The DC Council recently revised and gave final approval to Mayor Muriel Bowser’s 2025 budget, but it doesn’t immediately go into effect. Because the District is not a state, the United States Congress can reject or alter the District’s budget, and each year they insist on changes. This process serves as a glaring reminder of DC’s lack of statehood and lack of autonomy, including in areas like reproductive rights.
For more than 30 years, Congress has imposed the Dornan Amendment on the DC budget as a “rider” — an extra requirement — that restricts DC from using locally-raised tax dollars to pay for abortion care through Medicaid (as many states choose to do with their locally-raised funds). For many low-income Washingtonians, the Dornan Amendment makes legal, essential health care inaccessible. While the Planned Parenthood of Metropolitan Washington, DC (PPMW) Abortion Access Fund and the DC Abortion Fund make a true difference in the lives of patients, these funds aren’t able to meet the needs of all patients nor do they address the root issue.
To learn more about the Dornan Amendment and how DC’s lack of statehood is a reproductive health and rights issue that impacts patients on a daily basis, we spoke with Assistant Vice President of Policy and Advocacy Franki McDaniel and Assistant Vice President of Business Operations Natasha at PPMW.
Could you expand on how DC’s lack of statehood impacts its ability to self-govern?
McDaniel: In 1974, Congress passed the Home Rule Act, which gave DC residents the ability to elect their own local government. The DC Council acts as the legislative and policymaking body in the District. Our legislative process is similar to states. The DC Council passes laws and they go to the mayor, who can enact or veto them. The council can also override a mayoral veto with a two-thirds vote. So, that’s a fairly normal legislative process, but limitations appear after a bill is passed.
When a bill passes, it must go through a unique congressional review period, which Congress can use to interfere with DC’s budgets and laws. Congress can even prohibit bills passed by DC’s elected officials from taking effect. No state is subjected to this kind of control. And because DC doesn’t have statehood, its nearly 700,000 residents also have no voting representation in that very Congress that is deciding on their future.
Can you explain the Dornan Amendment and its impacts?
McDaniel: The Dornan Amendment is one way that Congress has interfered with DC's legislative process and laws. It prevents Medicaid dollars from being spent on abortion, so if you're a resident of DC and you are a recipient of Medicaid, you can’t use your Medicaid coverage to pay for an abortion if you need one. All U.S. states are allowed to choose whether or not their locally-raised tax dollars can cover abortion, and there are several states that do choose that. But because DC is not a state and Congress has control over its laws and budgets, they can and have restricted access to abortion care.
Preventing people from accessing critical health care is undemocratic and disproportionately impacts communities of color and people with low incomes. The Dornan Amendment forces many patients to choose between paying for their health care and fulfilling their other basic needs.
It is also important to keep in mind that Congress could go even further by prohibiting abortion in DC. Because of the ever-present risk of further Congressional intervention, we don’t truly have any guarantee of reproductive freedom in DC and won’t until statehood is achieved.
How does PPMW support patients who are covered by DC Medicaid and can’t use it for abortion care?
Natasha: About half of our patients have Medicaid, and many of those have DC Medicaid. Because patients using DC Medicaid can’t access it for abortion care, we rely on other funds, including our donor-supported PPMW Abortion Access Fund and community funds, like the DC Abortion Fund.
With these options, abortion care can be 100% covered for most patients unable to secure other insurance coverage. This protects our patients from having to make impossible decisions, like choosing between paying for rent, groceries, or their medical care. However, these funds are very in-demand and would quickly be depleted without ongoing donor support.
Does the Dornan Amendment have other effects on patients?
Natasha: Patients who use DC Medicaid aren’t always informed about what it covers and what limits Congress has imposed — the system can be very complex and confusing. This means they will often think that services are covered and then find out when they come to our health center that there are costs they didn’t expect. For example, in addition to DC Medicaid not covering abortion care, it also doesn’t cover family planning.
It becomes our job at the health center to assess which services their benefits will cover and to seek other funding options to fill the gaps. We want to make sure every patient can access the care they need, and the limits imposed by Congress definitely make that more challenging.
What is PPMW doing to advocate for DC statehood?
McDaniel: Organizers on our team are out in the DC community and surrounding areas helping to educate people on the importance and intersectionality of reproductive rights and DC statehood. We also partner with other organizations that are well-established in the DC statehood space, forming coalitions and bolstering their efforts. This includes groups like DC Vote, Neighbors United for DC Statehood, and ACLU-DC.
DC statehood is always a crucial part of the work we’re doing when it comes to organizing, policy, and thinking about how we can continue to expand and protect access to sexual and reproductive health, rights, and justice.
What can supporters do to help?
McDaniel: It’s very important to raise awareness. Talk with family and friends about this issue, even those who may not live in the DC area. A lot of people forget DC is not a state and even fewer know about the Dornan Amendment and how it relates to reproductive health, rights, and justice.
PPMW also offers volunteer opportunities that give participants the chance to advocate in the communities we serve and help educate others about the Dornan Amendment and need for DC statehood. And supporters who want to make a direct impact today can donate to the PPMW Abortion Access Fund.
To learn more about the Dornan Amendment, DC statehood, and reproductive rights, listen to PPMW’s interview on the podcast Local Selection.
You can help PPMW protect and advance reproductive rights and equitable access to reproductive health care by donating to support our advocacy work today.
Header image: APK, John A. Wilson Building west side, image cropped for formatting, CC BY-SA 4.0