The Dobbs Decision — Exacerbating U.S. Health Inequity
- On June 24, 2022, reproductive health care in the United States was dealt a major blow when the U.S. Supreme Court overturned the landmark Roe v. Wade decision and removed federal protection for abortion.
The Decision
The Dobbs Decision, which overturned Roe v. Wade and removed federal protection for abortion, will negatively affect the health and well-being of all pregnant people and their families. Low-income women and members of marginalized racial and ethnic groups will be most affected by the decision. The Hyde Amendment, which banned federal Medicaid funding for abortion, has disadvantaged low-income people.
Medicaid Expansion
Medicaid expansion reduced the number of uninsured women of reproductive age and provided more people access to primary and gynecologic care before pregnancy. However, the Hyde Amendment greatly disadvantaged low-income people by blocking the use of federal Medicaid funds for abortion services except in cases of rape or incest or to save the pregnant person’s life. In 32 states, Medicaid programs adhere to the strict guidelines of the Hyde Amendment, making it difficult for low-income people to access abortion services in these states.
Fallout
Access to abortion services under Medicaid will continue to vary by place of residence and depend on the confluence of restrictions or bans on abortion care and Medicaid policies currently in effect within each state. After Dobbs, complete or partial bans on abortion went into effect in more than a dozen states, forcing people in those states to travel to other states to access abortion care. Marginalized women and communities, for whom Roe was never enough, are leading grassroots efforts for just and equitable abortion care that builds on decades of advocacy and support. Policies to ensure comprehensive access to abortion have the potential to address the effects of systems of oppression.
Conclusion
The Dobbs Decision will negatively affect low-income women and members of marginalized racial and ethnic groups. Access to abortion services under Medicaid will continue to vary by place of residence and depend on the confluence of restrictions or bans on abortion care and Medicaid policies currently in effect within each state.