Artists celebrate Flag Day in Washington, DC, on June 14, 2011. (Courtesy of Flickr.)   DC residents realize that if the district is ever going to wrest control over local revenue spending from Congress, then they have to take matters into their own hands.   “Home rule,” an expression synonymous with administrative and budgetary autonomy, is closer than ever to being achieved in DC, thanks to multi-pronged efforts both inside and outside of Congress. The federal government currently dictates how DC can spend its own local tax dollars, which make up 70 percent of the district’s budget. The lack of home rule has had profound implications for not just needle exchanges and medical marijuana programs that the City Council approved and Congress rejected but also for low-income women. House Republicans have repeatedly prohibited the district from using local funds to help Medicaid-enrolled women access abortions, even though the mayor, city council and the district’s congressional representative, Congresswoman Eleanor Holmes Norton, are all in favor of doing so.

The best hope for DC autonomy may come in the form of an amendment to the Home Rule Charter, which 83 percent of the district’s voters supported in a referendum in April. Though the House Appropriations Committee dismissed the referendum as “an expression of the opinion of the residents, only,” that lacked “any authority to change or alter the existing relationship between federal appropriations and the District,” it went unchallenged during a thirty-five-day period of congressional review that just concluded.

“I don’t think Congress was paying attention to the charter amendment,” Congresswoman Norton told The Nation. Absent a double take by Congress, the charter amendment will become law January 1, 2014, to be implemented for the next fiscal year.

Were DC to have control over its local funds, says Kimberly Inez-McGuire, the National Latina Institute for Reproductive Health’s associate director for government relations and public affairs, “more women, when faced with an unintended pregnancy, would actually have real, meaningful choices, choices that are supported by health insurance coverage, rather than the situation now, which is incredibly coercive.” NLIRH is one of the organizations behind the “All Above All,” advocacy campaign, which aims to restore and sustain abortion coverage for low-income women.

The DC Abortion Fund, an entirely volunteer-run group, has had to step in to fill the gap between what Medicaid-insured women can contribute towards their abortions and the full cost of the procedure. To Kate Vlach, a member of the fund’s board, budget autonomy and home rule for DC would mean healthcare coverage for women that’s actually accessible.

“Private, volunteer organizations wouldn’t have to scramble to fill a social services gap that typically would be filled by a government or public entity, that, if not for congressional interference, would be filled by local government,” she said.

According to research by Karin Bleeg, a DCAF board member who is authoring a study on the characteristics of women seeking funding from an abortion fund, from January through mid-July of this year, the DC Abortion Fund was in contact with (and collected data on) 116 women in DC, and ultimately pledged to help ninety-eight women. Of those 116, eighty-six were on Medicaid, and twenty-four had no health insurance whatsoever. From July 2011 to July 2012, the fund saw an average of 210 calls per month. 458 patients received an average of $221 in assistance. The cost of the procedure ranged from $160 to $20,000.

Said Vlach, “When the ban is imposed, it means that women have to patch together funding from any source they can find, from selling extra valuables they may have—we’ve had people pawning wedding rings, returning their children’s birthday presents, women calling and asking everyone they know for $5—to slowly chip away at the cost of their abortion that seems insurmountable. When the ban is imposed, women’s lives are thrown into chaos in a way that they shouldn’t be.”

For a brief period from 2009 to early 2011, the congressional ban on DC using its own revenue to help pay for abortions was lifted. During that time, says Vlach, calls to their DC hotline “dropped precipitously…. the system was working the way that it should.”

Said Congresswoman Norton, “We had a period in which we saw low-income women who had the same reproductive rights as other women in the district.”

The ban was reimposed when the federal government faced a shutdown in April of 2011. The deal President Obama made with Speaker Boehner involved removing the GOP’s proposed defunding of Planned Parenthood from budget negotiations, but allowing the prohibition on local funds for abortions to be reinstated. President Obama infamously told Speaker Boehner, “John, I’ll give you DC abortion; I’m not happy about it.”

Last week the Senate Appropriations Committee approved a funding bill for FY2014 that eliminated the restriction, while in the House, a new proposal for DC autonomy appeared in the form of the “District of Columbia Financial Efficiency Act.” Representative Darrell Issa, chair of the House Oversight and Government Reform Committee (which has jurisdiction over DC affairs) proposed the bill, which would give DC more (though not total) control over its budget. However, DC would still be subject to the sort of policy riders, like the one banning local funds for abortion. Issa’s proposal is contingent upon Congress failing to pass a spending bill for DC by October 1 (which, given congressional dysfunction, seems likely). Issa’s bill isn’t a good long-term solution for the district, but the language of the bill could still change.

DC Vote Executive Director Kimberly Perry is most optimistic about the referendum as a means to achieve autonomy from Congress for DC’s residents.

“We’re cautiously celebrating, because at any time Congress could decide to overturn it, but they haven’t thus far, so it’s exciting for DC voters,” said Perry. “We are very attuned to any amendments that could potentially be attached the FY 2014 budget that’s going through now. Our message to members of Congress is, ‘Please respect DC home rule and the laws that our local government puts into place on behalf of our residents,’ so we don’t want any amendments attached to our DC related bills that aren’t decisions we’ve already made for ourselves locally.”

If the charter amendment takes effect without congressional meddling, then DC’s low-income women would face the not-insignificant cost of having an abortion without the prospect of being pitched into further economic turmoil.

To Vlach, the issue of home rule can be looked at through two different lenses.

“It’s about low-income women being able to access abortion care with their Medicaid coverage and it’s also a question of local rule. So while some folks may think that abortion rights are controversial, I know of very few, if any folks who are not in support of home rule, states rights, local jurisdiction. While it might be somewhat controversial from one vantage point, from the other, it should be a no-brainer.”

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