by Miriam Stiefel, ACLU of Virginia Reproductive Freedom Project Intern
Imagine that you are a woman who decides to have a second child. The excitement builds as you go in for a routine ultrasound. But, at 20 weeks, you find out that there may be an abnormality with the fetus’ heart and spine. Further tests indicate congenital diaphragmatichernia, a complication preventing vital organs from growing properly. The news is devastating, and you have to decide quickly whether to carry the child full-term and let it suffer or end the pregnancy. This happened to Christie Brooks. As Christie explained to a committee of Virginia legislators considering a bill that would restrict funds for access to abortion, she did not want her child to endure agony, so out of love for her baby she ended the pregnancy. Unfortunately, many Virginia women like Christie must also face restrictions, which are the result of political interference into private medical decisions that should be made by a woman and her doctor.
Restrictions on public funding for abortion coverage exist at both the federal and state level. At the federal level, the 1977 Hyde Amendment prohibits public funding of abortion coverage under Medicaid except in the case of rape, incest, or, life endangerment. Since the passage of the Affordable Care Act, Virginia has created its own Hyde-like restrictions. 
As we first wrote in 2011, the Virginia health care exchanges created under the Affordable Care Act cannot cover abortion services, except in the case of rape, incest, or life endangerment. This 2011 law was reauthorized in 2013. As a result, insurance provided through the exchanges cannot cover abortion, unless under the exceptions noted above, even if Virginians pay for the insurance with their own money. Virginia is one of 23 States that have banned abortion in the health care exchanges.
These restrictions marginalize and discriminate against low-income women, including the 418,000 (16.3%)uninsured Virginia women who will enter the health care marketplace this fall and the 850,000 non-elderly female Medicaid recipients in Virginia. Due to these restrictions, the health care system intended to serve under and uninsured populations will be unable to meet all the needs of its recipients. This is yet another reason why Virginians should care about the Hyde Amendment and its Commonwealth counterpart.
To make matters worse, in 2014 we should expect legislation designed to further threaten a women’s right to safe and affordable abortion services. While no woman plans to have an abortion, every woman deserves the opportunity to make the best decision for her circumstances.Without insurance coverage for her abortion, Christie would have paid $15,000 out of pocket, devastating her financially. It is wrong to deny women access to safe care simply because they lack the insurance that Christie fortunately had.
Christie’s story is just one example of the many things that can happen during a pregnancy. Virginians should care about Hyde because decisions about whether to choose adoption, end a pregnancy, or raise a child must be left to a woman, her family, and her faith, with the counsel of her doctor or health care provider. Abortion coverage should be part of any comprehensive insurance plan.