A massive defunding for women’s health care is now under consideration in the United States Senate. All told, it represents billions of dollars annually that will come straight out of primarily women’s wallets.
You may not usually think of the federal government as a philanthropic institution. Yet from our country’s start, congressional acts have subsidized various segments of the population and for a variety of reasons. Take the 1792 Postal Act. A spirited debate went on in the second session of Congress, over maintaining access to information. That Congress voted to create low postal rates for newspapers and to improve roads by creating postal routes to ensure expansion and development of our fledgling country, rather than solely serve existing communities. Americans still benefit from reduced media postal rates today.
The proposed Better Care Reconciliation Act (BCRA) put forth by Majority Leader Mitch McConnell in the 115th Session is an entirely different matter. It will adversely impact the finances of women – particularly poor women and women of color, and all rural people, especially women. By cutting off funding – just so the wealthy 1% can get tax breaks – American adult women, 126 million strong, will again have to shell out of pocket money for all kinds of basic health care or forego health services, often to the detriment of their own well-being and the well-being of their families. People will die as a result of this bill. The greater proportion of those deaths will be women.
Dawn Laguens, Executive Vice President of Planned Parenthood Federation of America, stated it succinctly, “It is outrageous that a group of men are negotiating to make it harder for women to prevent unintended pregnancy, harder to have a healthy pregnancy and harder to raise a healthy child.”
The Impact on Medicaid
The Better Care Reconciliation Act proposes gigantic cuts in Medicaid, rolling back the expansions that were put in place by the Affordable Care Act, or Obamacare. An estimated $772 Billion will be siphoned off from this program that benefits low income people. This impacts 25 million women in the US, who are 36% of the Medicaid beneficiaries. Their children, under age 18, are another 44% of Medicaid recipients. Over the first 10 years of this proposed bill the deep cuts into medicaid are expected to be 25%, but in the 2nd decade starting after 2027, the cuts go far deeper to 35%.
These Medicaid cuts threaten rural hospitals. Simply, many will close. As a group, 14% of their budgets come through medicaid reimbursements for their services.
Though not named, criteria specifically targets Planned Parenthood for the chopping block, however, at present, only for one year. This vital health service agency provides everything from cancer screenings to birth control. It has historically served one in five women in America. Planned Parenthood would be denied reimbursement, like other health care agencies, for the low income women, who comprise over 50 percent of their patients. In 2015 Planned Parenthood affiliates received $553.7 million in government reimbursements and grants for services. This means some 2.4 million women who regularly use the 600 Planned Parenthood facilities across America will no longer have access to these vital services.
Many conservative lawmakers claim women can as easily be served by other existing clinics.“…[Community health centers] are vastly bigger in network, there are so many more of them, and they provide these kinds of services without all of the controversy surrounding this [abortion] issue,” touted House Speaker Paul Ryan in January. But a report from the non-partisan Congressional Budget Office estimates that these other community clinics could not make up for the flood of uninsured patients to their doors.
Further, in an investigation by Rewire, numerous of these clinics are religious in affiliation and fail to offer a full range of reproductive health care. They restrict family planning. So, in fact they are both in contradiction to the services offered at Planned Parenthood clinics and fail to adhere to the tenets of the ACA.
Being Female, A Pre-existing Condition
The Senate’s BCRA bill, like the House’s version, the AHCA, avoids outright omissions of the essential success of the Affordable Health Act. That is the inclusion of all people in health insurance despite so-called pre-existing conditions. Prior to the ACA women universally had to pay higher premiums solely due to their sex as a pre-existing condition.
The BCRA and the AHCA theoretically keep pre-existing conditions. But the laws pass the political buck to states to allow for waivers that effect various types of pre-existing conditions. “Because they [the states] are closer to the public’s health needs,” numerous Congressional supporters of the two bills disingenuously claim, the states can make the decision on how to handle pre-existing conditions.
But combined with all the fiscal cuts, many states will be hard pressed to shoulder the costs related to pre-existing conditions. Instead, the public will get a hodge-podge of programs that will make some states semi-bright beacons of partial health coverage and others wilting lilies where poor citizens are on the hook personally for the high and rising costs of health care that they cannot afford. This dynamic will have larger ramifications on the impact of businesses to attract workers and other developments and programs within certain states. It is a far cry from the 1792 Postal Act. Or Obamacare.
People of color in larger numbers have historically lacked insurance. The ACA started to close that gap, though there is far more to go. The Groundswell Fund and Ms. Foundation for Women are two foundations that for decades have supported women of color health groups addressing these disparities. It is from these groups that new theoretical frameworks and progressive advancements like Reproductive Justice have emerged and that, in turn, have impacted the international health community.
Teresa C. Younger, President and CEO of Ms. Foundation said, “The bill is called The Bettercare Act but it will only result in worse care for women of color. [ It ] siphons resources to pay for yet another tax cut for rich white men. It’s clear women of color are in Conservatives’ anti-woman, pro-billionaire crosshairs with this bill, but women of color won’t stand for it. We are literally fighting for our survival.”
The Impact on Birth Control
Not until 1965 did birth control become legal. State laws prohibiting it were struck down that year in Griswold v. Connecticutt by the Supreme Court.
Post 1965, with oral contraceptives available since 1961, almost three generations of sexually active women have practiced birth control. According to the Kaiser Family Foundation, contraceptions make up an estimated 30-44% of out-of-pocket spendingfor their health care by sexually active women. The ACA recognizes the unique health needs of women throughout their lifespan. The Health Resources and Services Administration (HRSA) created a set of guidelines for women’s care. This includes contraception. An estimated $1.4 billion in the first year alone of Obamacare was saved by 55 million women because they had access to birth control through copayments in their health insurance.
Despite 71% of the US population being in favor of full coverage of birth control, the current administration is not listening. The BCRA does not directly strike down the birth control provision, but already rumors are afoot that the Tom Price lead Health and Human Services Department is about to do away with a component of the benefit.
The first line of attack on this widely acceptable copay is based on religious and moral grounds. In a leaked rule, the Trump administration may be poised to significantly roll back birth control through the ACA. Building on the Supreme Court’s Hobby Lobby ruling, it would allow any employer or university to deny coverage based on their beliefs. Religious and moral grounds of women are obliterated. Also, there seems to be an attempt to bypass the mandated 60-day public comment period.
$200 Billion in Incentives Luring Senators to Pass BCRA
Women are primary caregivers, tending to the upbringing of children and caring for aging parents. The majority of this work is unpaid labor. Women’s reproductive organs warrant greater health care. Combined, these factors mean women interact with health care providers far more frequently than men. Cutting funds for some of the most essential health needs of women as provided in the ACA is a direct slap in the face to 51% of the US population.
McConnell’s pulling of the BCRA just before the Fourth of July recess was momentary. To understand better the horse trading that the Senate Majority Leader has at his disposal to get Senators on board his health care train wreck, long time Hill correspondent, Michael McAuliff, has written an especially informative article. Hint, the reporter calls it “Candy”. While he makes no mention of women per se, McAuliff explains how the Majority Leader has about $200 billion worth of incentives at his disposal. That’s our tax money at play, being used as inducements to decimate our health care systems.
Gloria Feldt, who for thirty years worked with Planned Parenthood, ten years as President and CEO of the Federation, and is now co-founder of Take The Lead Women, summed it up this way: “Families who thought their company plans would cover a new child’s birth may find themselves paying a very high premium just to have coverage–and then be bankrupted by devastating costs if there are complications of pregnancy or birth. [The BCRA creates] high profits for insurance companies. Now that’s about as foolish a piece of legislation as you can get.”