Health Care Reform, At Whose Expense?

Guest post by Aimée Thorne-Thomsen, Pro-Choice Public Education Project (PEP)

Despite the headlines and excitement over the signing of the health care bill, today is not a great day for many of us. After months, and let’s be honest, years of struggle to reform America’s decayed health care system, we got…what, exactly? Yes, young people can now stay on their parents’ insurance until they are 26, assuming that their parents have insurance. The legislation expands Medicaid to cover family planning and other preventative reproductive health care. Insurance companies will no longer be able to charge women more than men or deny coverage based on pre-existing conditions. So, yes, women and our families gain a lot from the passage of this bill but at what cost, and at whose expense? This law makes the most vulnerable among us – young women, women of color, immigrant women, low-income women, and transgender women – more vulnerable. And I don’t consider that a victory.

I have already heard it argued that this bill was the best progressives could get. I absolutely reject that. The President was elected along with majorities in both the House and the Senate to pass health care reform that removed barriers and improved access to health care, for all of us, not just the most politically palatable. Many of us who believed in the ideals of hope and change thought that we could achieve universal health care, if not in policy, then certainly in practice. That didn’t happen. Poor people, immigrants, and women, among others, were all used as bargaining tools from the very beginning.

As often is the case, women’s bodies and health, was the ultimate battleground. The Stupak Amendment and then the Nelson Amendment in the Senate banned the use of public funds for abortion. Both were unnecessary and redundant because the Hyde Amendment, which has been renewed every year since it was first introduced in 1977, remains in place. But that wasn’t enough. Stupak and Nelson went further by also barring women who would use the exchanges from getting insurance that would cover abortion. When that still did not satisfy Stupak and his anti-choice cronies, the President agreed to sign an executive order barring public funding of abortion in return for their support for the overall bill. Women’s health was traded away for a handful of votes.

Some people contend that these funding restrictions are not new, but
rather they reinforce the status quo. That thinking lends legitimacy to
the idea that the long-standing bans on federal funding for abortion
are just. The status quo is immoral and it is wrong.
Hiding behind that argument as the rationale for including it in health
care reform and then expanding it, is not only craven, it is also
unjust. These restrictions are harmful to women and their families.
They will limit access to abortion for low-income women, who tend to be
disproportionately women of color, immigrants and young, as well as
women who may purchase insurance through the exchange. These funding
bans will further codify discrimination against poor women for being
poor. Finally, they will continue to stigmatize abortion and isolate it
from women’s overall health care, because let’s be clear: abortion is
basic health care.

Other colleagues and allies in the reproductive health and
progressive movements contend that the executive order will have very
little impact; that it is largely symbolic. Well, symbols matter. And
what this symbolizes to me is that as a woman, my health needs are less
important, my ability to make my own health care decisions is suspect,
and my vote for who I believed was a pro-choice President certainly
doesn’t amount to much. Our political leaders in the White House,
Senate and House of Representatives sold out women not just in the
legislation, but in the process itself. There remain many questions
about the implementation, oversight and real-life effects of this
health care bill. However, one thing is clear. Until women’s lives and women’s health are not used as trade goods for votes, we will remain vulnerable and invisible.

Aimée Thorne-Thomsen is a long-time social justice activist with
extensive experience in leadership and communications. In her role as
Executive Director of the Pro-Choice Public Education Project (PEP),
she focuses on creating spaces for and elevating the voices of young
women in the reproductive justice movement.