Today marks 35 years since Congress first passed what's come to be known as the Hyde Amendment, which bans most federal abortion funding.
While the actual language of the rider to the annual funding bill for the Department of Health and Human Services has changed considerably over the years, since 2003 it has allowed federal Medicaid funds to pay for abortions in cases of rape, incest, or if the life of the woman is endangered by the pregnancy.
But in practice, according to a new study published in the American Journal of Public Health, even abortions that technically qualify for public funding often don't reimbursed.
Researchers from Ibis Reproductive Health, which supports abortion-rights, conducted 50 interviews with abortion providers in 11 states that pay for abortion under Medicaid only under circumstances specified by the Hyde Amendment.
The researchers found that 37 percent of the 1,165 abortions provided for cases of rape, incest, or life endangerment included in the research were ultimately covered by Medicaid.
The rest were paid by the women themselves, by the abortion providers or by nonprofit, contribution-based abortion funds.
Earlier research found some of the barriers to getting Medicaid reimbursement include bureaucracy and Medicaid staff who don't understand the rules.
"Ibis' research has shown that in states where abortion coverage is limited to the Hyde Amendment exceptions, it is extremely challenging for providers to get reimbursed," said Kelly Blanchard, principal investigator of the study and president of Ibis.
But while abortion-rights advocates would like to see the Hyde Amendment eliminated, abortion opponents are pushing just as hard to see it written into permanent law, so it doesn't need to be passed separately each year.