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It’s the most basic of rights and foundational to our ability to thrive: Every person should have the freedom to decide if, when and how to raise a family. But for many women struggling to make ends meet, this is not reality. Instead, they face obstacle after obstacle, including denial of access to abortion coverage and a lack of workplace supports.

This week marks the 40th year of the Hyde Amendment — a shameful federal policy that denies millions of women Medicaid funding for abortion care. While 15 states use state-only Medicaid funds to cover abortion care, 35 states and the District of Columbia do not, leaving the majority of reproductive-age women enrolled in Medicaid without coverage.

For four decades, the Hyde Amendment has had devastating effects on women and families struggling to get by. Beyond the harm it causes, many states even further restrict women’s access to abortion coverage. Withholding abortion coverage has meant that millions of women who work hard just to make ends meet have to delay care while they struggle to come up with the funds to pay out of pocket, sacrificing other essentials like food, rent or gasoline.

Even so, not everyone can get the care they need. And research shows that a woman who wants an abortion but is denied is more likely to fall into poverty than a woman who is able to obtain care.

When a child is born, our nation’s laws do not provide the support expecting and new parents need — and few states have passed laws to guarantee paid family and medical leave, paid sick days and pregnancy accommodations.

Women need state laws to supplement inadequate federal laws. Each year, an estimated quarter of a million women are denied reasonable pregnancy-related workplace accommodations, and many more do not ask for the accommodations they need. Just over one in five worksites offer paid maternity leave to all workers. Having a baby is the most expensive health event that families face during their childbearing years, and it is estimated that nearly 13 percent of families with a new infant become poor within a month.

Because women of color live at the intersection of a multitude of disparities and structural barriers, they are more likely to be Medicaid-eligible and subject to the harms caused by the Hyde Amendment and also in low-wage jobs that do not provide essential workplace supports. Women of color therefore are more likely to be denied access to abortion coverage, and pregnant and parenting women of color are disproportionately without access to workplace supports like paid time off to address their health needs and care for a new child.

Today, the National Partnership for Women & Families released an issue brief and map that illustrate the impact of the Hyde Amendment and state restrictions on abortion coverage when combined with a lack of workplace policies needed to support families’ economic security. They reveal the impossible double bind women are forced into when they cannot make the decision best for themselves about whether to have a child and then are denied the workplace supports they need during and after pregnancy. Our research shows that women in most states are denied both abortion coverage and access to public policies that support expecting and new parents in the workplace. Conversely, the states with the fewest restrictions on abortion coverage tend to offer stronger workplace protections and supports.

The conclusion is obvious: We need policies that lift women and families up, instead of deepening their struggles. We need legislation like the EACH Woman Act, which would restore abortion coverage to women who receive health care or insurance through the federal government. And we need legislation to support families’ economic security like the FAMILY Act, which would create a national paid family and medical leave insurance program.

Providing women of reproductive age with access to abortion care and addressing the workplace needs of pregnant and parenting women — and of all expecting and new parents — would strengthen the workforce, promote gender equity on the job and at home and improve economic security for families.

There’s simply no excuse for lawmakers not to act right now.