Here's How We Should Be Talking About Health Care Reform

On Thursday, President Trump quipped to reporters, “The only thing more difficult than peace between Israel and Palestine is health care.”

Social media users were quick to mock the president for likening healthcare reform to the decades-old dispute that is often considered to be insurmountable.

However, it is true that health care does have remarkable complexities (which President Trump seems to have finally realized, just two months after telling Time magazine that he “understood everything there [is] to know about health care.”)

And because health care reform is so complex, the danger arises that politicians and political pundits can easily gloss over the consequences of Republicans’ new legislation. So it is crucial that we speak clearly and intentionally about what exactly will be lost and who exactly will lose should Republicans succeed in repealing the Affordable Care Act.

Women, and particularly low-income women, stand to lose most dearly.

Women were among the greatest beneficiaries of the ACA. Before the passage of the Affordable Care Act, only 13 percent of plans sold on the individual market including maternity care, and women were often charged more than men for identical plans, according to NPR.

Obamacare also helped to close the gender gap in health coverage. Before the ACA, women were particularly at-risk of not receiving health coverage through their jobs. According to the Center for American Progress, only 48 percent of women are eligible to get health insurance through their jobs, compared with 57 percent of men. Minority women, among the lowest paid workers in America, were particularly vulnerable to not receiving employer based coverage.

When Kellyanne Conway said last month on ABC’s This Week that “able-bodied Americans should probably find [jobs]” to get healthcare when they lose coverage under the proposed Republican plan, it misrepresented the fact that many Americans who work full-time still cannot afford health care.

But her words particularly ignore the fact that women, two-thirds of whom are either breadwinners or co-breadwinners, would not be able to obtain health care for their families without the help of Medicaid and the ACA. Conway’s statement is particularly ironic because the Trump administration often claims to support working women, yet that support does not seem to extend to women working low-wage jobs who are disproportionately minorities.

To be clear, the Affordable Care Act is not without its imperfections. But it also has made remarkable strides in women’s healthcare. Approximately 5 million women age 19-44 years old gained health care coverage from 2010-2015, according to the Urban Institute. The ACA required insurers to cover maternity care, as well as preventive services such as mammograms, Pap smears, and well-baby care. Women who had previously been victims of sexual assault, nor women who had had Caesarean sections could be denied care, and much more.

If passed the new Republican health care bill will remove many of these benefits from women, but not in a straightforward way. Though Republicans may claim that women will still not be allowed to be discriminated against for pre-existing conditions, backdoor methods will allow states to drop maternity care and other well woman services from among the Essential Health Benefits.

The fact that the Republican bill takes care to strip women of health coverage only surreptitiously demonstrates the fact that Republican lawmakers recognize that taking away basics such as maternity care might not sit well with people. Thus, if Republicans are to pass this bill, it will require efforts to divert from the truth that this bill discriminates against women by hiding behind complexities of health care law.

So let’s be intentional to not allow women’s bodies to become an abstraction in the healthcare debate by speaking clearly and intentionally about how much women will lose if Senate Republicans succeed in their endeavor to repeal health care.

It would be unrealistic to hope that this effort to speak clearly about the plights of low-income women would move those politicians already set on repealing Obamacare to do otherwise. But what we can do is to at least make sure that low-income women, among the most vulnerable in our society, have a voice in this debate.

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