The Dornan Amendment: How Congress Controls DC's Reproductive Healthcare
Washington, DC is the only city in America where Congress controls local healthcare funding. The Dornan Amendment has blocked DC from using its own tax dollars for Medicaid-funded abortions for 30 years.
Washington, DC has some of the strongest reproductive healthcare protections in the country. There are no gestational restrictions on abortion. DC has robust shield laws protecting providers who deliver reproductive healthcare and gender-affirming care via telehealth to patients in restrictive states. Abortion is legal, accessible, and protected by local law.
But there's a catch — and it's a big one.
What is the Dornan Amendment?
The Dornan Amendment is a rider attached to DC's annual federal appropriations bill that prohibits the District of Columbia from using locally raised tax revenue to fund abortions through its Medicaid program. Not federal money — DC's own local tax dollars, raised from DC residents and businesses.
Named after former California Congressman Robert Dornan, this restriction has been in place for most of the past 30 years. DC is the only city in America subject to this kind of congressional interference in local healthcare funding.
What this means in practice
Medicaid is the health insurance program for low-income Americans. In most states, state Medicaid programs can choose to cover abortion services using state funds. Seventeen states and DC's local government have expressed the desire to do so.
But because of the Dornan Amendment, DC's Medicaid program cannot use locally raised tax revenue to cover abortion care — even though DC voters, DC's elected officials, and DC's local budget all support doing so. A patient on Medicaid in DC who needs an abortion must find another way to pay.
This is not about federal funding. The Hyde Amendment separately restricts federal Medicaid dollars from covering abortion (with exceptions for rape, incest, and life endangerment). The Dornan Amendment goes further: it tells DC that it cannot even use its own money the way its own residents want.
The statehood connection
The Dornan Amendment exists because Washington, DC is not a state. Congress has plenary authority over the District's budget under the Constitution, and it exercises that authority to impose policy restrictions that DC residents have never voted for and actively oppose.
DC residents pay federal taxes, serve in the military, and have a higher population than Wyoming or Vermont — but have no voting representation in Congress. The Dornan Amendment is one of the most tangible examples of how this lack of representation translates into direct harm to DC residents' healthcare.
How CE Repro Fund fills the gap
The Dornan Amendment is one of the reasons CE Repro Fund exists. When Congress prevents DC from funding Medicaid abortions, private donor funding is the only way to ensure that low-income DC residents can access the care their elected leaders want to provide but are constitutionally blocked from funding.
CE Repro Fund provides direct financial assistance to patients in the greater Washington, DC area who cannot afford reproductive healthcare — including abortion care that Medicaid would cover if not for the Dornan Amendment.
Every donation to CE Repro Fund is, in a very real sense, filling a gap that Congress created.
DC's strengths despite congressional interference
Despite the Dornan Amendment, DC remains one of the strongest jurisdictions in the country for reproductive healthcare access. DC has no restrictions on abortion at any gestational age. The District's shield laws protect providers who deliver reproductive healthcare and gender-affirming care via telehealth to patients in other states. Multiple healthcare providers in the DC area offer comprehensive reproductive services.
DC is also a destination for patients traveling from states with abortion bans. Its geographic location, strong legal protections, and network of providers make it a critical access point for patients from the South and mid-Atlantic region.
CE Repro Fund supports both DC residents navigating the Dornan Amendment gap and patients who travel to DC for care they cannot access in their home states.
What you can do
Donate to CE Repro Fund to directly fund the reproductive healthcare that Congress won't let DC fund through Medicaid.
Learn about DC statehood. The Dornan Amendment would be irrelevant if DC had the same self-governance rights as every state. Supporting DC statehood is supporting reproductive healthcare access.
Share this information. Most Americans — including many DC residents — don't know about the Dornan Amendment. Awareness is the first step toward change.