Last week, the New Hampshire House voted on 10 laws that impact women’s health and access to safe and legal reproductive health care. Earlier this month, the Supreme Court heard arguments on the most significant abortion-related case of the past two decades, in Whole Woman’s Health v. Hellerstedt. And in the past year, the candidates vying for the highest office in the country have weighed in with their thoughts on women’s health in general and abortion in particular.

So, this begs the question: when equal access to reproductive health care is being discussed, who gets to frame the conversation?

Planned Parenthood was in the news quite a bit last year, and there was no end to discussion about the organization and the critical services they provide to millions of women. So as an advocate of abortion rights, do I accept the premise that abortion is bad or shameful and respond defensively that “only 3 percent of Planned Parenthood services include abortion”? Or do I instead ask why the Hyde Amendment is still in place, creating a barrier for poor women to equally access their legal rights to safe abortion care?

The Hyde Amendment is the law that restricts federal dollars from being used on abortion services. In effect, this law says poor women and families do not have equal rights to make their own reproductive health choices. Medicaid and other federal funding covers health care services for people who need but cannot afford them. An abortion is a legal medical procedure.

Roe v. Wade established that it is the right of every woman to make her own reproductive decisions. But the Hyde Amendment, in effect, says, “only if you have enough money to pay for it yourself.”

This is not about personal ideologies — this is an issue of inequality. Poor women should absolutely have equal access to the same medical care as rich women. When issues of equal access are being decided, often those most affected are left out of the conversation entirely.

Since 1979, the Hyde Amendment has been available to hide behind when the conversation about federal funding for family planning of any kind was pushed into a debate on abortion. “Don’t worry,” we could say, “federal Title X funding can’t be used for abortions, only for reproductive health services like breast cancer screenings, contraceptives, education and STD screenings.” This felt like a good way to have the conversation: separate out the most controversial part of the discussion and, in this way, perhaps more easily advocate for other basic reproductive health access.

But there is something insidious about accepting this premise and allowing the conversation to be divided in this way — restricting access to medical care for millions of women due to the personal objections of a vocal minority.

The Hyde Amendment in one fell swoop accepts the premise that a completely legal medical procedure is something of which to be ashamed, and that poor people should be subject to have their health care choices screened by politicians. This is how our rights and voices are stripped away — death by a thousand cuts.

The majority of the American public still agrees women should have access to safe, legal abortion. Both major Democratic presidential candidates have called for a congressional repeal of the Hyde Amendment. Secretary Hillary Clinton backed up her longstanding opposition to the amendment by outright calling for its repeal in early January, and Sen. Bernie Sanders joined her later that month by advocating the same.

In July 2015, Rep. Barbara Lee, D-Calif., introduced a bill called Equal Access to Abortion Coverage in Health Insurance Act or the EACH Woman Act. In addition to equalizing access to abortion across insurance providers including the Affordable Care Act, this bill “would end the harmful Hyde Amendment policies that restrict a woman’s ability to make the best health care decisions for herself and her family.” I was proud to see New Hampshire Congresswoman Annie Kuster signed on as a co-sponsor. These lawmakers are listening to people most affected by this legislation and helping them reclaim the conversation.

Restricting abortion access, through the Hyde Amendment or through TRAP (Targeted Regulation of Abortion Providers) laws like Texas’ HB 2, results in women — and most especially poor women — being stripped of their reproductive choices and medical options, regardless of Roe v. Wade. As Solicitor General Don Verrilli said in the Supreme Court hearing on Whole Woman’s Health v. Hellerstedt (which challenges HB 2) on March 2, “If you do find that this law is upheld, what you will be saying is that this right really only exists in theory and not in fact.”

The N.H. House voted on 10 bills last Wednesday that impacted reproductive health care — including several that specifically targeted access to abortion care and would have made state law even more extreme and discriminatory than the Hyde Amendment. I’m very pleased that nine of the bills were defeated — although some were defeated by upsettingly small margins. The repeal of N.H.’s buffer zone law (HB 1570) passed, and will now be heard by the state Senate.

These TRAP laws and the Hyde Amendment are based on the premise that health care should only be accessible on an equal basis if they are not the subject of political controversy. Do you accept this premise? Pay attention to how your elected representatives vote on issues like these. It will say a lot about the premises that they accept in their representation of you.

I encourage you to look for the voices of the underrepresented in the conversations your decision makers are having. Please join me in telling your elected representatives to support legislation like EACH Woman Act and to repeal the Hyde Amendment if equal access to reproductive health care matters to you, too.

This article was originally published as an Op Ed column in the Seacoast Sunday edition of The Portsmouth Herald and Fosters Daily Democrat, and online at seacoastonline.com.