This is part two in my three-part series about what the Affordable Health Care Act means in tangible terms to each of us. The first post in the series was Barbara O’Brien’s optimistic “Health Care Reform Will Help Everybody.” Today, in a post that originally appeared in the Women’s Review of Books blog, I address women’s health specifically in both a personal and political context.
Remember, that the Department of Health and Human Services launched a new website, HealthCare.gov, on July 1 to help consumers wade through the new law’s provisions and how they will affect our access to health care. So do check that out, and as always, your comments and ideas are very welcome here.
Let me be clear: Had I been a member of Congress, I would have pressed the “yes” lever for the health-reform bill when it came down to the vote for final passage. It was incredibly important that we start somewhere to make health care accessible and affordable to all Americans. And we can celebrate, as Ms. magazine recounts in “What the Health Care Bill Means for Women,” that contraceptives will be covered, gender rating that discriminates against women has been eliminated, and preventive services such as pap smears will be covered without co-pay under the new plan.
But sometimes when you win you lose.
I am spitting mad about the way my values—and those of so many women and men, including the band of forty or so Congresswomen, led by pro-choice caucus chair Rep. Diana DeGette, who fought valiantly against the Stupak-Pitts amendment–were callously pitted one against another. Stupak-Pitts would have written into permanent law the current Hyde Amendment ban on coverage for abortions for women whose health care is paid for by the federal government. And it would have extended the ban to the rest of us if we purchased insurance with private funds through a federal insurance exchange
This Solomon-like decision represents not the proverbial win-win compromise that politicians are supposed to seek but a net loss for women. The loss of important health coverage hurts, but I predict the political loss will ultimately turn out to be even more devastating.
In the end, President Obama himself, who during his campaign supported getting rid of the Hyde amendment, issued an executive order that implements restrictions almost identical to Stupak-Pitts.
And candidate Obama, who in 2008 enthusiastically promised to pass the Freedom of Choice Act to guarantee reproductive right including access to abortion, just a year later as president said FOCA wasn’t on his legislative agenda.
As RH Reality Check put it, insurance coverage for abortion is now an endangered species.
This show of weakness by the president, the congressional leadership, and the women’s movement for not holding politicians’ feet to the fire has serious political consequences. The women’s groups early on acceded to the so-called “compromise” Capps Amendment that would have maintained the status-quo Hyde restrictions: leaving poor women out in the uncovered cold but retaining coverage for women with private-pay insurance.
Once they had given in on that key principle, there wasn’t much women’s groups could say or do to establish their moral authority or political power to buck the administration’s appeasing ways. Appeasing is like throwing a hungry jackal a small piece of red meat—it just howls for more.
Predictably, a proliferation of state measures aimed at restricting abortions, punishing women who seek them, and serving as test cases to overturn Roe v. Wade, has been unleashed. In “A Spreading Peril for Women’s Privacy and Freedom,” Dorothy Samuels catalogued these new threats the New York Times.
“We have to use every opportunity to improve this badly flawed legislation,” Judy Norsigian, executive director of the Our Bodies, Ourselves women’s health collective recently told me. “We have to keep the anti-abortion folks from doing even more damage as they now try to push through state-level restrictions on abortion coverage in private health plans. And we have to work at the state level to keep educating the public about what single-payer health care is all about.”
Fights about abortion aren’t about abortion at all but about the nature and purpose of human sexuality and gender roles. So no surprise that abstinence-only sex education funding also stealthily made a return appearance in the health bill to the tune of $50 million, along with funding for more comprehensive education that includes abstinence but gives young people medically accurate information about sexuality, sexual health, and contraception.
A strategy that didn’t require women to choose which important health-care service to sacrifice would have taken us much closer to universal coverage and coverage for all reproductive health services. That includes abortion with no refusal clauses for institutions and individuals who oppose legitimate women’s health-care services (which often include refusing to provide emergency contraception, certain infertility treatments, and even birth control).
Had we done that, we might not have succeeded in eliminating the Hyde Amendment yet. But that sort of loss, rooted in principle and justice, would have constituted a win by elevating the issue and demonstrating that reproductive rights are indivisible—either everyone has them or no one has them.
It would have been a step toward taking us beyond Roe and toward reproductive justice for women.
It’s no small matter that a health-reform bill was passed. But we’re a very long way from finishing the job, especially when it comes to women’s health care. The question is whether we women will use our power to demand it in the next round.