Brittany Mostiller still remembers the moment when she realized that she couldn’t afford an abortion.“I didn’t know anything about this Hyde Amendment until the clinic told me that they could offer me a $75 discount, but the procedure cost about $700,” Brittany tells Refinery29. “For me, I couldn’t understand it, because I was already a parent of three and my Medicaid insurance covered every doctor’s visit, the prenatal care, the delivery, the follow-up care, the post-natal care.”At the time, Brittany, a 23 year-old mother of three living in Chicago, was like thousands of women in America who are unable to access safe abortion because of the Hyde Amendment, which bans Medicaid coverage of abortion care — making abortion the only medical procedure that has ever been banned from Medicaid. The Hyde Amendment also applies to other federal health insurance programs , including military personnel and their families, federal employees and their families, inmates in federal prison, Peace Corps volunteers, residents of Washington, D.C., and more.“For me, it made no sense,” Brittany says. “As someone who was low-income and who couldn’t afford my rent, coming up with $700, which was the same amount as our rent, was extremely hard.”Friday marks the 40th anniversary of the Hyde Amendment, which is reauthorized by Congress every year. For 40 years, this legislation has reinforced the stigmatic notion that abortion is different, that abortion isn’t worthy of public or legislative support. For the nearly one in six women of reproductive age in the United States who rely on Medicaid for health insurance, like Brittany did, this law is a strict barrier between them and accessing safe medical care. Only 15 states currently allow state Medicaid funding for abortion and 60% of women who rely on Medicaid for coverage live in one of the 35 that do not.Luckily, Brittany was able to afford an abortion with help from the Chicago Abortion Fund (CAF), a nonprofit organization which provides financial assistance to those seeking safe abortion care. Today, at age 32, she is its executive director. CAF is part of the National Network of Abortion Funds , which are grassroots groups that emerge locally to help people afford safe abortion care to fill the gap that the Hyde Amendment has left in coverage and access.While Brittany got the help she needed to have her abortion, too many women do not. In the past four years of my work as an activist for safe and legal abortion, I’ve watched hundreds of abortion restrictions sail through state legislatures, forcing some women to travel hundreds of miles to the nearest clinic. I’ve walked scores of emotional patients and companions past screaming protesters at a safe abortion clinic in northern New Jersey. I’ve heard from hundreds of frightened low-income women who need help paying for an abortion as a former board member of the New Jersey Abortion Access Fund.I have heard many harrowing and heartbreaking stories from women just like Brittany. I’ve heard from immigrants, rape survivors, and frightened teenagers, all desperate for help and unsure where to turn because they cannot afford a safe abortion. That’s what the Hyde Amendment does: It turns what should be a simple, private medical procedure into a nightmare of desperation and it does so to populations that are already incredibly marginalized and vulnerable.The Hyde Amendment targets low-income women and disproportionately impacts women of color, who are at a greater risk of being uninsured . If they are insured, they are more likely to depend on government-based insurance for health care. According to the Guttmacher Institute , 30% of Black women and 24% of Hispanic women aged 15 to 44 are enrolled in Medicaid. These are communities that are also more likely to be in poverty. In 2014 , 26.2% of African-Americans and 23.6% of Hispanics were poor. To deny a woman access to safe abortion not only denies her constitutional right — it also makes her three times more likely to fall into poverty than those who can access safe abortion.“This ban on insurance coverage for abortion has interfered with women’s health decisions and really pushed abortion out of reach for those struggling to make ends meet,” says Destiny Lopez, co-director of All* Above All, an organization that is leading a campaign to end bans on abortion coverage and expand abortion coverage to everyone, regardless of circumstances. “Those are disproportionately low-income people who are more likely to be women of color, young, immigrants, transgender, or gender-nonconforming people.”What might surprise you is that the Hyde Amendment has long been a quiet bipartisan agreement: For decades, no Republican or Democrat would touch it and no one would argue against it. Since its initial passage 40 years ago this week, the Hyde Amendment has been one of the few legislative areas upon which the two parties have primarily agreed. They may disagree on whether abortion should be safe and legal, but at least they both agree that the government shouldn’t help low-income women access it.