Battle over Women’s Health Arrives at the Supreme Court
By: Amina Abbas, JD
Director of Government Relations, Asian & Pacific Islander American Health Forum
What is a right to abortion if one does not have true access? How much of a burden on access is “undue” enough not to pass constitutional muster? And more importantly, what happens to women when a state regulates abortion within its borders to the level that providers far and wide are forced to shut their doors?
This week, the Supreme Court will hear a case, Whole Woman’s Health v. Hellerstedt, that raises these questions. The case will determine whether Texas’ law imposing restrictions on abortion clinics and doctors providing abortion services creates an “undue burden” on a woman’s right to have an abortion. Later this month, the Court will also consider Zubik v. Burwell, a challenge by religious-affiliated institutions to the Affordable Care Act’s (ACA) requirement that contraceptive coverage be available under their employee’s health plans.
To understand the context of these cases, one need only examine the glaring lack of equitable access to comprehensive reproductive care across the nation and resulting statistics. Half of all pregnancies in the U.S. are unintended. While the factors are multifold, part of the challenge is access to affordable contraceptives in a way that is truly accessible. On top of that, federal and state legal barriers create an environment that is often hostile to women’s health as a whole when it comes to accessing abortion care. Legal restrictions, whether targeting providers or women result in the same effect: diminished access to care. These restrictions disproportionately impact low-income women and women of color — women who already face multiple barriers locking them and their families out of critical medical care.
After many abortion providers like Planned Parenthood clinics were forced to close across Texas, birth rates significantly increased in the state. In an 18-month period, analysis found a birth rate increase of 27 percent in areas where women lost access to affordable contraception. The law’s disproportionate impact fell most heavily on low-income women, as more than 60 percent of them relied on Planned Parenthood clinics for reproductive health services prior to the law going into effect. Diminished access to comprehensive health care jeopardizes the well-being of women and their families.
The stakes before the Court are particularly high for low-income women and women of color, including many Asian Americans, Native Hawaiians and Pacific Islanders (AAs and NHPIs), who like many other diverse communities already experience roadblock after roadblock to getting the care they need and can afford. Asian American women have the lowest rate of oral contraceptive use, in part due to challenges over accessing them.
Abortion restrictions like the one at issue before the Supreme Court in the Texas case, commonly known as TRAP laws (targeted regulation of abortion providers) effectively try to regulate abortion providers out of existence. As a result, they trap women, particularly those who are low-income, live in rural areas, cannot travel hundreds of miles to find a provider and/or cannot take multiple days off of work.
Much like the Hyde Amendment, which prohibits federal funding for abortions in federal health programs except under limited exceptions, abortion restrictions targeting providers harms struggling women and their families the most by legislating access to medical care on the basis of one’s zip code and paycheck. In Texas, for example, research from the National Asian Pacific American Women’s Forum found that over half of the 64,172 Asian American women living in the state at or below the poverty line are women of reproductive age. Nationally, nearly one in eight AA and NHPI women lives under the federal poverty level. Contrast that reality with the cost of a first trimester abortion, averaging $500 or a vaginal delivery that can cost $10,000 or more in Texas — weeks of pay for an AA or NHPI woman making the State’s $7.25 per hour minimum wage. Losing access to an affordable and accessible health clinic like Planned Parenthood is not only the consequence of legally restricting abortion — it is devastating physically and financially.
The Supreme Court this term has an opportunity to focus attention squarely on what matters most, the impact of the law on women’s access to care. The ability to make decisions about and care for the well-being of not only themselves, but their families, is a right that all women should have regardless of their financial resources, where they live or where they work. It is time for the Supreme Court to uphold that right.
