Sometimes it's hard to fathom the ways laws and policies evolve in this country, with little coherence and an often-painful disregard for their impact. Today marks 40 years of the Hyde Amendment - a shameful, callous public policy that denies Medicaid funding for abortion care, pushing women deeper into poverty and exacerbating the health disparities that plague our country. It may be impossible to fully grasp the extraordinary harm this punitive policy has done in 40 years.

But exacerbating the problem even further, according to A Double Bind: When States Deny Abortion Coverage and Fail to Support Expecting and New Parents - an analysis the National Partnership for Women & Families released this week - is the fact that many women who struggle without insurance coverage for abortion care are also without the pregnancy accommodation laws, paid sick days and paid family and medical leave they need to hold onto their jobs during pregnancy and care for themselves and their families. So while we deny women the ability to make their own decisions about if and when to have children, we also undermine their economic security by failing to provide basic workplace supports when they are expecting and become parents.

It's hard to overstate the problem. When a woman who was denied abortion coverage cannot keep her job because her employer refuses to make reasonable accommodations for her pregnancy - when she has no paid sick days to use for prenatal appointments or well-baby care - and no paid family and medical leave to use after giving birth - the deck is truly stacked against her. But that's the situation federal and state lawmakers have created through the Hyde Amendment and the failure of Congress and most states to provide abortion coverage and workplace supports. All that conspires to push women into poverty and keep them there.

As is so often the case, women of color are disproportionately affected because they are at higher risk for unintended pregnancy, more likely to be enrolled in Medicaid, and disproportionately without access to paid time off to address health needs.

Here's the stark reality today:

The Hyde Amendment is in place in 35 states and the District of Columbia. Just 15 states use state-only Medicaid funds to cover abortion care.

Many states further restrict women's access to abortion coverage, even beyond the Hyde Amendment: 25 restrict abortion coverage in plans in state health insurance marketplaces, 10 restrict abortion coverage in all private health insurance plans and 21 restrict abortion coverage in insurance plans offered to state public employees.

Few states have passed laws that improve upon inadequate federal law by providing paid family and medical leave, paid sick days and strong pregnancy accommodations.

Alabama, Arizona, Georgia, Idaho, Michigan, Mississippi, Missouri, Nevada, Oklahoma, South Carolina, South Dakota and Wyoming have especially failed to foster women's economic security, based on the factors in our analysis.

Conversely, California and New York have the most expansive workplace protections for expecting and new parents, and both provide state Medicaid coverage for abortion care.

For too long, lawmakers have been playing politics with women's health and ignoring the urgent need for family friendly workplace policies. There are federal and state policies that would support women and families, instead of deepening their struggles. Congress needs to pass the EACH Woman Act, which would restore abortion coverage to women who receive health care or insurance through the federal government. And the country urgently needs the Family And Medical Insurance Leave (FAMILY) Act, which would create a national paid leave insurance program; the Healthy Families Act, which would establish a national paid sick days standard; and the Pregnant Workers Fairness Act, which would help ensure pregnant women have equal access to reasonable workplace accommodations.

The National Partnership is proud to work alongside the fierce advocates who have sparked a national movement to end the Hyde Amendment, once and for all. It's time for lawmakers to undo 40 years of harm and to #BeBoldEndHyde.