Americans finally got their first look at Senate Republicans’ proposed health care overhaul this week, a dense 142-page document that provides a massive rollback on the ACA’s commitment to promote health care access nationwide.
Many of the cuts directly affect women, specifically threatening medical coverage of childbirth, family planning services, reproductive cancer screening, parental leave, abortion and childcare responsibilities that disproportionately affect women who are more likely to be primary caregivers.
Reproductive rights advocacy groups and non-partisan health organizations that serve women wasted no time in condemning the bill, issuing statements on Thursday calling it an “assault on women’s health” (The Center For Reproductive Rights) “reckless” (The American College of Obstetricians and Gynecologists) and warning that it is “worse than the bill passed by the House” (the American Psychological Association).
With just days before it could head to the Senate floor for a vote, experts and analysts are are furiously diving into the details, attempting to determine what this bill means for the future of health care in this country. But what’s already very clear is that women will pay a steep price if it passes.
Here are just a few of the ways in which the GOP Senate health care bill targets women:
1. It slashes Medicaid.
More than 25 million women are covered by Medicaid, including some 17 million non-elderly women who rely on it as their primary source of health care. Translation? Medicaid is this country’s single largest provider of reproductive health care coverage, and the deep cuts to it will hit women hard. The non-partisan Congressional Budget Office (CBO) estimate found that 14 million fewer people would get Medicaid over the next decade based on the House bill and the outcome under the Senate bill could be similar — or worse. Women who count on Medicaid will now have a much harder time accessing birth control, cancer screening and tests for sexually transmitted infections, as well as so many other essential health services.
It’s also worth noting that 44 percent of the Medicaid population are kids under the age of 18, which is why the American Academy of Pediatrics slammed the GOP health care bill on Thursday, saying that it “fails to meet children’s needs” and puts everyone, from a newborn requiring emergency heart surgery to a toddler who requires a wheelchair, at risk. Women still tend to more of the hands-on childrearing and care of children when they’re sick, even in two-parent heterosexual families in which both parents work full-time. An attack on children’s health care is also an attack on them.
2. It threatens to price millions of women out of maternity care.
Obamacare transformed maternity coverage in the United States by making it an essential health benefit, meaning that all plans had to cover prenatal care and childbirth. Before that, only 12 percent of individual market plans actually covered maternity care, and it was totally legal for insurance companies to deny coverage to women who were pregnant or who could plausibly become pregnant down the road.
The Senate bill, much like the bill that narrowly passed the House in May, gives states leeway to waive those essential health benefits requirements. Which means that millions of women stand to lose maternity coverage. Plus, estimates suggest that nearly half of all births in the United States are covered by Medicaid. It’s not good news for those women that the Senate bill includes even deeper cuts to Medicaid than the House version of the Obamacare overhaul called for.
OB-GYNs understand this. “Hardworking women and families would return to the days when having a child or facing a devastating diagnosis could mean bankruptcy,” ACOG warned in a statement.
3. It “defunds” Planned Parenthood.
After years of threatening Planned Parenthood, the new bill could finally succeed in “defunding” the health care provider for a full year. While the words “Planned Parenthood” aren’t actually written anywhere in the bill, it blocks Medicaid reimbursement to any health care provider that offers abortions (except in specific cases, like rape and incest). Which means that Medicaid patients would be effectively blocked from going to Planned Parenthood for preventive services, like Pap smears or contraceptive counseling. After the House version of the bill was released, the CBO predicted that “defunding” Planned Parenthood for one year would particularly affect low-income women and women in rural areas, leaving 15 percent of those women without services that prevent pregnancy, The Washington Post reports.
“Slashing Medicaid and blocking millions of women from getting preventive care at Planned Parenthood is beyond heartless,” Cecile Richards, president of the Planned Parenthood Federation of America said in a statement.
4. It could penalize moms who don’t meet certain work requirements soon after they give birth.
Reproductive rights advocacy groups like the Center for Reproductive Rights and Planned Parenthood have pounced on a section of the bill that they say makes it possible for states to basically force some women to go back to work two months after they give birth, at which point many moms are still healing and all parents are very much in the thick of caring for a needy, helpless newborn. That’s because the bill includes a Medicaid work requirement that lets states yank coverage from women who haven’t found a job by that point.
The bill “imposes optional work requirements on Medicaid recipients, allowing states to force new mothers on Medicaid to find work as soon as 60 days after giving birth,” the Center for Reproductive Rights said in a statement.
5. It punishes women for buying plans that cover abortion.
The Senate bill, much like the House version, prevents people from using tax credits to buy insurance on the individual market if they want to buy a plan that covers abortion (again, except in the case of rape or incest or to save a woman’s life). Reproductive rights advocacy groups argue that this move will discourage private insurance companies from offering plans that cover abortion, even employer-sponsored plans.
“Coupled with current restrictions ... this measure would create a system where virtually all women – whether they are uninsured, insured through Medicaid or another federal program, insured through the individual market, or even insured by an employer – in the United States don’t have coverage for abortion services,” The Center For Reproductive Rights said in a statement.