or incest, or if the mother's life is in danger.
Although Medicaid programs are administered by each individual state, they are partially funded by the federal government and must adhere to federal Medicaid guidelines to receive funding. Thus policies created at the national level impact the states. As the Hyde Amendment has tightened restrictions on abortion, so too have individual states.
According to the Reproductive Freedom Project of the American Civil Liberties Union (ACLU):
Most states have followed the federal government's lead in restricting public funding for abortion. Currently only seventeen states fund abortions for low-income women on the same or similar terms as other pregnancy-related and general health services....Four of these states provide funding voluntarily (HI, MD, NY, and WA); in thirteen, courts interpreting their state constitutions have declared broad and independent protection for reproductive choice and have ordered nondiscriminatory public funding of abortion (AK, AZ, CA, CT, IL, MA, MN, MT, NJ, NM, OR, VT, and WV)Essential health care under Medicaid may include doctor's visits, hospital stays, home medical equipment, long-term care, dental coverage, and eyeglasses; eligibility varies by individual circumstances and by state. Although 'essential health care' included abortion in the first three years following the Supreme Court decision in Roe v. Wade (1973-76), once the Hyde Amendment was enacted in 1977, abortion was removed from federally funded coverage.
In addition to prohibiting abortion coverage under Medicaid, abortion is not covered for women in the military, the Peace Corps, federal prisons, and those who receive care from Indian Health Services.
"Medicaid: A Program Overview." U.S. Dept. of Health and Human Services, Health Care Financing Administration at Almanac of Public Policy, policyalmanac.org, September 2000.
"Public Funding for Abortion." Reproductive Freedom at ACLU.org, 21 July 2004