SOURCE: iStockphoto

The Hyde Amendment discriminates against poor women by prohibiting Medicaid from covering abortion care.

In 1973 the Supreme Court decided in the landmark case Roe v. Wade to recognize the constitutional right to abortion for all women. Forty years later, however, this guarantee remains an empty promise for thousands of poor women and women of color thanks to the Hyde Amendment, an annual appropriations measure first passed in 1976. This provision intentionally discriminates against poor women by prohibiting Medicaid, the health-insurance program for low-income individuals and families, from covering abortion care.

Because of the intersection in our country between race, ethnicity, and socioeconomic status, this restriction also has a disproportionate impact on women of color. Due to a number of root causes related to inequality, women of color are more likely to qualify for government insurance that restricts abortion coverage, more likely to experience higher rates of unintended pregnancy, and less likely to be able to pay for an abortion out of pocket. The Hyde Amendment therefore does not only undermine gender equity, but it also violates principles of racial and economic justice.

The Hyde Amendment discriminates against poor women

• Congress passed the Hyde Amendment in order to deny poor women access to abortion. Former Rep. Henry Hyde (R-IL), the law’s sponsor, admitted during the debate of his proposal that he was targeting poor women. “I certainly would like to prevent, if I could legally, anybody having an abortion, a rich woman, a middle-class woman, or a poor woman,” he said. “Unfortunately, the only vehicle available is the … Medicaid bill.”
• 1 in 10 women of reproductive age in the United States relies on Medicaid for their health coverage. By prohibiting Medicaid from covering abortion services, the Hyde Amendment has used the primary source of health care for low-income women to restrict access to abortion.
• Poor women face significant disparities when it comes to reproductive health. Compared with higher-income women, poor women’s rates of unintended pregnancy and abortion are each five times as high, and their unplanned birth rate is six times as high. These disparities are rooted in deeply entrenched inequities in the areas of health-insurance coverage, health care, and medically accurate sex education, as well as other health-promoting resources.
• Abortion costs between $300 and $950 in the first trimester, making it unaffordable for poor women without insurance coverage. In 2009 more than half of nonelderly adult women enrolled in Medicaid had family incomes below the poverty level; one-quarter had incomes below 50 percent of the poverty level. The monthly income for a family of three living at half the current poverty level is $813.75.
• One in four Medicaid-qualified women who seek an abortion is forced to carry her pregnancy to term because of cost. Many more are forced to delay their procedure for as long as two to three weeks while they raise money, with the costs and risks of the procedure increasing the longer they wait.

The Hyde Amendment discriminates against women of color

• A dissenting Supreme Court opinion recognized that the Hyde Amendment was discriminatory. Supreme Court Justice Thurgood Marshall’s dissenting opinion in Harris v. McRae noted that the law was “designed to deprive poor and minority women of the constitutional right to choose abortion.”
• Women of color are disproportionately poor and therefore less likely to be able to pay out of pocket for their health care. According to 2011 census data, 25.5 percent of African Americans and 25 percent of Latinas are living below the poverty level, compared to only 10.4 percent of whites and 12.2 percent of Asians. Moreover, certain groups of Asian and Pacific Islander women face much higher poverty rates than are reflected in the aggregate census data. For example, 67 percent, 66 percent, and 47 percent of people of Laotian, Hmong, and Cambodian descent, respectively, live in poverty in the United States.
• Women of color are more likely to be enrolled in government insurance. In 2011, 40.9 percent of African American females and 36.3 percent of Latinas had government-based insurance, including 29.2 percent and 29.6 percent participation, respectively, in Medicaid. In contrast, 32.6 percent of white females and 24.4 percent of Asian American females got their insurance through a government program. While Asian and Pacific Islander women use Medicaid at lower rates for a variety of reasons—only 6 percent were enrolled in the program in 2004—participation is quite high among various subgroups. For example, 20 percent of women of Southeast Asian descent are covered by Medicaid.
• Women of color are disproportionately more likely to need an abortion. Black women had the highest unintended pregnancy rate of any racial or ethnic group and more than double that of non-Hispanic white women. The unintended pregnancy rate of Latinas is 78 percent higher than the non-Hispanic rate. These high unintended pregnancy rates are part of the reason women of color seek abortion at higher rates than non-Hispanic whites. Although they represent much smaller segments of the population as a whole, black and Latina women comprise 30 percent and 25 percent of women who have abortions, respectively. Data on Asian and Pacific Islander women’s utilization of health services, including abortion, is extremely limited, but one study has shown that 35 percent of pregnancies for Asian and Pacific Islander women end in abortion, compared to 18 percent for non-Hispanic white women.
• These health disparities mirror other health disparities that women of color experience. In addition to higher rates of unintended pregnancy and abortion, women of color face higher rates of reproductive cancers, HIV and other sexually transmitted infections, premature births, low birth weights, and maternal and infant morbidity and mortality. They also encounter poorer health outcomes for diabetes, cardiovascular disease, and obesity, among other health conditions.
• Root causes of inequality drive the health disparities women of color face. Differential access to treatment, lower levels of respect and competency from health care providers, lack of trust in the medical establishment, lack of accurate information, and a host of other socioeconomic factors lead to poorer outcomes along racial and ethnic lines for overall health indicators, specifically with regard to reproductive health.

The Hyde Amendment treats the rights of women in this country according to two different standards: whether you can afford to pay for your rights or not. That is not equality.

Repealing the Hyde Amendment and similar restrictions will not, by itself, ensure full equality for poor women and women of color. But doing so is a necessary precondition. Anyone who cares about fighting racism and poverty must realize that attacks on abortion—and especially on abortion coverage—are first and foremost attacks on poor women and women of color.

Jessica Arons is the Director of the Women’s Health and Rights Program at the Center for American Progress. Lindsay Rosenthal is a Research Assistant with the Health Policy program and the Women’s Health and Rights program at the Center.

In the fourth installment of our podcast series examining the state of the reproductive health, rights, and justice movement in the United States on the occasion of the 40th anniversary of Roe v. Wade, we speak with University of Pennsylvania Professor Dorothy Roberts, a pioneer in the reproductive justice movement. Professor Roberts explains how she came to the movement, shares lessons about how to ensure that the movement be inclusive, and explores the connections between reproductive justice and the child-welfare system in light of the recent Supreme Court case, Adoptive Couple v. Baby Girl.

Elizabeth Chen: What has Roe v. Wade meant for women throughout the United States, not only for their ability to have or not have children but to parent the children they do have?

I am Elizabeth Chen, a policy analyst for the Women’s Health and Rights Program at the Center for American Progress and a Reproductive Justice Law Fellow. University of Pennsylvania Law Professor Dorothy Roberts has written extensively to bring to light the reproductive rights of marginalized women, especially low-income black women, through her seminal work Killing the Black Body. She joins us today to talk about her work and how different communities address and fight reproductive oppression through a number of different social justice movements. I am very pleased to welcome Professor Roberts.

You were starting college just as the Supreme Court decided Roe v. Wade. Can you tell our listeners a little bit about what that was like?

Dorothy Roberts: Well, in some ways, interestingly and unexpectedly, I feel as if there was more of a climate of freedom for women. It may have been because where I went to college was particularly open to women’s control over their bodies and students’ control. So birth control was available. Even the morning after pill was available.[1] And abortion services were available. But I was aware that there was a struggle going on in other communities for access to abortion. And I was also aware that there were many women who had died or suffered great loss because of lack of access to safe, legal abortion.

EC: What did you notice about those people who didn’t have access to a lot of these services?

DR: Well, I knew that there was a movement among women activists, feminists, and health advocates to ensure women have access to legal abortion and a fuller ability to have good health and control over their childbearing and over their bodies. I was aware that Roe v. Wade was an essential decision to make sure women could make these kinds of choices for themselves and also be able to have a safe abortion without the fear of either having an unwanted pregnancy or having an abortion that could potentially harm them because it wasn’t legal in some states prior to Roe v. Wade. So I was very aware of the importance of a constitutional right to abortion, even though when I went to college I assumed that women should have that right. It didn’t seem controversial to me. But I did realize it was a very important decision because there were places where women were prohibited from having abortions or had to seek them under very dangerous circumstances.

EC: So was it strange for you seeing the backlash to the decision?

DR: Yes. I continue to be disturbed by the backlash to the decision that I think continues to this day and that in some ways has intensified. There was a period after the decision in Roe v. Wade when I graduated from college, when I was clerking for Constance Baker Motley in the Southern District of New York, and I recall that there were a number of decisions—except for the abortion-funding decisions—but there were a number of decisions that fortified the right of women to access to abortion, and with the exception of the unfortunate denial of funding—public funding for abortion—it seemed as if there was increasing legislative and constitutional support for women’s right to access to abortion services. Again, I would highlight that the lack of public funding was a major barrier for many, many women. But I feel as if today with the onslaught of all sorts of laws designed to block women from getting an abortion in very blatant and inhumane ways, that to me seems today to create a much more hostile climate than I recall when I was in my twenties.

EC: Did this influence your decision to become a lawyer and then your work later on—seeing the different reactions to Roe?

DR: I think what influenced my decision to become a lawyer and to go into law teaching and advocacy around reproductive freedom was in part my assumption—which I think was fortified by the Roe v. Wade decision—that women should have [an] absolute right to reproductive health services and to make decisions about their reproductive lives. Now the aspect of reproductive freedom that propelled me into this field was not the right to abortion; it was the brutal regulation of black women who were pregnant and wanted to have children, the denial of their right to bear children, and the control that black women had experienced historically as well as in the present day of their decisions about their reproductive lives and their bodies.

The decision that really got me outraged and interested in advocating in this field was a decision that involved a white woman. It was the In re A.C. decision in 1987 involving a woman who was dying of lung cancer and wanted to survive to see the birth of her baby, and doctors at the George Washington University Hospital determined that she may not live long enough for the baby to be born and got a court order against her will compelling her to have a Cesarean section. And the doctors performed the Cesarean section and she died, and the fetus wasn’t viable and also did not survive. And when I read that decision, I was so outraged that because a woman was pregnant she could be violated in that way. I considered that to be an assault and battery against her because she was cut into without her permission.

And that was the decision—not abortion rights but the rights of a pregnant woman to be treated like an equal human being despite being pregnant—that got me interested and compelled me into the field of reproductive freedom and justice. And then learning about the multiple ways in which black pregnant women had been treated and black women’s childbearing had been devalued throughout the course of U.S. history and into the 1980s and ‘90s—this was a time when poor and low-income black women who used drugs during pregnancy were being prosecuted for various kinds of crimes and treated in extremely brutal and inhumane ways; it was those prosecutions that really compelled me to get involved in the fight for reproductive justice.

EC: Your work has provided a great deal of the analysis and intellectual capital for the reproductive justice movement. Can you tell us how you understand reproductive justice and how it relates to the concepts of reproductive rights that Roe puts forth?

DR: Roe v. Wade was certainly, as I said, a landmark decision that was essential and remains essential for protecting women’s equality, self-determination, control over their lives, and over their bodies—no doubt about it. But it has many limitations because it relies on a concept of protection of a woman’s private decision—what reproductive rights groups began calling freedom of choice; you know, her choice to end her pregnancy—without taking into account the social, political, and economic conditions, including poverty and racism, maybe physical disabilities, other aspects of her life where she might experience discrimination and inequality. And those also affect women’s lives and decision making. And Roe v. Wade doesn’t take that into account, nor did mainstream reproductive rights and women’s rights organizations that focused on a concept of choice: protecting a woman’s choice against government interference. And so the concept of reproductive justice places decision making about childbearing in a social context and in the context of the struggle for social justice and recognizes that without social justice, women cannot—or all women cannot—truly have reproductive freedom, cannot truly have control over their reproductive lives and over their bodies.

A simple example is the Hyde Amendment that was passed in 1977 right after Roe v. Wade and was upheld in Harris v. McRae in 1980.[2] And the Hyde Amendment denies federal funding for abortion for women who can’t afford them. Even in cases where the state provides for other health care services, the Supreme Court has also allowed the state to discriminate against this particular decision to have an abortion. And so without the money to pay for an abortion, many women’s actual ability to make this decision is hindered. That’s just a simple case where just having a choice isn’t enough if you don’t have the resources to really make that choice.

But even more broadly than that, women’s ability to make decisions about their childbearing is affected by the social conditions they live under and the discrimination they may face, whether their childbearing is valued or devalued. And that is beyond the decision to have an abortion. It also includes the decision to have a child and the ability to raise your child in a healthy way and to have your relationship with your child respected by the state and by society. So this is way beyond the limited protection of choice against government interference. It takes into account issues of social justice as well in order to guarantee women and men a true ability to make reproductive decisions and be self-determining when it comes to whether or not to have children and their relationships with their children.

EC: So you just mentioned being able to raise your child in a healthy way as part of the reproductive justice framework. Last week the Supreme Court heard oral arguments on a case involving the Indian Child Welfare Act. You signed onto an amicus brief along with other family law professors in support of the child’s father. Can you tell us a little about the case and about the arguments you made and how this particular issue relates to reproductive justice?

DR: The case is called Adoptive Couple v. Baby Girl, and it involves an unwed couple. The mother, who was not Native American, decided to put the baby girl up for adoption and did not get permission from the father, who was a member of the Cherokee Nation. Under the Indian Child Welfare Act, members of Indian tribes have particular protections against state interference in their parental rights because of a long history of the government deliberately taking children—Indian children—from their families and communities and placing them with white families or in boarding schools. Because of that law, the father in this case had certain special protections, so that even if, as an unwed biological father who hadn’t complied with state laws to get legal status as a parent, he still had status as a parent under the Indian Child Welfare Act. And it was only after the mother gave the child up for adoption that the father learned about this and intervened, and the Cherokee Nation also intervened to undo the adoption.

In the case the South Carolina family court judge found that denying the father the right to parent his child did in fact violate the Indian Child Welfare Act, and the Supreme Court of South Carolina affirmed that decision. And now the parties came before the Supreme Court. The adoptive parents petitioned the Supreme Court to overturn this decision, and the father argued that the Supreme Court should uphold the South Carolina decision granting him custody rights to his daughter.

I signed onto a brief by some family law professors because I think it’s very important for the U.S. Supreme Court, number one, to affirm the protections of the Indian Child Welfare Act because the act is important to prevent the kind of devaluation and kidnapping of children based on stereotypes and myths and discrimination against their parents because of their, in this case, tribal heritage. I am also concerned about this in the case of other children of color who don’t have the protections of a special law like the Indian Child Welfare Act. But I think it’s very important for the Supreme Court to uphold that protection.

And I think it’s also very important for the Supreme Court to recognize the importance to children of having a relationship with their parents as long as their parents haven’t been deemed to be unfit. And in this case, there was no evidence that the father was unfit. He simply hadn’t asserted his rights in time according to the adoptive couple under state law. But there was no evidence that there was a reason why he shouldn’t be able to have a relationship with his daughter and parent his daughter. So for those reasons—because of my interest in protecting the rights of families that have historically been devalued—I joined this brief.

I think this case is related to reproductive justice because the concept of reproductive justice doesn’t just end with a pregnant woman and her decision whether or not to carry the pregnancy to term. It also recognized that women who have babies want to—usually, in the vast majority of cases—parent the baby and have a relationship with their child. Reproductive justice also recognizes that this is more than just a choice of the mother or father to parent the child. It’s also a decision that is deeply affected by societal stereotypes based on race about certain groups of people. And so there is a long history, for example, of black mothers being devalued and being stereotyped as not caring about their children, being sexually promiscuous, and having babies without really an intent to mother them or a love for their children or an ability care for their children properly. And these myths have been perpetuated since the time of slavery, and I believe they’re a central reason why black mothers are at higher rates than other mothers in this country—except for maybe Native American mothers—of losing their children to the foster care system.

EC: How do you see the child welfare system’s treatment of privacy and government intervention both converge and diverge from those concepts that Roe sets forth and that women’s rights advocates have pushed for?

DR: I think many people don’t understand that reproductive justice must involve the right and ability to parent a child as well as to decide whether or not to have a child. So Roe v. Wade could be interpreted as very narrowly just having to do with the right to terminate a pregnancy or maybe stretched a little bit further to the decision whether or not to have a child. But the decision to parent a child and the ability to parent a child is often seen as outside the scope of Roe. And then, in addition, the privacy concept, if it’s interpreted as just being able to avoid interference by the state, does not take into account the ways in which parents—really all parents but especially poor and low-income parents—need support in order to take care of their children. And so there is an approach to child welfare in the United States that says that parents should privately care for their children. And if they’re unable to, the state then can come in and remove their children and place them in foster care.

For some reason, many people don’t see that state intervention of removing the children as being a problem because it’s in the context of a very narrow private view of caring for children. And I believe that the child welfare system in the United States that swoops in to intervene in struggling families, remove the child, and place the child in foster care, perpetuates this idea that parents should be able to take care of children on their own, and if they can’t, they can be punished by losing their children. I think that is a very harmful way of thinking about families.

And it harms everybody because it sets up this false view of parents as either being those who are good parents and can take care of their children or being pathological, neglectful parents who can’t, when in fact, it may just be that because of societal inequities, some parents who are very loving and caring parents just don’t have the resources that they need. And an alternative child welfare system would recognize that and provide general support for children and families, rather than rely so much on foster care to deal with it; the vast majority of foster children are from poor families, so I see this as dealing with poor families in a very punitive way.

EC: We see that privacy is an inadequate frame when we are talking about reproductive justice. So what constitutional principles should we be looking to as we look forward?

DR: Well, some of the options are privacy, equality, and liberty. None of them is perfect. I prefer social justice as a concept, which you don’t see very much mention of in your Supreme Court decisions.

But privacy has the benefit of protecting relationships against government interference, and it is the case that there is a lot of unjust government interference that people need to be protected against. The problem is that it often isn’t seen as government interference if it’s in a context that doesn’t pay attention to social justice. So again, it doesn’t look like unjust state interference in families when children are removed and placed in foster care if you don’t notice the inequities that led to the policy to remove children to place them in foster care or the inequities that led to the decision to remove certain children from their parents and not other more privileged children from their parents. So privacy has some advantages, but only if it’s interpreted within a context that understands social justice and social inequities and cares about them.

Liberty, similarly, is an important concept for protecting people’s ability to make decisions for themselves and not be controlled and manipulated by state forces, but again, without that understanding of the social context in which liberty takes place and a concern for social justice, it can just be a way of avoiding government interference and not seeing the duty—the public duty—of the state and the public to support people living within society, especially those who are disadvantaged by longstanding institutionalized inequities.

And then equality is another alternative, which recognizes that all people deserve the same rights and protections regardless of their social status, but again, I would say the same thing. Without understanding equality in a context of social justice, equality can mean treating people the same, and if there are people who are already disadvantaged by unjust social institutions and systems, treating them the same without taking into account the disadvantage isn’t necessarily going to be helpful; it can just perpetuate the disadvantage.

So I think all of these constitutional principles have something to say for them. But they don’t really help lead to a place of true justice and true equal respect for human beings unless the social context—the political context—is taken into account. So I prefer social justice. Another concept with great potential, again not recognized by the U.S. Supreme Court by and large, is human rights, which has that positive claim on the state and also has the concept that all human beings deserve to make that claim. And that is another possibility that many people, even within the reproductive justice movement, have used as a way of moving beyond the limitations of choice, and privacy, and formal equality.

EC: Thank you so much for joining us today.

Endnotes

[1] While modern progestin-only emergency contraceptives were not approved by the FDA for use until the late 1990s, as early as the 1970s, off-label uses of existing drugs were available and prescribed as emergency contraceptives. Laurence M. Demers, “The Morning-After Pill,” The New England Journal of Medicine 284 (18) (1971): 1034–1036.

[2] The Hyde Amendment was actually first passed in 1976, but was part of the FY1977 budget.  Heather D. Boonstra, “The Heart of the Matter: Public Funding of Abortion for Poor Women in the United States,” Guttmacher Policy Review 10 (1) (Winter 2007): 12–16.

This interview was edited for clarity and length.

Elizabeth Chen is a Policy Analyst for the Women’s Health and Rights Program at the Center for American Progress and a Reproductive Justice Law Fellow.

SOURCE: AP/Matt Rourke

Supporters of Pennsylvania's new law increasing the minimum wage rally in Philadelphia. If women were paid a living wage, the gender-based wage gap would decrease in growing industries.

Approximately 6.2 cents, or 27 percent, of our nation’s 23-cent gender wage gap can be explained by occupational segregation. This means that women are more likely to be employed in low-wage or minimum-wage service-sector positions such as home health aides, retail salespersons, or food-service workers.

These jobs fill essential functions in our economy, are increasingly in high demand, and represent occupations with the largest projected job growth over the coming years. Unfortunately, they are also undervalued and most of these positions are not currently providing adequate compensation to the people who work in them, predominantly women.

The top 16 occupations with the most expected job growth will create a total of 6.5 million new jobs by 2020.[1] Women made up 70 percent of workers in these occupations in 2010,[2] but the median annual wage for these 16 jobs was just $30,015 (in 2010 dollars). If these trends hold true through 2020, a disproportionately large and growing number of women will continue to occupy these oftentimes low-wage jobs.

One way that policymakers can help close the gender wage gap is by supporting policies that ensure that all jobs pay a living wage and provide adequate protections and benefits to workers. Our labor policies, including minimum-wage requirements, should help protect those who occupy important, if currently undervalued, positions in our economy.

Sectors with projected job growth must pay a living wage

As shown in the chart below, two of the top four occupations with the most projected growth are home health aides and personal care aides. (see Figure 1) In 2010 women were 88 percent of home health aides and 86 percent of personal care aides. Of these women, half were women of color, who on average experience an even larger gender wage gap than white female counterparts in the same industries.

Jobs in the fastest-growing sectors could decrease the wage gap if they paid a living wage

.

The median annual wage for these jobs is around $20,000 per year, and many do not offer important benefits. Less than half of home health aides and personal aides employers provide health insurance, and even fewer offer paid sick leave. Women who work in these jobs frequently rely on public benefits such as food stamps, public housing, or energy assistance to make ends meet even though they are fully employed. While providing important and needed care to other people’s families, they are often forced to choose between missing a day’s pay or caring for their own loved one.

While home health and personal care aides are not currently receiving the compensation they deserve, they provide vital services by caring for elderly and disabled Americans. Millions of Americans currently rely on home health and personal aides for their care and medical needs, and that number is only going to grow in the coming decades as the ratio of people over age 64 to people ages 20 to 64 is expected to rise by 80 percent. Moreover, the home care industry is thriving, bringing in more than $84 billion in revenue in 2009 alone.

Since positions such as home health and personal care aides don’t offer access to decent wages or benefits, these positions suffer from turnover rates of 40 percent to 60 percent. High turnover rates take a toll on the bottom line of the companies that employ these workers because the costs of replacing and training an employee are very high. Replacing an employee making $30,000 a year or less can cost an employer as much as 16 percent of the employee’s annual salary. Turnover also may take a toll on the quality of care that patrons receive. Having a workforce that is always in flux likely limits consumer access to highly experienced home-care providers.

Our society needs the services women are providing in the health sector, and we need to offer them wages and benefits that makes holding those jobs sustainable.

Conclusion

Women are overrepresented in professions that make the list of the top 16 jobs with the most projected job growth over the next few years, but these occupations also pay the lowest median wages.

Looking at particular industries shows stratifications between men and women’s access to higher-paying jobs. Figure 1 above, for example, shows that women are 94 percent of child-care workers, who typically make a median annual wage of less than $20,000 per year. Conversely, women make up less than half of postsecondary teachers, who earned a median annual wage of more than $45,000 in 2010. While women are also more than half of all food-service workers—one of the fastest-growing professions—they are 70 percent of low-paid counter workers, servers, and food-preparation workers but only 20 percent of chefs and head cooks. The same can be said of women and men in retail. The gender wage gap within retail sales is among the largest of any occupation, with women only making 64.3 percent of what their male counterparts make.

The evidence is clear: Women are currently employed in jobs that are serving vital functions in our society. In fact, their labor is in such demand that many of the jobs primarily held by women are among the fastest growing in the country. But we are not valuing their work by compensating them fairly and giving them access to the benefits or salaries that they need. Until we recognize and reward the work of women who currently hold the lowest-paying jobs in this country, we are unlikely to eliminate the wage gap.

Jane Farrell is a Research Assistant with the Economic Policy team at the Center for American Progress. Lindsay Rosenthal is a Research Assistant with the Health Policy program and the Women’s Health and Rights program at the Center.

Endnotes

[1] We chose the top 16 occupations because they were all projected to grow by approximately a quarter of a million jobs or more between 2010 and 2020.

[2] Based on author’s calculations using data from the Bureau of Labor Statistics, Employment and Earnings Report, January 2011 (Department of Labor, 2012); Bureau of Labor Statistics Employment Projects, “Table 1.4: Occupations with the most job growth, 2010 and projected 2020,” available at http://www.bls.gov/emp/ep_table_104.htm (last accessed April 2013).

SOURCE: AP/ Kathy Willens

A waitress serves steamy containers of dim sum at the Golden Unicorn restaurant in Chinatown in New York. Asian American women earn significantly less than their male counterparts.

Each year the United States commemorates Equal Pay Day to illustrate the gap between men’s and women’s wages. Data show that women still earn 77 cents to every dollar a man earns. This gender-based wage gap stubbornly remains despite the passage of the Equal Pay Act in 1963 and a variety of legislation prohibiting employment discrimination.

The wage gap is even greater for most women of color including Asian American women. Asian American women make 87.6 percent of what the average man earns and 73 percent of what Asian American men make. Pay equity is therefore crucial to the economic advancement of Asian American women, as well as their families and communities.

Here are 10 numbers that demonstrate why pay equity is important for Asian American women and their families.

1. $770: The median weekly earnings for Asian American women in 2012. Asian American women might show the smallest gender gap, but it is growing. Asian American women’s earnings dropped from 86.6 percent of all men’s earnings in 2010 to 84.8 percent in 2011.

2. 48 percent: The share of Asian American women working in service and sales occupations, compared to about 1 in 10 Asian American men and a similar share of white men. These are generally low-paying jobs, as the median hourly wages in the service and sales industries are $10.02 and $12.06, respectively. This exacerbates the wage gap for Asian American women and highlights the need for pay equity.

3. 12.1 percent: The share of Asian American women living in poverty, compared to 7.7 percent of white men. In 2011 there were more than 1 million Asian American women living in poverty—an increase from less than 0.7 million in 1999. According to the American Community Survey, from 2002 to 2010 the number of Asian Americans living in poverty increased by 46 percent. Pay equity will help decrease the number of Asian American women living in poverty and will combat poverty in the community as a whole.

4. 21: The number of Asian American and Pacific Islander women who are officers of large corporations. This represents 0.3 percent of the total number of officers of large corporations. Men hold close to 85 percent of all board seats. Although Asian American women currently make up 57 percent of the labor force, Asian American and Pacific Islander women leaders are significantly underrepresented in the four major employment sectors—corporate, government, nonprofit, and education. This underrepresentation serves to widen the gender wage gap.

5. 60 percent: The share of Asian American women living in the United States who are immigrants. According to the U.S. Census Bureau, 40 percent of all Asian Americans speak English less than “very well,” and 1.2 million Asian Americans are undocumented. Although foreign-born women have similar educational attainment levels as U.S.-born women, foreign degrees and technical skills are often nontransferable due to language and cultural differences. This, combined with a lack of legal status, often results in women working low-wage laborious jobs.

6. 45.5 percent: The share of Asian American women who do not have access to paid sick leave from their jobs. The lack of paid leave creates barriers to taking care of sick children, as well as their own health, resulting in poorer health outcomes and higher health care costs. Access to paid leave is directly related to type of employment, as low-wage work typically offers fewer benefits and less flexibility, leaving these women especially susceptible to the economic challenges presented by low-wage work alongside little flexibility and minimal or no benefits.

7. 7.1 percent: The long-term unemployment rate of Asian Americans in 2010. As of March 2013 approximately 25,000 of the 166,000 unemployed Asian American women were looking for full-time jobs compared to the approximately 19,000 unemployed Asian American men looking for full-time jobs. The higher number of Asian American women seeking full-time jobs indicates that this group in particular faces greater issues of underemployment. By closing the wage gap, we can offset some of the wage inequities caused by underemployment.

8. $10,840 less: The annual wage disparity between Asian American women who held a bachelor’s degree and their Asian American male counterparts as of 2010. The disparity in earnings of Asian American women compared to white men is even greater at $11,354. This large disparity hinders Asian American women, who receive the same education as males and are unable to earn the same salary due to pay inequality.

9. 31 percent: The share of Asian American and Pacific Islander women raising children with a same-sex partner in California. Studies show that lesbian couples have a greater poverty rate than both different-sex couples and gay couples.

10. 20.6 percent: The percentage of Asian and Pacific Islander women who are uninsured. This is particularly harmful for Asian American women since, as a group, they have one of the highest risks of cancer. Additionally, many of them do not have access to health insurance since many Asian American women work in low-income jobs without health benefits.

Although the wage gap tends to be smaller for Asian American women than for other minority women, the numbers above show how they are still significantly impacted by pay inequity. Closing the wage gap will bring more Asian American women into leadership positions, give equal opportunity to immigrant women, and bring positive change to all of our communities.

Jennifer Molina and Morriah Kaplan are interns with Progress 2050 at the Center for American Progress.

SOURCE: AP/Toby Talbot

People gather on the steps of the statehouse in Vermont for a rally on National Equal Pay Day. Recent surveys show that women earn more than men in only 7 out of 500 professions.

The median wage gap between genders fell since 2000, but progress is currently stalled. Women still earn less than men in nearly every occupation, though some suffer from greater wage disparities than others. The following is a list of the top 10 occupations with the largest and smallest gender wage gaps.

Of the 534 occupations listed by the Bureau of Labor Statistics, women earn more than men in exactly seven professions. Together, these seven occupations account for about 1.5 million working women, or about 3 percent of the full-time female labor force. The remaining 97 percent of full-time working women work in occupations where they earn less than their male counterparts.

The median weekly earnings for all full-time wage and salary workers in 2011 were $756. Both women and men in the 4 out of 10 jobs with the smallest wage gaps notably earn below this threshold. This indicates that jobs where women don’t experience a wage gap tend to be lower paying than the average. But in the 10 jobs with the worst gender wage gaps—where men earn significantly more than women—men’s average weekly earnings are always at or above the median. In these jobs, men are earning more than the average worker, but interestingly women’s wages fall below the national average of $756 in 4 of the 10 jobs noted above.

Education, success, and occupational prestige are not enough to protect women from the gender wage gap. While data show that American women are in more senior managerial professions than other OECD countries, these high-achieving women are still disadvantaged by an above-average wage gap. Managerial professionals, CEOs, and administrators all rank in the top 10 occupations in which women earn less than men.

So what does this list show? Even in the top 10 jobs with the smallest gender wage gaps, women make more than men in only seven professions. Additionally, it tops out with women earning a premium of 6.4 percent compared to their male counterparts, compared to a 39.4 percent gap in the top occupation where men earn more than women.

Let’s be clear: There should not be a gender wage gap in either direction. But a comparison of what that wage gap looks like in actual dollars per week shows that the situation is much more serious for women than for men. The 51,000 female operations research analysts earn $68 per week more than men. Compare this to the 745,000 male chief executives who earn an average of $658 more per week than similarly employed women.

We cannot attribute the wage gap to just one factor, which means that we need multiple strategies to eradicate it. The Lilly Ledbetter Fair Pay Act was an important first step but more needs to be done. Passing the Paycheck Fairness Act would prevent employers from firing workers who voluntarily talk about their salaries with co-workers, sanction employers who illegally commit wage discrimination, and provide funds for negotiation training for women and girls. It is also necessary to establish a National Equal Pay Enforcement Task Force that would bring together the Equal Employment Opportunity Commission, the Department of Justice, the Department of Labor, and the Office of Personnel Management to address barriers to pay equity and recommend steps that could be taken to address the issue.

Nancy Wu is an intern on the Economic Policy team at the Center for American Progress. Sarah Jane Glynn is a Senior Policy Analyst at the Center.

This interview is part of a podcast series on faith and reproductive justice, a project of CAP’s Faith and Progressive Policy Initiative. The project aims to strengthen the leadership and increase the visibility of faith-based advocates who work on women’s reproductive health and rights. You can learn more about this project here.

Sally Steenland: My name is Sally Steenland and I direct the Faith and Progressive Policy Initiative here at the Center for American Progress. With me today is Rabbi Dennis Ross. He is a religious advocate and congregational rabbi, serving Congregation Beth Emeth in Albany, New York. Rabbi Ross is also the director of Concerned Clergy for Choice, a nationally recognized multifaith network of religious leaders supporting reproductive rights.

Rabbi Ross frequently appears in the media and has written for The New York Times, The Boston Globe, Jewish Daily Forward, and other outlets. His most recent book is All Politics Is Religious: Speaking Faith to the Media, Policy Makers and Community. Rabbi Ross has taught at Hebrew Union College, Manhattanville College, Williams College, and the University of Massachusetts Medical School where he taught biomedical ethics.

Welcome, Rabbi Ross—we’re glad you’re with us today.

Rabbi Dennis Ross: Thank you so much for those generous words of introduction.

SS: Let’s start with your most recent book, All Politics Is Religious: Speaking Faith to the Media, Policy Makers and Community. In the book you say that faith helps us uphold a vision for a better world and we should talk about faith in the public square. At the same time, we should keep church and state separate. How do we do that?

DR: That’s a really big question. But everyone who lives in this country has a right—really, a responsibility—to make their beliefs known with policymakers and the community. We don’t lose that right just because we’re religious. And at the same time we can have separation of church and state.

SS: You’re saying that separation of church and state means you are allowed and even obligated, as you say, to bring your religious beliefs and argue them in the public square. I have had conservatives say to me, “There’s a real double standard here. Progressive faith leaders say it’s fine when people bring their faith into politics when it comes to protecting the environment or a woman’s right to choose. We really like that. But when conservatives lobby to protect unborn life or say they’re working for family values and it is a political agenda we don’t like, then we say, ‘Oh, you’re not allowed to do that.’” Is it a double standard or is there a difference?

DR: That’s a great question. It’s one that I get asked a lot and I say that when it comes to abortion rights, there is a big difference between what I am asking for versus what opponents of abortion are asking for. They’re asking for their religious restriction to be imposed on the whole country. They’re saying it is wrong in their faith and, therefore, no one else should be allowed to have it.

My argument is that when it comes to religious restrictions, we have to keep church and state separate. We need laws and policies that allow, in this case, a woman to make her own personal, private decision about her pregnancy. Whether to raise a child, whether to opt for adoption, whether to end her pregnancy—she should be protected as she makes that personal decision. And for many women it’s a religious or spiritual decision. She’s entitled to religious liberty, to privacy; her needs come first.

As opposed to abortion opponents who are calling for their beliefs to be enshrined or codified as law, I am calling for each one of us to have the personal, private religious freedom that we are entitled to in our lives. So that’s the first very big difference.

The second major difference is that many opponents of abortion simply point to their religious teaching and say, “It’s forbidden,” and assume that’s the final word. Whereas in my denomination and many other denominations, we make our feelings known—and this goes back to your first question—and at the same time we expect policymakers to take other factors into consideration. What is the public health need? What does science show? So there are two very big differences, for starters, between what I am saying and what people that disagree with me are saying.

SS: It sounds as if one thing you are saying is that in a pluralistic democracy, everyone has the right to argue their case. You can go on TV, you can preach, stand on a soapbox, take out ads in the newspaper—that’s free speech. But there is a difference when it comes to codifying your particular theology into law. Then it becomes a legal matter and you’re forcing everybody, whether or not their conscience tells them to do something else, to follow that law.

DR: That’s what I am saying. I work in New York state and when our state legislature ratified marriage equality, we were in the halls lobbying and so were the opponents. The opponents started shouting, “God says NO!” So what are we going to say? “We believe God says yes!” So it became a shouting match.

What you had here was a very clear religious disagreement. What they wanted the state to do was walk in and referee what was essentially a religious dispute and declare one religion the winner. Now the state didn’t do that. Instead what we have is a law that says those religions that don’t want marriage equality or see something wrong with it don’t have to have these ceremonies in their houses of worship. The law protects them. Their clergy don’t have to officiate if they don’t want to.

On the other hand, in my congregation and many other denominations, we say that a same-gender relationship has the potential to become holy, where it reaches for the moral high ground and strengthens our community. Our ceremonies are recognized in the eyes of the state. It’s a law that protects everyone’s religious freedom and safeguards everybody’s religious practice. The state isn’t playing favorites. People can do what they want to do in their own houses of worship and in their private lives. They can act on their conscience and live as they believe. So here you have a situation where the state did right and allows each one of us religious liberty.
SS: I am really glad you pointed that out because to hear some conservatives talk about religious liberty—and it’s an issue that has been in the headlines this past year—and you’d think that religious liberty was hanging by a thread in this country. You’ve just pointed out all of these exemptions—if you’re a house of worship and don’t believe in marrying same-sex couples, or interfaith couples, or intergenerational couples, you don’t have to. Your religious liberty is protected. 

But groups that are not houses of worship are complaining that because of marriage equality laws, or because of the contraceptive mandate in the health care law, their religious liberty is being violated. A religiously affiliated hospital, university, charity, and also for-profit companies where the owner happens to be religious, are saying they don’t want to provide contraception in health care plans for any of their employees. They could have thousands of employees of all different faiths.

DR: I am glad you brought up the birth control provision under the Affordable Care Act, because as folks may know, beginning last summer, insurance companies began covering birth control for women under the Affordable Care Act. And first you want to make clear: No one is getting free birth control. No one is giving out free birth control. The birth control coverage is getting paid for by the women who work and earn it—you know—it’s theirs!

The reality is the person who works and earns the insurance, like they earn their salary and their pension, also earns their insurance coverage for birth control. And again, the Department of Health and Human Services has bent over backward to try to accommodate those religious objections. And I believe they’ve reached a very fair and equitable solution. There are more than 300,000 to 350,000 churches, synagogues, mosques in this country who do not have to include birth control insurance coverage in their employer-sponsored health plan. These religious organizations already are exempt.

What the dust-up is now is hospitals with religious affiliation. They are not the arms of the church; they are nonprofit businesses that hire people from all walks of life and provide secular services to people from all walks of life. These religiously affiliated hospitals are not religious institutions like churches, synagogues, and the like. They hire people from across the religious spectrum, many of them from faiths like mine that recognize the moral good in access to birth control and believe that the needs of the insured woman carry a moral high ground over someone else’s objection. So if she decides she needs basic health care—which is what birth control is—she should be able to get it under her insurance plan without her boss barging in and saying, “Gee, it’s against my religion!”

You know, all we’re asking is for somebody in the human resources department to pass a few pieces of paper across their desk that have the words “birth control” written on it. That doesn’t have the same moral claim as a woman at a pharmacy counter saying, “Can I have my prescription refill?” She’s the one who’s going to need that and it’s none of her bosses’ business. I think the Health and Human Services Department made a wonderful accommodation. I think everybody ought to be satisfied with it and life should move on. I also think that here in New York state, we have a similar kind of policy in terms of insurance coverage for birth control; it’s been on the books for a decade. It works well, it has been tested in the highest court in our state, it stands. There’s a similar provision in California and I hope the Affordable Care Act stands as it does as it works its way through the courts.

SS: I really like what you said about women earning their health insurance, which is absolutely right. Another thing is that nobody is forcing women; this is an option for employees. As you know many women take birth control for medical reasons. Their doctor prescribes it because it reduces their risk of ovarian cancer or they have ovarian cysts. And then what do you do? It’s like bringing your boss a note. It’s horrible to even think of; it sounds very 19th century.

DR: It would roll back the clock in a bad way, by decades and decades.

SS: It sure would. I want to ask you about Concerned Clergy for Choice. Tell us about the group.

DR: I work in New York state where we have a very long history in advocacy for reproductive rights and reproductive advocacy for women and families. The very first birth control clinic in the United States opened up in 1916 in Brooklyn. I hit the Smith College archives and I found a letter from Rabbi Maxwell Silver from the synagogue in Flushing who invited the very first birth-control educators and advocates to speak from the pulpit of his congregation here in New York. That’s in 1921.

Then in 1970 the very first abortion clinic in the country opened in Manhattan, East 73rd Street. So the state has a very strong and wonderful history in advocacy for family-planning services for women and families.

And our work here at Concerned Clergy for Choice—we are a network of 1,000 clergy; we have ministers from Baptist, Methodist, Episcopal, Unitarian churches, and more. We have rabbis like myself; we have Muslim leaders, and Buddhists—we’re quite a diverse bunch. And right now we are working with advocates here in New York state to enact the Women’s Equality Agenda proposed by Gov. Cuomo. It’s a 10-point agenda that would strengthen protections against human trafficking, help ensure equal pay for women at work, strengthen protections against sexual harassment, and make sure that a woman’s health is protected through her pregnancy, which is a very important need here in New York state.

New York was one of the first states to legalize abortion in 1970. It was a wonderful law in its time but it has to be updated to protect the health of the woman. So that’s what we are working on right now. The governor is very strongly behind it and we are looking forward to seeing the legislation passed and enacted.

SS: Let me just play devil’s advocate for a minute. If somebody said to you, “You’re a man of God. How can you be in favor of a woman killing her baby? How can you be in favor of abortion?” So give me what you say to that.

DR: Well, first of all, it’s a good question and I am not taking a position on abortion. It’s really for the woman to make a decision. We don’t walk in her shoes, we don’t know what her life is like; she’s really the expert in herself. And it’s not for any legislative body or religious leader to barge into her life and tell her, “You have to carry your pregnancy to term.”

Secondly, to my faith and in many faiths, we understand that a pregnancy has a moral standing. However, it’s the woman’s moral standing that’s higher. It’s her decision making, it’s her life, her responsibility to determine her destiny and her future. And making sure that she is able to do that, we make sure she has access to birth control and teens have access to sex education. And we want to make sure that if she and her doctor decide that her pregnancy isn’t right for her, that she should be able to take the steps she needs to take to end it and be able to get safe and legal abortion.

SS: One thing I find often in talking to faith leaders is if you want to say “pro-choice,” it’s because the issue is not theoretical. Often when women are making this decision, they talk to their clergy, to their rabbi, their priest, or their minister. And so faith leaders like yourself hear stories and I think what changes theory into a more complex reality is hearing what some of those real stories are. I think it makes it a lot harder to judge.

DR: Absolutely. You know, to go back to your previous question and move into this one, my faith has a different teaching and many faiths have different teachings about the Bible, about the nature of God, about what happens after we die. And we also have different teachings about intimate life. One faith may have one teaching about abortion; mine has a different one. And you’re right that our teachings are informed by our experiences as pastors to women and families.

I was a number of years ago at a cemetery for a ceremony for an older woman and the son of the deceased pointed to a grave of a woman; she was in her earlier twenties. She died around 1935 or so, and he says, “Rabbi, this was my aunt. She died of a botched abortion.” That shouldn’t happen to a woman. Because her moral standing takes precedence. Her health, her decision making. She comes first in my faith.

SS: It sounds like as you look at this year, you are going to be working hard for the Women’s Equality Agenda to pass. Are there other priorities for you in the coming days? And related to that, some of this work is very challenging, and when you get up in the morning, what gives you energy, what gives hope so that you say, “OK, I am going to go to work today,” and not just turn over and put the covers over your head?

DR: As you know, one of the things that motivated me to write All Politics Is Religious is that we too often hear only one side of the religious spectrum when it comes to intimate life. So it’s really important that our communities hear from everybody and we find that many of our clergy aren’t sure what to say or they need support. And they want to work with others and show that their whole faith and their whole denomination has a certain approach to sex education for teens or access to birth control.

So, I think one of the most important things to me: empowering our clergy with the skills, with the knowledge, with how to use social media, how to talk to the press, how to decide whether or not to take an interview when you get a press call, how to understand all these things that we never really learned in seminary but we knew we need to know. I mean, when I was first ordained and I’d get a call from a reporter, I thought I had to answer that question on the spot. Nobody in the world does that. Even reporters don’t expect you to. So I had a lot to learn, and our clergy also.

We also have a wonderful day of advocacy, Clergy Day, on April 22 in Albany, New York, where religious leaders from across the state will be coming to the state capitol to call for the passing of the Women’s Equality Agenda. And again, this is a bill that keeps church and state separate; it protects religious liberty and it will protect the well-being of all the women and families in New York state.

What gets me out of bed in the morning … you know, I was a congregational rabbi for 25 years and I had written a couple of books; I was a licensed social worker as you mentioned. I taught bioethics. I always saw myself as a congregational rabbi and never imagined myself doing anything else. And I left my congregation in Massachusetts and a few people said, “You should look into this position with Family Planning Advocates and direct Concerned Clergy for Choice and working with Planned Parenthood.” And this was nine years ago.

When I interviewed for the job and was offered it and accepted, I had no idea what I would be doing. And it’s a whole new window of living out the social justice teaching that I was preaching about; seeing how religion plays out in making public policy. Especially here in New York state, there are religious lobbyists in the capitol each day of the week. They are speaking, sharing their beliefs, while trying to impose their beliefs about intimacy onto others who follow different faith teachings. They are advocating for public funding for religious education; they are talking about a host of things that people just don’t know about. And I think it is just getting the word out.

The other thing I found is that our policymakers really want to hear what their constituents think; they want to hear what their clergy think; they want to hear what their faith communities think. They hear much less from the public than you might expect. And most of what they hear is negative. People will call in to complain. One of the most important things I learned here is that when a policymaker does something you like, call up and say thanks. You see them on TV, they need to hear that, they count those calls.

I was giving a speech in Barney Frank’s district—former Congressman Frank’s district. And I said, “You know, you gotta call your congressman and tell them what you think!” And someone said, “Why should I call Barney Frank? He’s perfect on every issue!” It’s because if you count every issue, there may be two dozen, and when he hears from you, he will know which one to put first. You have one guy with a limited staff and he has to prioritize. You’re going to help him and everybody likes to hear a word of thanks. So all this is very important. After all my years as a congregational rabbi, I am now a religious advocate, and I work with a wonderful team here at Family Planning Advocates and I just love the work.

SS: Well, I want to give you a word of thanks because I really appreciate your including women’s reproductive health as a core issue. We know that these are tricky issues to talk about. A lot of people shy away from them or see them as sideline issues and not as important as economic or other issues, when we know they are closely connected. And as you said earlier, religion is a damaged brand among a lot of people because it is perceived as negative and even bigoted. When you’re out there in the public square and you’re connecting these issues, it’s important. You’re a person of faith and that’s really an important thing to do too. So huge thanks from all of us for this good work you are doing.

DR: Thank you.

SS: And thanks for talking with us today.

DR: Thanks for the invitation. I really enjoyed our time together.

This interview has been edited for length and clarity.

Sally Steenland is Director of the Faith and Progressive Policy Initiative at the Center for American Progress. For more on this initiative, please see its project page.

SOURCE: AP/Charlie Riedel

Evelyn Craig, left, executive director of reStart Inc., and LaTonya Jenkins, a reStart client who lives at the facility, pose at the homeless shelter in Kansas City, Missouri, March 19, 2013. The women are concerned that Missouri's refusal to expand Medicaid under the Affordable Care Act will harm residents of the shelter such as Jenkins.

This month marks the third anniversary of the enactment of the Patient Protection and Affordable Care Act, the landmark health care reform legislation that was a victory in many ways for women’s health. Thanks to the Affordable Care Act, women’s access to high-quality, affordable health care will increase dramatically, as key reforms are implemented and the country moves toward near-universal health coverage.

Due largely to the high cost of health care coverage—especially for women without access to employer-based coverage—19 million American women between the ages of 18 and 64 were uninsured in 2011. Uninsured women receive lower-quality care, and they generally have poorer health outcomes than insured women. Beginning October 1, 2013, however, millions of Americans will be able to shop for health insurance and compare plans through marketplaces known as exchanges, where some consumers may also be eligible for subsidies to help them afford coverage. The reform has also expanded access for low-income women by expanding Medicaid, and many states have already agreed to expand coverage under the program.

Below are the top three achievements to celebrate, the top three things to look forward to, and the top three items that we need to put on our agenda in order to advance women’s health through the Affordable Care Act.

3 achievements to celebrate now

Most of the law’s benefits will begin to take effect in 2014, but the law is already having an impact in a number of ways. Here are the top three benefits that have taken effect so far.

No-cost coverage for contraception and other preventive services

Since August 1, 2012, the Affordable Care Act has required all new, nongrandfathered health care plans to provide women with no-cost coverage for all methods of contraception and sterilization approved by the Food and Drug Administration, as well as host of other preventive services, including annual well-woman visits; lactation consultation and supplies; screening and counseling for interpersonal and domestic violence; screening for gestational diabetes; DNA testing for the human papillomavirus, or HPV, for women ages 30 and older; counseling for sexually transmitted infections; counseling and screening for HIV; and more.

Nearly 27 million women have already accessed at least one of these no-cost preventive services as of March 2013, and millions more are expected to access these services when the law’s major coverage expansions are implemented in 2014.

Protections for children

Women make the majority of health care decisions for themselves and their families. They can now rest a little easier knowing that there are fewer barriers to getting the coverage and care that their children need.

The Affordable Care Act has already made it illegal to deny children coverage because of a pre-existing health condition. In other words, plans may not exclude children who are under the age of 19 based on a health problem or disability that the child developed before a parent applied for coverage.

In addition, the law has already allowed young adults to stay on their parent’s health insurance policy until they are 26 years old, which has benefited young women who would otherwise be uninsured. More than 3 million young people have gained coverage though this provision, and the rate of insurance coverage for young women ages 21 to 25 increased from 71.2 percent to 77.5 percent since the law went into effect.

Finally, the law requires plans to cover preventive services for children such as vaccinations and well-baby and well-child visits without a co-pay.

Increasing affordability and consumer protections

Prior to the passage of the Affordable Care Act, 39.5 million women and 28 million children were enrolled in health insurance plans that had lifetime limits on their coverage. Women were hit especially hard by these limits, as they are more likely than men to suffer from chronic conditions. This meant that a woman who was diagnosed with a chronic condition or serious illness such as breast cancer, or a woman who had a child with a serious condition, would find that her insurer would cover only a fixed amount of medical costs and refuse to cover any additional expenses. These families would essentially lose coverage for their medical care precisely when they needed it most.

The Affordable Care Act has already prevented insurance companies from imposing lifetime limits on coverage, and it has begun phasing out annual limits on coverage, which have had a similarly detrimental effect. Beginning in 2014 annual limits will be eliminated entirely.

3 things to look forward to

Here are the top three reforms for women that are in the pipeline for 2014.

Ending discriminatory exclusions against women in the health insurance market

Prior to the Affordable Care Act, women were denied coverage for certain gender-specific conditions such as breast cancer or having had a Caesarean section. Even sexual assault and domestic violence were sometimes categorized as pre-existing conditions. But as of 2014 it will no longer be legal to deny women coverage because of a pre-existing condition.

Ending gender rating

In 2014 the Affordable Care Act will also end gender rating, a common practice in the individual insurance market where insurers frequently charged women as much as 150 percent more for their premiums solely because of their gender. One study found that women were charged $1 billion more per year in premiums for the same coverage as men. The new provision, however, will ensure that women have coverage for the care that they need without receiving this discriminatory treatment.

Ensuring that women have access to coverage for maternity care

Having a baby is an expensive endeavor. One study found that the average cost of a healthy birth in the United States is more than $8,000 for prenatal care and delivery alone—and costs only increase for complicated deliveries. Prior to the Affordable Care Act, 88 percent of individual-market insurance plans did not cover maternity care, which has created a significant barrier to obtaining needed care during pregnancy.

Beginning in 2014, however, all nongrandfathered health plans in the individual market will have to offer an essential-health-benefits package that includes coverage for maternal health services. Having this coverage will make a tremendous difference in women’s ability to access the care they need during pregnancy, protecting their own health and the health of their children.

3 items to add to the agenda in 2014 and beyond

While many accomplishments have been made in the area of women’s health since the Affordable Care Act was enacted, there is still plenty of work to be done to ensure that women have the coverage and care that they need. The following are three items that must be on our health care reform agenda in order to continue the progress that we have made for women’s health.

Push for Medicaid expansion in every state

Low-income Americans, and women in particular, face significant health disparities relative to more affluent Americans in large part because of inequitable access to insurance coverage and health care.

To ensure that low-income Americans can gain access to the health insurance coverage that they need, the Affordable Care Act expanded Medicaid eligibility to all people with incomes up to 138 percent of the poverty line—$14,856 a year for individuals—regardless of whether they are pregnant or parenting. Of the 17 million uninsured Americans who could become newly eligible for coverage under the Medicaid expansion, at least 7 million are women. But at least 4 million of those women live in states that have rejected the expansion or have not yet decided whether to expand coverage.

Without access to Medicaid coverage, low-income women in these states will have nowhere to turn to for health insurance and will continue to be at greater risk for poor health outcomes. We must continue pushing for all states to expand their Medicaid programs to ensure that these women’s health needs are not ignored.

Fight to ensure abortion will be covered in the health insurance exchanges

The Affordable Care Act includes language that allows states to pass legislation prohibiting private insurance plans in their exchanges from offering abortion coverage. In at least 21 states already, women will be prohibited from buying a private insurance plan that covers abortion in their health insurance exchange, and some of these states have gone so far as to ban abortion coverage in all private insurance plans in their state, including those remaining outside of the exchanges.

Creating this additional barrier to abortion coverage will hinder access to abortion for all women, but it will especially work to further increase disparities for lower-income women. We must keep fighting for abortion coverage to be included in the exchanges.

Defend against attempts to repeal the Affordable Care Act and decimate Medicaid coverage through block grants

There have been almost constant efforts by lawmakers on Capitol Hill to repeal some or all of the health care law. Some Republican lawmakers have also worked to replace guaranteed federal funding for Medicaid with block grants to the states, which would dramatically reduce federal spending on Medicaid and force states to cut back on coverage and benefits.

Both of these proposals would harm women around the country by turning back the clock on the gains made to improve access to quality health care. We cannot allow these erosions to occur.

Conclusion

After just three short years, women have already benefited significantly from the Affordable Care Act, and there is a great deal more to which we can look forward. But there is still a lot to be done to ensure that women have access to affordable and high-quality health care as we continue with the implementation of this historic law.

Lindsay Rosenthal is a Research Assistant with the Health Policy program and the Women’s Health and Rights program at the Center for American Progress.

SOURCE: AP/Denis Poroy

Guadalupe Benitez, right, walks with her partner Joanne Clark, left, and their son Gabriel Clark-Benitez, center, after a news conference held at the Hall of Justice in downtown San Diego, Monday, August 18, 2008. The California Supreme Court ruled that Benitez, a lesbian, was unfairly denied a common infertility treatment by doctors at the North Coast Women's Care Medical Group based on their religious beliefs.

Endnotes and citations are available in the PDF version of this report.

In 2007 the Center for American Progress released its report “Future Choices: Assisted Reproductive Technologies and the Law,” which described a range of assisted reproductive technologies and their legal and regulatory background. The report also examined the policy implications of the largely unregulated field of reproductive technology, especially in the context of traditional feminist positions on reproductive rights. If a woman has the ultimate right to decide whether or not to bear a child when she is pregnant, for instance, does that principle hold true when she would like to become pregnant with the use of specific embryos? Is surrogacy a noble pursuit undertaken by autonomous, well-informed, and altruistic women, or is it a practice that exploits the low-income and vulnerable?

These questions have not gotten any easier to answer in the intervening years. Indeed, advances in reproductive technologies have continued to outpace the development of the laws that might govern them. At the same time, more and more people who would have been unable to procreate or become parents in past generations have been able to bring a child into their home or build a family of their choosing, including those who have historically been deemed “infertile” for social reasons such as their sexual orientation, gender identity, or unmarried status. When things do not go as planned, however, the law’s failure to prescribe clear guidelines for resolving the disputes that inevitably arise can lead to real confusion and hardship for families. And all the while, the questions keep coming.

The landscape of assisted reproductive technologies has continued to evolve since our 2007 report, and new questions have arisen as a result. Case in point: In 2010 President Barack Obama signed the Patient Protection and Affordable Care Act. Should fertility treatments be considered essential health benefits that must be required in every health plan, and what are the implications of including or excluding these services?

As assisted reproductive technologies become increasingly common and accessible, other questions demand answers: How should states define family relationships? Should the government support children created after the death of a parent as it does the children of deceased parents created when that parent was alive? Should religiously affiliated employers be allowed to discriminate against employees who use assisted reproductive technologies with which the employers disagree? How do we address the rise in international surrogacy and other forms of reproductive tourism as world economies become increasingly globalized? What are the parameters for establishing citizenship for such children born abroad?

While some court opinions offer new clarity to a handful of unresolved issues, many court decisions only further muddle the landscape. We find that despite the increasing popularity of assisted reproductive technologies, the rights and responsibilities surrounding those who take part in these processes are still largely undefined.

As with the first “Future Choices,” this report examines the three primary areas in which legislatures and courts have spoken—health insurance coverage, embryo disposition, and parentage determinations—as well as additional areas where significant developments in the laws governing assisted reproductive technologies have occurred.

Jessica Arons is the Director of the Women’s Health and Rights Program at the Center for American Progress. Elizabeth Chen is a Policy Analyst for the Women’s Health and Rights Program at the Center.

In the third installment of our podcast series examining the state of the reproductive health, rights, and justice movement in the United States on the occasion of the 40th anniversary of Roe v. Wade, we talk to Viviana Waisman, executive director of Women’s Link Worldwide. In recognition of International Women’s Day and the struggle for gender and reproductive justice throughout the world, she explains some of the successful strategies she has employed to enforce human-rights standards before a number of foreign and international courts and shares lessons that advocates around the world can adopt. 

Jessica Arons: My name is Jessica Arons, and I am the Director of the Women’s Health and Rights program here at the Center for American Progress. I am joined today by Viviana Waisman, who is the executive director and co-founder of Women’s Link Worldwide, a nonprofit organization that strives to advance women’s rights through the implementation of international human rights standards and strategic litigation. Viviana is an attorney and an expert in women’s rights and international human rights law.

Thank you very much for joining us today.

Viviana Waisman: Thank you so much for having me.

JA: We recently celebrated International Women’s Day and Viviana happened to be here in Washington, D.C., because of a case before the Inter-American Court [of Human Rights]. So this seemed like the perfect opportunity to have a conversation that connects human rights, U.S. constitutional law, and reproductive rights.

Viviana, can you tell us a little bit more about Women’s Link and its mission? How do you use international jurisprudence to promote gender justice, especially in the area of reproductive rights?

VW: Women’s Link is an international human rights organization. We work, as you said, strategically with the courts to advance gender equality. We have two offices: one in Bogota, Colombia, and one in Madrid, Spain. And from those offices we do global work on women’s rights issues, both in English and in Spanish.

We work predominantly in Latin America, Europe, and East Africa right now. And what we do is we use both comparative law and international human rights standards to advance rights, with a special focus on reproductive rights and abortion.

JA: Can you tell us how international precedent in this area of the law compares to the doctrine adopted by the U.S. Supreme Court in Roe v. Wade, and are the international and U.S. trends convergent or divergent?

VW: Yes. It’s a very interesting question. As I stated before, we work very much with comparative law, which means that we often look to see what the best arguments or what the arguments are that have advanced rights in different jurisprudences in different countries. To that end, we have an observatory—a gender justice observatory—that’s a free online tool anybody can use to see how rights have been interpreted. And what we have seen since we started to work in this field [is] that there is a real need when you do litigation around reproductive rights and abortion to make sure that the arguments that are used point to state obligations in this regard. And so I actually studied law in the United States and studied Roe v. Wade as a law student, and one thing that was clear to us was that it was dangerous to only rely—and I know that’s not what happened in the Court here—but that the evolution of the law of the right to abortion around the privacy issue can be very dangerous because it doesn’t call for state-paid support. We know in the United States and in other countries in the world that the issue of access to reproductive care and abortion is usually much more difficult or is really a problem for low-income women, women of ethnic minorities, immigrants, and rural women.

So the litigation that we did in Colombia—and I’ll come back to that—but we focused on the woman’s right to health and right to life, and we focused on public health issues generally, the right to dignity, and also the right to nondiscrimination. And in focusing on these rights and having these rights recognized by the national court, we were looking to force the state to take on its obligations in terms of health care and nondiscrimination toward women. And that is a trend that has since followed in Latin America in terms of how things are moving forward in recognizing reproductive rights and the right to abortion in certain circumstances.

JA: I see. So, in effect, what you’re seeing in the international arena in some cases is by using human rights law, not only are the rights respected but they’re protected by ensuring that governments have obligations to ensure access. So it’s not just that a woman can decide to have an abortion, but that she actually can afford to have an abortion, unlike here in the United States sometimes.

VW: Correct, because we do know that it is always a problem in all places. But I do want to make one distinction—which I think is important, especially for a U.S. audience—that when we’re comparing [the] United States to other countries, we often—and you just said, when you compared the United States to international—

JA: —not that the United States isn’t subject to international law, but as opposed to constitutional law—

VW: But it’s not because of that that I make the difference, and I understand that there is a lot of resistance, not just in the United States, but in almost all countries in the world to the use of international law and sometimes the concept of human rights. But we are doing our work in national courts and doing comparative law and using really the best arguments before the court that we have in front of us. Because we’re finding that in order for there to be a movement on reproductive rights and reproductive justice to go forward, courts can learn from each other. And that it’s much more likely that a judge in a Supreme Court in one country will look to what a judge or another court is saying in another national context because they all have the similar issues, which is that they want to use their own constitutions. In some places maybe they’re more open to using international human rights arguments, but when they’re not, we still are pushing for the standards, no matter where they’re coming from and what they are being called. And so in that sense, the United States can be seen as part of the international arena, another national court making decisions on these issues.

JA: That’s a helpful clarification. So that actually, I think, is a good segue to another question I had, which is: I wanted to hear more about the significant victory that Women’s Link won for reproductive rights several years ago in Colombia, which you just referred to. And I especially wanted to hear about the strategies that you used to achieve that win because I think they were fairly novel—and then whether you think there are lessons from that experience that could apply elsewhere.

VW: We brought a challenge to the Constitutional Court in Colombia that in 2006 led to a historic decision that legalized abortion under three circumstances. In order to take the case on, we used a methodology that we have since then replicated, which is to do, before we start any project, what we call a mapping exercise in order to understand the best legal avenue and also to make sure that we understand the audience that we have in front of us.

I think this is more common in terms of how litigation is done in the United States but not as common outside of the United States. We do an alliance strategy, which means that we look to see—not necessarily for agreement on how we’re doing things, but really the understanding that all women’s rights groups, reproductive rights groups, and human rights groups have a role to play in what we are trying to achieve. And then also a very strong communications strategy.

One of the objectives that we were looking for when we brought the case—of course we wanted to change the law, but we wanted to change the terms of the public debate. The debate at that time was very polarized. The only voices that were being heard were the Catholic Church, and then, seen as very extreme, the feminist movement, kind of being called radicals for demanding rights. And there were no other voices being heard, in terms of doctors, public health specialists. And through the litigation we were able to bring those voices into the debate.

And the litigation that we did in Colombia that led to the decision in 2006 was the first time that, in the region, strategic litigation started to be a way, an advocacy tool for achieving social change. And we have seen that, since then, strategic litigation is talked about left and right and we really are very pleased to see that women’s rights and reproductive rights groups are seeing the courts as a place to seek social change, which was something that was not happening before our case in 2006.

JA: I’ll just add one anecdote that I am aware of, that I know a strategy you used was actually looking at what was in the libraries of the justices in the Colombian Supreme Court and then sending them publications to be in their libraries, their personal libraries, so that they would have resources that could help them inform their decision. That’s correct, right?

VW: Yeah, that’s true. It’s one thing that we always say—and it goes back to my point of saying of groups thinking of the courts as a place to seek social change—when we go speak at forums and there’s a lot of different groups that work on reproductive rights from all different spectrums of specialties. Everyone produces publications and then you ask them if they—on their list of who they send the publications—have judges, and almost nobody sends these publications to judges. So one strategy that we use, and we urge others to use, is that the publications should be sent to the judges in your own country and other countries, because maybe then they don’t have a case in front of them, but when they do, then they’ll turn around to the publications that organizations in our sector are producing with the information that they need on the different aspects of reproductive rights.

JA: In the United States there’s a strong conventional wisdom that when Roe was decided, it created a legal, political, and cultural backlash, including the violence that we’ve seen so often against abortion providers and clinics. There also has been a sharp reaction by some to the liberalization of the abortion laws in Colombia that likewise include a violent streak. Can you talk a little bit about how those experiences compare if they do in your mind, and what your own thoughts are on backlash theories?

VW: Yes. And actually I want to answer that question and then I want to go back to something you asked me that I didn’t answer about whether the trends are convergent or divergent, and I think those two things come together.

We have found everywhere we work that there’s always a backlash. And so I think that the experience of the United States in that respect is not unique. And we think of working on these issues and working on reproductive rights and the issues that are hardest for society as a pendulum. And one thing we have seen is that the larger the victory, the more the pendulum swings, and it’s higher, and the backlash will probably be stronger. But the upside of seeing it that way is realizing that things come and go. So if there is a bad decision, then you can fight for a good decision. But also it’s important to always be ready. Once you’ve won, you can’t let your guard down, because you know that the pendulum is going to swing in the other direction. So I do think that’s something that’s shared everywhere—everywhere that we have worked at least on these issues.

When you asked me before and I didn’t answer you about whether the trends in the United States and in other countries and in the international arena are convergent or divergent—I think they are very much convergent in two very important aspects. One is that, from what I understand, that the reproductive rights movement and now the reproductive justice movement in the United States is very much working toward focusing on access to reproductive rights and abortion for women who have less access. And so I think that’s a trend that’s the same in different parts of the world, including the United States.

And the other trend that I see that’s convergent and worrisome, is how the opposition is attacking fundamental rights. I understand in the United States there is a move toward personhood bills. And something very similar is happening in different countries in Latin America, which are having their constitutions protect the right to life in the moment of conception. And we’re seeing a trend in that direction—which is really seeking the same thing, which is seeking to protect the fetus and focusing away from the rights of the woman, the protection of the woman. And in that respect, for example, in the Dominican Republic, such a law, was passed—I mean, the constitution was changed to protect from the moment of conception and the consequences are terrible. And just last year a young woman, a 16-year-old woman, was pregnant and had leukemia, and she was not given access to an abortion. And what was cited in the case was the fact that life was protected from the moment of conception in the constitution. So that’s something that’s a very worrisome trend.

But there’s an upside that I think is nice to point out, which is that there was a recent decision from [the] Inter-American Court of Human Rights, which focused on in vitro fertilization—it’s a case out of Costa Rica. And in that case the Supreme Court in Costa Rica said that it was OK to ban in vitro fertilization because they were protecting life. And the Inter-American Court diverged and went against Costa Rica, saying that the embryos don’t have rights and the right to life is not an absolute, which is another trend that we’re seeing in Latin America, which is understanding that not all life gets the same protection. And the constitutional court in Colombia did something similar in explaining the different times in which the right to life exists and the different degrees of protection. And importantly, the Inter-American Court in this decision talks about the woman as the one who is the subject of the protection and not the fetus. And this is [a] very important decision both for women who want to have children and for women who need to end pregnancies.

JA: And just to close the loop on that question about divergence and convergence, how do you see the trends of U.S. constitutional law as it compares to international law or other national decisions around the world?

VW: It’s a difficult comparison to make because of the way that reproductive rights, contraception, and abortion have been interpreted under the U.S. Constitution, under the clauses that they’ve been interpreted. Because the way that this litigation has happened in other countries, it happens under more direct rights—under right to life, under right to health, under right to nondiscrimination.

JA: In international human rights documents or under national laws?

VW: Using both national laws—the constitutions—and interpretations from the U.N. treaty-monitoring bodies. In Colombia the way that the Court did it is that they looked—the Colombian Constitutional Court, first of all, has a 1991 constitution, which is very different than interpreting a constitution that’s more than 200 years old. The modern constitutions in that regard are easier to interpret in these rights because you don’t have to be looking for the rights within other rights. But what they did is they looked not just at the—all these rights are in the national constitutions, the right to life is in every single constitution, and the right to nondiscrimination is in almost every single constitution and every international human rights document has a nondiscrimination clause.

But they had also been looking at what the treaty-monitoring bodies had been saying to Colombia. And they were using a doctrine in which they were looking at it as a constitutional bundle—to translate it, “un bloque constituciónal.” And the only issue in which they had not done that was on the issue of abortion. And so when we brought the case to the constitutional court in Colombia, we asked them to just be coherent in the way that they were looking at international human rights as part of the constitution of Colombia, and look at the recommendations by the U.N. treaty-monitoring bodies, which all were recommending that there be a liberalization of the very strict abortion laws in Colombia.

JA: I think my last question will be: Do you see any opportunities to use international human rights norms here in the United States to advance reproductive rights?

VW: I think I am going to go back to my explanation that I said earlier. I think it doesn’t matter what we call the rights. It doesn’t matter if we’re citing an international convention or a constitution or using comparative law. What matters is that the standard be applied. And I do hope that someday the U.S. Supreme Court will look to other supreme courts around the world or to international human rights treaties the way some constitutional courts do in other countries. But if not, we can only hope that within the interpretation of the U.S. Constitution, those rights will be upheld in the same way whether they are being called international human rights or not. I think it’s the strategy, and getting the results is what matters as opposed to saying that we are using international human rights standards.

JA: Thank you very much for your time today.

VW: Thank you.

This interview was edited for clarity and length.

Jessica Arons is the Director of the Women’s Health and Rights Program at the Center for American Progress.

SOURCE: AP/Tsvangirayi Mukwazhi

Faustine Janjira prepares food at her home in Highfields, a high-density suburb of Harare, Zimbabwe, October 17, 2006. Janjira, who lives with her sisters and their 10 children in a two-room house, struggles to feed the big family as only one member of the family works.

President Barack Obama pledged during his January 2013 State of the Union address that the United States would join with its allies to “eradicate” extreme poverty over the “next two decades” by connecting more people to the global economy and empowering women.

Putting an end to extreme poverty requires providing opportunities for all individuals, especially women, to thrive through education, nutrition, and health. In order to achieve this goal, a greater emphasis must be placed on gender equality and the removal of barriers that disproportionately affect women.

A great deal of progress has been made in the fight against poverty, particularly since the adoption of the U.N. Millennium Development Goals, or MDGs, in 2001. From 1990 through 2008, the number of people worldwide living in extreme poverty fell by more than 800 million. Yet barriers to prosperity still remain—such as inequality and discrimination against marginalized populations—and new challenges continue to emerge that impede goals to reduce poverty.

Approximately 1.3 billion people still don’t have access to electricity, and overcoming the lack of reliable sources of energy is an absolute hurdle to getting out of poverty. Other threats to the economic well-being of individuals and families—including climate change—endanger development gains and threaten to reverse them. And where there has been measurable progress alleviating poverty, that progress has been uneven: The most disadvantaged and poorest of the poor have not received the same benefits of development.

While the poverty rate has declined in many developing countries, much of that improvement has been concentrated in China. Worldwide, rural populations, ethnic minorities, the disabled, and women have not benefitted from the rising economic tide. From a global perspective, women own only 1 percent of property, earn 10 percent of all income, and yet they produce half of the world’s food.

Any poverty agenda must focus on women because they are 70 percent of the world’s poor. Women comprise two-thirds of the global illiterate population and all women face additional hurdles to their economic and social well-being, including the pay gap and the fact that women are much more likely to hold vulnerable jobs.

Because women constitute the majority of the world’s poor and because development goals have not been achieved—particularly where gender inequality thrives—women’s empowerment and gender equality must a focus of the U.N. development agenda beyond 2015 when the Millennium Development Goals are set to expire. The expiration of the Millennium Development Goals and the development of new Sustainable Development Goals are stimulating global conversations about how to address poverty and sustainable development. This issue brief looks at gender equality and women’s empowerment in the post-2015 U.N. development agenda framework.

Why focus on women?

The vital role of women in sustainable development has long been recognized. The 1995 Beijing Declaration from the United Nations’ Fourth World Conference on Women and the 1992 Rio Declaration recognized that empowering women is essential to sustainable development. Yet gender discrimination continues to be a key driver of poverty.

Meeting Millennium Development Goals to address poverty and gender inequity

Global gender discrimination gained further attention when the U.N. General Assembly considered a new agenda for addressing global poverty in the beginning of 2000. The Millennium Development Goals were introduced in September 2001 after a mandate by the U.N. General Assembly for its secretary-general to prepare a roadmap on how to implement the Millennium Declaration that was agreed to in 2000.

While the Millennium Development Goals stimulated investments, improved measurements of inequality, and informed ways to accelerate progress, not all of the goals are on track to be fulfilled, including two gender-related Millennium Development Goals: Goal 3—which aims to promote gender equality and empower women; and Goal 5—which pledges efforts to improve maternal health.

The Millennium Development Goals Report Gender Chart 2012 provides a status update on Goal 3:

• The average gap in primary education has been closed, however, disparities persist regionally and the poorest girls are not enrolled in school. There has been little progress in secondary and tertiary education gender parity since the 1990s.
• Women’s employment outside the agricultural sector increased from 35 percent to 40 percent between 1990 and 2010, but women’s participation in the labor market lags behind men, regardless of education and skills.
• Women make up less than 21 percent of parliamentarians worldwide. According to the report, “At the pace registered during the last 15 years, it will take nearly 40 years to reach the parity zone.”

Thus Millennium Development Goal 3 has not been achieved. A lesson learned from the Millennium Development Goals is the need to focus on the underlying barriers of educating young women and making opportunities available to women.

Progress on MDG Goal 5 also has not kept pace with global trends. The prevalence of contraceptives worldwide has increased since the 1990s but the expansion of contraceptives has slowed and remains low among the poorest and uneducated women. In half of the 48 countries in sub-Saharan Africa where data is available, the rate of contraceptive use is under 20 percent, according to a 2009 U.N. report.

The reduction in the adolescent birth rate, which is perpetuated by poverty and lack of education, has also progressed at a slow pace. Wealth and geographical gaps also impact the availability of prenatal and maternity care such that wealthy urban women are three times more likely than poor rural women to have skilled assistance during delivery. Only one in three rural women in developing regions receive adequate prenatal care. Inadequate funding for family planning is a major impediment to women’s reproductive and maternal health, yet the need for these services remains high in most regions, especially in sub-Saharan Africa where one in four women in relationships desire contraceptives but do not have access to them.

United Nations Development Programme Administrator Helen Clark pointed to a range of social, cultural, and economic factors preventing MDG Goal 5 from being achieved, including “gender inequality; poverty; poor or little protection of the human rights of women and girls; food insecurity and poor nutrition; and inadequate infrastructure and services, including lack of access to energy or to transport to health services.”

The need to address such structural factors was underscored in the U.N. System Task Team report to the secretary-general, titled, “Realizing the Future We Want for All.” According to the report:

The global development agenda should seek not only to address and monitor the elimination of specific gender gaps, but also to transform the structural factors that underpin the widespread persistence of gender inequalities, gender-based violence, discrimination and unequal development progress between women and men, girls and boys. The empowerment of women and girls and the protection of their rights should be centre-pieces of the post-2015 agenda.

The U.N. Secretary-General’s High-level Panel on Global Sustainability, co-chaired by the former Finland President Tarja Halonen and South Africa President Jacob Zuma, was meant to be one input feeding into various international bodies and forums, including the U.N. Conference on Sustainable Development, or Rio+20, and the United Nations Framework Convention on Climate Change, or UNFCCC, and the post-2015 development agenda. U.S. Ambassador to the United Nations Susan Rice was appointed to be the U.S. representative on the panel.

The panel’s 2012 report, “Resilient People, Resilient Planet: A Future Worth Choosing,” concluded that promoting human rights and advancing gender equality were fundamentals of development. According to the report:

Any serious shift towards sustainable development requires gender equality. Half of humankind’s collective intelligence and capacity is a resource we must nurture and develop, for the sake of multiple generations to come. The next increment of global growth could well come from the full economic empowerment of women.

The panel recommended that governments repeal discriminatory laws and reform institutions and cultural practices to ensure that women have equal access to jobs, markets, reproductive and health services, and property. It also recommended that women have an equal role in decision-making processes.

The June 2012 Rio+20 conference was aimed at renewing political commitment for sustainable development and addressing new and emerging challenges that had been identified since the first Rio+20 summit in 1992. The Rio+20 outcome document, “Realizing the Future We Want for All,” was adopted by the U.N. General Assembly in 2012 and highlighted the need to address the structural causes of poverty by addressing inequalities. The document notes:

Transformative change will require recognizing and tackling both manifested gaps and their structural causes, including discrimination and exclusion, widely faced by women and girls, persons with disabilities, older people and members of indigenous and minority groups.

Some of the key obstacles to women’s empowerment, as outlined in the document, are threats and acts of violence against women. In “The Future We Want,” the elimination of all forms of violence against women and girls is recognized as integral to development.

The prevention and reduction of all forms of violence and abuse—and protection against their specific manifestations, including trafficking in human beings, torture, organized crime, the press-ganging of children, drug-related criminality, sexual abuse and labour exploitation—should be at the heart of any agenda which fully recognizes the centrality of human security, both as a human rights imperative and as integral to development.

Michelle Bachelet, executive director of UN Women, speaking on gender equality and the post-2015 developmental framework at a conference in Dublin, Ireland, said, “There is no country in the world where women and girls live free of the fear of violence. No leader can claim: This is not happening in my backyard.” According to Bachelet, between 40 percent and 50 percent of women in the European Union report being sexual harassed at work. In some countries, up to 70 percent of women will suffer violence in their lives, and one in three women worldwide will experience sexual violence in their lifetime. “As long as women face violence and discrimination, our efforts to eradicate poverty, achieve equality, and advance human rights and democracy will not succeed,” said Bachelet.

The way forward

Because the Millennium Development Goals will expire in 2015, the United Nations has now begun the process of evaluating them and deciding whether to renew or rework them. After several reports were published on the current state of achieving the goals, U.N. Secretary-General Ban Ki-moon last July created a High-level Panel on the global development agenda for the period post-2015. The panel is tasked with providing recommendations on continuing the U.N. global development framework. The High-level Panel is being chaired by Liberia President Ellen Johnson Sirleaf, Indonesia President Susilo Bambang Yudhoyono, and U.K. Prime Minister David Cameron. The panel is comprised of 27 leaders from civil society, the private sector, and government.

To date, the panel has convened three times—September 2012 in New York at the opening of the U.N. General Assembly; November 2012 in the United Kingdom; and most recently in Monrovia, Liberia, in January 2013. The panel’s final report is expected to be released at the end of May 2013 at the conclusion of two more meetings—one in Indonesia at the end of March, and one final meeting in New York at U.N. headquarters.

The communiqué from the third panel meeting in Monrovia indicates that there is agreement among panelists that a development agenda should extend beyond economic growth to focus on equality, sustainability, and reaching populations that were left behind in the Millennium Development Goals. The communiqué emphasizes that any post-Millennium Development Goals global development agenda must include the empowerment of women and girls, the expansion of social protection schemes, and universal access to health care—including sexual and reproductive health. In addition, growth must be inclusive and accompanied by strong institutions and transparent government to protect rights. The next meeting of the High-level Panel will be in Bali, March 25–27, and will focus on methods of implementation.

Expectations for the panel giving due consideration to women’s issues runs high. President Sirleaf and another panel member Tawakkul Karman, a women’s rights activist, jointly received a Nobel Peace Prize in 2011 for their promotion of women’s rights and peace. President Sirleaf, a long-time champion of women’s rights, is the first democratically elected female president in Africa. Karman, who became the face of the 2011 uprising in Yemen as part of the Arab Spring uprisings, and is known as “mother revolution,” is at the forefront of the fight for democracy in Yemen.

Lifting the earnings of 1 billion people who currently live on less than $1.25 a day is a key part of addressing extreme poverty. But alleviating poverty among the most marginalized populations requires moving beyond traditional measures of gross domestic product and focusing on the roots of poverty from discrimination against marginalized populations to the poor’s lack of access to markets, property, and employment. John Podesta, a member of the U.N. High-level Panel on the post-2015 development agenda, as well as the founder and current Chair of the Center for American Progress, explained in a recent issue brief on inclusive economic growth that “Sustainable economic growth is not simply about increasing the size of national economies but about shaping enduring systems that respect the rights of individuals and give them the tools they need to help lift themselves out of poverty now and forever.”

Podesta prescribes an inclusive approach to economic development, one that combats discrimination, provides economic opportunities, and improves the infrastructure—access to energy, property rights, and employment—to allow individuals and families to thrive.

Of particular significance to women, Podesta points out that reproductive and sexual rights and land tenure property rights are two components of development. Only between 10 percent and 20 percent of women in developing countries have land rights, and women hold fewer assets and face more difficulty attaining credit. Yet according to the U.N. Food and Agriculture Organization, if women had the same access to land, technology, financial services, education, and markets as men, yields on women’s farms could increase from 20 percent to 30 percent, which would feed between 100 million and 150 million more people—children, women, and men who would otherwise go hungry.

A World Economic Forum report titled, “The Global Gender Gap Report 2011,” underscored the imperative of women’s empowerment for national prosperity:

Because women account for one-half of a country’s potential talent base, a nation’s competitiveness in the long term depends significantly on whether and how it educates and utilizes its women … in order to maximize competitiveness and development potential, each country should strive for gender equality—that is, should give women the same rights, responsibilities and opportunities as men.

Looking forward, there are a number of other intergovernmental processes and civil society engagement processes surrounding the post-2015 development agenda preparations, which will also eventually impact the outcome of these deliberations.

During the Rio+20 conference, world leaders agreed to a process to consider the creation of a set of companion Sustainable Development Goals, which will focus on priority areas for the achievement of sustainable development that were laid out in the outcome document—including gender equality and women’s empowerment. A U.N. Open Working Group of 30 representatives shared by 70 member states has been created and will seek to develop a proposal for Sustainable Development Goals, which “should be coherent with and integrated in the United Nations Development Agenda beyond 2015.”

There are a number of other relevant intergovernmental processes for the post-2015 development agenda from now until 2015, such as the 2015 World Conference on Disaster Reduction and the 20-year review of the Program of Action of the International Conference on Population and Development in 2014. In addition, world leaders and civil society are gathering at the 57th Session of the Commission of the Status of Women at U.N. headquarters in New York over the next two weeks to discuss how to eliminate and prevent all forms of violence against women and girls, which is this year’s priority theme in line with International Women’s Day. They will also assess progress on the Millennium Development Goals and key gender equality issues to be reflected in the post-2015 development agenda.

Besides these processes, the United Nations plans to garner input from a variety of stakeholders, including the private sector, philanthropic organizations, and citizens, as it formulates the post-2015 agenda. Thus far civil society has responded with thoughtful proposals outlining the need to focus on addressing underlying inequalities and how to avoid uneven results. For example, Save the Children’s vision for a post-2015 framework recommends zero-based goals to tackle persistent inequalities, and think tanks such as the Overseas Development Institute are offering similar approaches to ensure the next development approach reaches everyone.

Globally, significant economic, social, and cultural barriers remain that prevent women from participating in economic development, which hinders the broader efforts to combat poverty and pathways toward sustainable development. Further progress will require a sustained effort to ensure that women around the world have greater economic rights, including the right to own property, as well as security to ensure they are protected from violence. Establishing these conditions will hinge on international development processes making women’s empowerment and gender equality pivotal to their efforts.

Rebecca Lefton is a Senior Policy Analyst working on international climate policy at the Center for American Progress.

Women make up more than 50 percent of the U.S. population and more than 49 percent of the workforce, yet they still hold a disproportionately small number of leadership roles in both the public and private sector. At every level of government across America, women are underrepresented. The United States ranks nearly 70th out of 188 countries in terms of women elected to national offices, having dropped down from 57th in November 2004.

While there is room for more research on how women in leadership roles affect policy outcomes, the advancement of women in our workplaces has had clear benefits for our economy and nation. Studies have shown that Fortune 500 corporations with more women on their boards perform better financially and that hedge funds run by women also outperform the industry standard. But right now, of the 1,000 CEOs leading our nation’s largest businesses, only 42—4.2 percent—are women.

Furthermore, women are more likely to work in many of the low-wage, service-sector jobs that underpin much of our economy. Women make up 54 percent of all service-sector workers and 77 percent of all education and health-service workers. This includes 80 percent of those in health care and social-assistance jobs, and more than 80 percent of workers in nursing and residential-care facilities. As these occupations are some of the fastest-growing jobs in our economy, it is important to pause and take note of not just the absolute gains women are making in employment, but the ways in which they are being represented and empowered—or disempowered—at every level.

Jane Farrell is a Research Assistant for Economic Policy at the Center for American Progress.

SOURCE: AP/Mel Evans

Inmates are seen at Integrity House, a transitional housing and residential treatment area for women incarcerated at the Hudson County Correctional Center in Kearney, New Jersey on August 2, 2011.

The female prison population in the United States continues to grow at an alarming rate. Specifically, from 2000 through 2009, the number of women incarcerated in state or federal prisons rose by 21.6 percent, compared to just a 15.6 percent increase for men. While the number of incarcerated men still far exceeds the number of incarcerated women, which was 205,000 women overall in prison or jail in 2010, the growth of the female prison population has a distinct effect on families and communities that are torn apart as a result.

What’s more, sexual violence, drug dependence, and poverty are all strongly correlated with women’s incarceration, meaning that our society still chooses to punish instead of heal—we lock women up instead of providing services that could help them live healthy, secure, and productive lives. Moreover, women of color experience all of these factors at disproportionate rates, which means that they also have a greater likelihood of becoming entangled in the criminal justice system.

A recent report released by the Sentencing Project, however, finds that there has been a dramatic shift in racial disparities among women inmates over the past decade. While black women were incarcerated in state and federal prisons at six times the rate of white women in 2000, this ratio declined by 53 percent, or about 2.8-to-1, by 2009. The disparity between Hispanic and non-Hispanic white women declined by 16.7 percent over the same period.

There are likely many factors at play in this laudable shift in racial disparities among incarcerated women—including but not limited to changes in law enforcement and sentencing practices and policies, or the involvement of women in crime—but the same report suggests that the reduced number of drug incarcerations is the likely explanation for a significant portion of the trend. That fact alone should be lifted up—because African American women were disproportionately affected by drug offense incarceration, any policies that result in a substantial reduction in these types of offenses would also disproportionately benefit them.

Despite these notable improvements, the rising rate of incarcerated women is still a substantial problem. For starters, the narrowing in disparities has not been felt equally among all women of color. While black women experienced a decline of 30.7 percent in their rate of incarceration between 2000 and 2009, Latino women experienced a 23.3 percent rise over the same time period. Likewise, white women experienced an incarceration rate increase of 47.1 percent. These disparate trends could be explained by the combination of increased methamphetamine enforcement—a drug disproportionately used by whites and Latinos—and the continued use of harsh sentencing policies.

The real travesty, however, is that the incarceration of women often masks the fact that some women are disproportionately vulnerable to a host of risk factors that increase the likelihood of their becoming involved in the criminal justice system. The vast majority of women in prison—85 percent to 90 percent—have a history of being victims of violence prior to their incarceration, including domestic violence, rape, sexual assault, and child abuse. And racial disparities strike here too: Girls of color who are victims of abuse are more likely to be processed by the criminal justice system and labeled as offenders than white girls, who have a better chance of being treated as victims and referred to child welfare and mental health systems. This disparity is particularly devastating for gender nonconforming girls, who are up to three times more likely to experience harsh disciplinary treatment by school administrators than their heterosexual counterparts.

In addition to intimate partner violence, other risk factors contributing to women’s criminal behavior include substance abuse and mental illness. It is estimated that up to 80 percent of women prisoners suffer from substance addiction. While it would be much more cost effective to treat these women than imprison them or pay for foster placement for their children, they are refused such rehabilitative measures—measures that could facilitate their integration back into society as productive members.

These high incarceration rates for women are tearing families apart and devastating communities around the country. Sixty-five percent of incarcerated women, compared to 44 percent of incarcerated men, report having minor children at home. Half of all women in prison are incarcerated more than 100 miles from their families and of the mothers who are imprisoned this far from home, 38 percent will not see their children even once during their incarceration. Not surprisingly, incarcerated women are often the primary caretakers of their children before their imprisonment, meaning children have the only parent they’ve ever known ripped from their lives. Fully, 77 percent of incarcerated mothers report providing most of their children’s daily care prior to being imprisoned and here again, women of color are more likely than their white counterparts to raise their children alone and be the single heads of the household.

Women’s incarceration also contributes to a significant risk factor in the future incarceration of their children. Two out of every three women in state prison have at least one family member who has been incarcerated and there are 1.5 million children who currently have a parent in state or federal prison.  These children are at a heightened risk for future incarceration and children of color are disproportionately represented in this group as well, with 1 in 15 black children and 1 in 42 Latino children reporting having a parent in prison, compared to just 1 in 111 white children.

The devastating impact of women’s incarceration doesn’t end when women are released. That’s because women also face significant obstacles to effectively reentering society and providing for themselves and their children. Once released, women find themselves restricted from governmental assistance programs such as housing, employment, education, and subsistence benefits. Many states even impose statutory bans on people with certain convictions working in certain industries such as nursing, child care, and home health care—three fields in which many poor women and women of color happen to be disproportionately concentrated.

Given the fiscal challenges that states are facing and the large-scale abandonment of children that women’s incarceration generates, it is imperative that states reassess the growing female prison population. Interestingly, just this past week Utah exceeded operational capacity for female inmates in its state prison. The limited funds that states have should be shifted from punishment to treatment and be considered an investment in rehabilitating families and communities that have already been disproportionately devastated by violence and poverty.

Julie Ajinkya is a Policy Analyst for Progress 2050 at the Center for American Progress.

These struggles are not unique to Indian women—women across the globe still struggle for equal opportunities as their male counterparts. On the occasion of International Women’s Day, the Just Jobs Network pays tribute to women worldwide.

For more, see the Just Jobs project page.

mp4

SOURCE: AP/Manuel Balce Ceneta

Then-Secretary of State Hillary Clinton, right, accompanied by then-Senate Foreign Relations Committee Chairman Sen. John Kerry (D-MA), left, talks about the START Treaty on Capitol Hill in Washington, November 17, 2010.

During her four years as secretary of state, Hillary Clinton was a global advocate for women’s rights and championed the security, health, and empowerment of women and girls throughout her record-breaking number of trips and meetings with world leaders and communities around the world. Her leadership and well-known personal interest in these issues dismantled silos and integrated women’s and girls’ issues across programs and offices at the State Department. But the promotion of international women’s issues as a key component of U.S. diplomatic and development efforts cannot begin and end with Secretary Clinton’s personal interest and hard work.

Newly appointed Secretary of State John Kerry can ensure that the initiatives and funding for women’s and girls’ issues championed by former Secretary Clinton continue over the next four years. Kerry’s record as a senator and his past statements on international women’s issues are promising, and the institutional framework established by former Secretary Clinton is sturdy. Moving forward, Secretary Kerry will have the opportunity to further integrate international women’s issues into effective diplomatic and development strategies that recognize the direct importance of women’s empowerment to global economic progress and stability.

Looking back

Advocating for equal rights and opportunities for women is not only morally aligned with American values, but it is the right path forward for successful societies. Research shows that communities are prosperous when they promote women’s health, security, and economic, social, and political empowerment, both in the United States and around the world. Secretary Clinton took this as a guiding principle in her work at the State Department and paved the way for women’s issues to be a central component in U.S. development and diplomacy, stating that “The United States must be an unequivocal and unwavering voice in support of women’s rights in every country, on every continent.”  The first-ever Quadrennial Diplomacy and Development Review and the creation of the Office of Global Women’s Issues were two of the former secretary’s early moves toward a comprehensive approach to women’s issues.

Secretary Clinton tapped Melanne Verveer to lead the effort as the first-ever ambassador-at-large for Global Women’s issues, tasked with the job of integrating women’s issues into U.S. foreign policy. Under Ambassador Verveer’s leadership, the Office of Global Women’s Issues oversaw the development of two women’s security strategies—the Strategy to Prevent and Respond to Gender-based Violence Globally and the Implementation Plan of the National Action Plan on Women, Peace, and Security. The broad frameworks provide U.S. government agencies, embassies, and consulates guidance on protecting women around the world. The two strategies recognize that women cannot progress politically or economically unless they are safe and protected from violence and conflict.

Moreover, the Quadrennial Diplomacy and Development Review commissioned by Secretary Clinton stated that women should be central to U.S. development and diplomacy and listed six specific areas in which women should be a key consideration, including sustainable economic growth, food security, global health, climate change, democracy and governance, and humanitarian assistance.

In addition to these overarching institutional directives, the State Department established various partnerships with both nongovernmental organizations and private companies to promote women’s economic empowerment. Secretary Clinton began the International Council on Women’s Business Leadership to discuss the advancement of women in international business and economic policy globally with American and foreign leaders of both private and public organizations. She also championed for the inclusion of women in economic growth in multiple meetings of the Asia-Pacific Economic Cooperation forum, asserting that “We need the economic engine that women can provide in every one of our countries, and I pledge that the United States will continue to work with you as a partner as we make progress together.”

The Women’s Entrepreneurship in Americas, or WEAmericas, which works with public and private partners to train women entrepreneurs and help them launch small- and medium-sized enterprises throughout Latin America and the Caribbean, is an example of the United States’ commitment to women’s economic empowerment. The Techwomen program also provides support for emerging women leaders in science, technology, engineering, and math from the Middle East and Africa for a professional mentorship and exchange program with women in the United States. This initiative is coordinated by the State Department’s Bureau of Educational and Cultural Affairs, demonstrating that women’s issues have diffused across departments and do not stay solely within the Office of Global Women’s Issues.

More recently, Secretary Clinton launched several initiatives in October 2012 on the eve of the first International Day of the Girl Child to protect girls from child marriage and promote education, including a pilot program in Bangladesh to address child marriage and ensuring schooling for thousands of adolescent girls in the Democratic Republic of Congo. Along with the Empowering Women and Girls Through Sports Initiative and the Techie Exchange Program for Teenage Girls, the State Department has shown its commitment to girls as well as women.

The cross-cutting nature of women’s issues in the State Department’s overall work is perhaps the most important legacy that Secretary Clinton leaves behind—more than one standout program or initiative among many. The Quadrennial Diplomacy and Development Review highlighted the need for greater integration of women’s issues across development and diplomacy programs and there is evidence that this is happening. From the U.S. Agency for International Development, or USAID , to the various bureaus, the action plans and programs across the State Department reveal awareness that men and women are affected differently in U.S. foreign policy and development initiatives, and we must actively engage with women and girls to promote the progress of women globally. The further institutionalization of women’s issues at the State Department is the task for Secretary Kerry.

Looking forward

While Secretary Clinton and Ambassador Verveer—now heading Georgetown’s Institute on Women, Peace, and Security—have left office, they leave behind a legacy of institutionalizing the importance of international women’s issues in American diplomacy and development policy. On January 30, Secretary Clinton’s penultimate day in office, President Barack Obama signed a memorandum on the “Coordination of Policies and Programs to Promote Gender Equality and Empower Women and Girls Globally.” This memorandum plays a key role in promoting the institutionalization of international women’s issue going forward by directing the secretary of state to appoint a coordinator with the rank of ambassador-at-large to run the Office of Global Women’s Issues—providing an enduring upgrade in status to the position formerly held by Ambassador Verveer. The next ambassador heading the Office of Global Women’s Issues will continue to report directly to Secretary Kerry as well.

Moreover, the memo enhances the institutionalization of international women’s issues across the foreign policy apparatus. It also orders USAID to maintain a senior coordinator for Gender Equality and Women’s Empowerment to “provide guidance to the USAID administrator in identifying, developing, and advancing key opportunities for U.S. development assistance.” What’s more, the memo directs the National Security staff to work with the White House Council on Women and Girls and the ambassador-at-large for global women’s issues to form an interagency working group that will “develop and coordinate Government-wide implementation of policies to promote gender equality and advance the status of women and girls internationally.” This group will include “senior representatives” of major cabinet agencies, including the State and Defense Departments, the intelligence community, and development agencies such as USAID, the Millennium Challenge Corporation, and the Peace Corps.

Secretary Kerry therefore has clear presidential guidance to continue the work begun by Secretary Clinton, and he has vowed to maintain “the momentum Secretary Clinton and Ambassador Verveer have built through their innovative office and laser-like focus.” But as with any endeavor, vigorous implementation will be critical to maintaining and increasing that momentum. Secretary Kerry’s Senate record, however, gives hope that implementation will not be lacking going forward.

As chairman of the Senate Foreign Relations Committee, Secretary Kerry sponsored and led the passage of the International Violence Against Women Act of 2010 out of his committee. In addition to codifying programmatic and emergency response plans to violence against women abroad, this legislation would have written into law many of the provisions institutionalizing international women’s issues in government agencies contained in President Obama’s executive memorandum. Unfortunately, then-Sen. Kerry’s international violence against women legislation failed to receive a vote in the full Senate. But Secretary Kerry now has an equally important opportunity to implement and further institutionalize many of the goals he pushed for in that legislation as head of the State Department.

In addition to this important, albeit failed, piece of legislation, Senator Kerry supported moves upgrading the importance of women’s issues in international forums and American foreign policy. He issued statements supporting the creation of a consolidated U.N. Agency for Women, condemning attacks against girls in Afghanistan, and applauding additional funding to combat gender-based violence through the President’s Emergency Plan for AIDS Relief, or PEPFAR, program. As Planned Parenthood recognized when his nomination was announced, “Senator Kerry has been a consistent supporter of women and their access to health care here in the U.S. and around the world.”

Since becoming secretary of state, Kerry has maintained the rhetorical commitment to international women’s empowerment established by Secretary Clinton. In major public remarks at the University of Virginia, for example, he noted “that countries are, in fact, more peaceful and prosperous when women and girls are afforded full rights and equal opportunity.” Similarly, speaking at USAID, Kerry said that in Afghanistan “we can be proud that even as we’re engaging the government and working to build their capacity of governance, we are also building it around a set of principles that are our values about those opportunities women ought to have.”

In the near term there are some important issues to watch that will indicate whether Secretary Kerry is following through on the institutional legacy of Secretary Clinton. First and likely most visible will be the implementation of President Obama’s memorandum, especially the appointment of a replacement for Ambassador Verveer as head of the Office of Global Women’s Issues. The formation of the interagency working group on international women’s issues will also be a critical signal of continued forward momentum. On more specific policy issues, further international initiatives on violence against women and, in particular, efforts to maintain the status of women in Afghanistan amid the withdrawal of U.S. military forces and negotiations for a political settlement will serve as important indicators.

Secretary Kerry faces a daunting array of issues in his first weeks and months as America’s chief diplomat, from Iran’s nuclear program to Syria’s civil war and fortifying relations with Europe while increasing attention to Asia and the Pacific. But these challenges do not obviate the imperative of building on the institutional and programmatic legacy on international women’s issues left by Secretary Clinton. This legacy serves as a sturdy foundation on which Secretary Kerry can build and strengthen the role international women’s issues play in American diplomacy and development policy.

Peter Juul is a Policy Analyst with the National Security team at the Center for American Progress. Arpita Bhattacharyya is a Research Assistant on the Executive Team at the Center. The authors would like to thank Rachel Curley, intern on the Executive team, for her help on this column.

SOURCE: AP/Thibault Camus

Mothers breastfeed their babies in Paris, France, Sunday, October 11, 2008, during a worldwide breastfeeding event. As part of the World Breastfeeding Week, many French women gathered in Paris, joining other women in other countries, in a bid to raise worldwide awareness of the benefits of breastfeeding babies.

Most national and international health organizations recommend at least three to six months of exclusive breastfeeding for newborns, with good reason: Ample studies have demonstrated that breastfeeding lowers infant mortality—and the transmission of HIV from mothers to infants—reduces the chance of developing chronic conditions later in life, and significantly improves maternal health after birth.

For millions of mothers around the world, however, these suggested guidelines are not always realistic or achievable. For some new moms, social, political, and economic barriers prevent them from accessing the support and resources—such as lactation counseling and breastfeeding supplies—and the paid leave from work that they need to breastfeed. Today, on International Women’s Day, it is important to reflect on what progress we have made in supporting breastfeeding, as well as on what policies we can promote to help improve the lives of women and children everywhere by making breastfeeding a more viable option for all new mothers.

Rates of breastfeeding vary greatly across developed and developing nations, as well as within countries, by class, race, and level of education. Less than 40 percent of children younger than 6 months old are exclusively breastfed in developing nations. Within developed countries, lower-income and minority groups are less likely to breastfeed than better-educated, older, or professional women.

This is in part because of the lingering effect of the development and intense marketing of formula that began in the middle of the 20th century. The marketing campaigns were geared toward all women, but those with the money to spend on formula were the earliest converts and trendsetters. While the 1950s’ move toward formula was led by wealthy and better-educated women—with formula subsequently becoming a symbol of status while breastfeeding was stigmatized—the move back toward breastfeeding that began in the late 1970s left behind many minority groups. Lower-income and less-educated women are less likely to be informed of the benefits of breastfeeding and are more vulnerable to the aggressive and targeted commercial promotion of formula permitted in many hospitals, especially in the United States.

This discrepancy within and between populations is one reason why it’s particularly important for health organizations and governments to take a multifaceted approach to supporting new mothers’ breastfeeding. For instance, policymakers cannot focus solely on waging informational campaigns or providing new mothers with breastfeeding equipment, although both of these are important goals. Instead, they need to support policies that begin at pregnancy and continue over the months—if not years—after childbirth. It is universally important to help mothers initiate breastfeeding immediately after birth, but hospitals often lack clinicians with sufficient experience in lactation medicine.

The international Baby-Friendly Hospital Initiative—which aims to champion and support hospitals that educate and assist new moms to start breastfeeding—is a good example of a program that ensures that hospital staff have adequate training in breastfeeding counseling and support. The Nurse-Family Partnership is another remarkable U.S. program that works to support new low-income mothers in all aspects of parenting—including breastfeeding—up to two years after the birth of a child. Despite the successes of programs such as these, they are not universal, and they do not change all the realities of what happens once a woman leaves the hospital with her newborn.

Once women have returned home or to their jobs, rates of breastfeeding drop precipitously around the world. This is especially true in countries that do not provide paid maternity or family leave, including the United States. Among developed nations, the United States ranks last in Save the Children’s 2012 Breastfeeding Policy Scorecard—which ranks countries based on whether they have policies that promote and support breastfeeding—in large part because it doesn’t guarantee any paid maternity leave after the birth of a new child. The lack of such a policy is especially regressive, given that women and mothers in the United States are increasingly likely to be their families’ breadwinners or co-breadwinners.

While some critics argue that paid family leave would be too costly for businesses and for Americans, not guaranteeing families this right is also costly. If women are allowed to take paid leave after the birth of a child, it is more likely that they will breastfeed for a longer period of time, which has health benefits for both children and mothers. The United States would save an estimated $13 billion annually in health care costs if 90 percent of mothers breastfed exclusively for six months. It would also save the lives of an estimated 1,000 babies.

American lawmakers have also failed to adopt any laws that might regulate the marketing and promotion of breast-milk substitutes such as formula, leaving the United States even further behind other developed nations that have such policies in place to discourage mothers from using substitutes too soon after the birth of a child. The Affordable Care Act helped make breastfeeding counseling and supplies available at no extra cost by covering them in health care plans, and it mandated that businesses with 50 employees or more allow women to have breaks and private spaces for pumping.

At the other end of the spectrum are countries such as Germany, Poland, and Portugal. These three countries support women who are back in the workforce but still breastfeeding by guaranteeing an hour or more of paid time daily for nursing breaks. Other nations guarantee the time to pump but do not protect the worker’s pay, meaning that the time taken to pump is unpaid. In the United Kingdom, national programs and initiatives educating expectant moms on the benefits of breastfeeding and supporting them postbirth have increased the relatively low rates of breastfeeding that the nation has had historically. France’s lack of data on breastfeeding has been a more difficult problem to navigate, although smaller studies have highlighted the importance of providing prenatal breastfeeding information to prospective mothers.

While there is a role for public-health advisories and suggested guidelines on breastfeeding in the United States, policymakers must do more to make sure that all women have equal access and economic support to act upon their inclinations. If a woman risks exacerbating her pay gap—or worse, her paycheck and employment completely—the myriad and long-term health benefits of breastfeeding for both mother and child will be negligible.

To make breastfeeding a choice that each woman is able to make, we must also make it an economically viable option for all of them. Developed nations such as the United States should be leading the way in setting an example for modern, equitable policies that support women and families. Unfortunately, we still have a long way to go.

Jane Farrell is a Research Assistant at the Center for American Progress.

SOURCE: AP/Seth Wenig

Tiffany Ashe prepares her son Aaron Ashe for his check-up at the William F. Ryan Community Health Center in New York, Wednesday, June 27, 2012.

If the automatic across-the-board budget cuts known as the sequester are allowed to take effect tomorrow, Title X—our nation’s family-planning program—could be cut by $15 million in fiscal year 2013.* The cut would be a significant blow to Title X, which has already been cut by more than $23 million over the past two fiscal years—limiting access to family-planning services and causing clinics to cut back on staff and hours.

For more than 40 years, Title X has served primarily low-income women, who rely heavily on community health centers for their reproductive health care. Cutting this vital women’s health program is just one of many examples of the ways in which sequester cuts would harm the most vulnerable Americans—all for the sake of protecting the wealthy few from higher taxes. The sequester cuts millions of dollars from a number of other key programs serving women.

Here is what you need to know about the critical role that Title X plays in access to reproductive health services around the country.

1. Title X clinics provide a range of services, including breast and cervical cancer screenings; Pap smear tests; prevention and treatment of sexually transmitted infections, or STIs; HIV testing, prevention, and counseling; infertility services; and health care referrals. In 2010 alone Title X provided 1.8 million Pap smear tests, 2.2 million breast exams, 6.1 million STI tests, and 1.1 million confidential HIV tests. Six out of 10 women who visit Title X clinics consider them a primary source of health care.
2. One-quarter of all poor women who obtain contraceptive services in the United States do so at a Title X-supported center. Title X is a crucial funding stream for public and community health centers around the country—expanding access to family-planning and reproductive-health services for poor women by allowing services to be offered in their communities. Ninety-one percent of all Title X clients earn less than $28,000 a year.
3. Title X has helped millions of women prevent unintended pregnancies. Unplanned pregnancies are associated with a range of negative health, social, and economic outcomes for women and their children. Nearly half of all pregnancies in the United States are unintended, and the rates are even higher for young women. Sixty-nine percent of pregnancies of women between the ages of 20 and 29 are unplanned, and nearly half of unplanned pregnancies for the same age group are experienced by women living below 100 percent of the federal poverty line. It is estimated that overall levels of unintended pregnancy would be one-third higher without the services provided through Title X-supported centers.
4. Title X saves money. Every $1 invested in family-planning care averts nearly $4 in Medicaid expenditures. The total public cost of unintended pregnancies is estimated at $11 billion a year, and that cost would be even higher without the critical family-planning services provided to women though Title X funding. Title X is estimated to prevent more than 900,000 unintended pregnancies each year.
5. Title X has raised national standards for providing high-quality care that meets the unique health needs of women. Title X is the first and only federal program focused exclusively on the provision of contraceptive services and reproductive health care. The program sets national policies and standards ensuring that clients receive high-quality reproductive health care. Title X clinics have worked to clear obstacles to women’s access to contraception by specializing care to overcome language barriers and meet special health needs, including the health needs of young women.
6. Title X is important for all women regardless of their income or insurance status because it funds specialized providers that offer women the care that they need. Whether a woman is covered by Medicaid, private insurance, or is uninsured, she needs access to a provider that offers a range of reproductive health services. Because Title X funding is flexible and can be offered to a diverse range of grantees, the program has effectively partnered with other public and private entities to create a vast network of reproductive health providers in every state, which benefits all women regardless of income by providing facilities where they can go to receive high-quality and specialized reproductive health care. As of 2011 there were more than 4,000 providers receiving Title X funds in the United States.

Title X has already been cut substantially in the deficit-reduction efforts of late, but cutting this cost-effective and crucial health service for women is more likely to hurt the country’s financial prospects than improve them. It’s a perfect example of why the blunt across-the-board spending cuts set to take effect tomorrow should be avoided in favor of a thoughtful and balanced approach to deficit reduction that protects crucial investments in programs such as family-planning services.

Lindsay Rosenthal is a Research Assistant for the Women’s Health and Rights team and Health Policy team at the Center for American Progress.

* Author’s calculations based on ‪Angela Napili, “Title X (Public Health Service Act) Family Planning Program” (Washington: Congressional Research Service, 2013), available at https://www.fas.org/sgp/crs/misc/RL33644.pdf.

SOURCE: AP/J. Scott Applewhite

From left, Sen. Jeanne Shaheen (D-NH), Sen. Dianne Feinstein (D-CA), and Sen. Patty Murray (D-WA) talk to reporters about the reauthorization of the Violence Against Women Act that was passed originally in 1994, Wednesday, April 18, 2012, on Capitol Hill in Washington.

Americans across the country are bracing for the impact of the sequester, the automatic across-the-board spending cuts to domestic programs—including vital human-needs services—set for this Friday, March 1. The nation faces dire consequences should these cuts take effect, but it’s even worse for low-income women and their families suffering from domestic violence.

Poor women and their families are facing a super storm of grim outcomes. Not only will the severe cuts to critical domestic-violence, sexual-assault, and human-needs services devastate low-income victims and the providers that serve them and their families, but the reauthorization of the Violence Against Women Act also remains held up in Congress after its expiration more than a year ago. This lack of needed legislation combined with severe funding cuts will seriously undermine the support services and assistance from law enforcement that low-income women rely on to escape abusive situations, protect their families, and seek justice.

This is particularly troubling because low-income women are uniquely at risk for domestic violence. Though women of all income levels can experience domestic violence, women who live in economically distressed households and neighborhoods are more likely to experience domestic violence. Women without their own financial resources or who are economically dependent on their abuser are more likely to stay with their abuser or return to their abuser if they have already left, and they are less likely to get a restraining order against their abuser. This situation leaves low-income women trapped by their lack of financial resources, a circumstance that is often exploited by abusers to keep these women and their children in a cycle of violence. To make matters worse, children who witness domestic violence are more likely to perform poorly in school, experience behavioral problems, and develop longer-term problems such as depression and a tolerance for violence in relationships.

The House continues to drag its feet on the Violence Against Women Act

This Thursday the House of Representatives will vote again on reauthorizing the long-stalled Violence Against Women Act. Originally enacted in 1994, and subsequently reauthorized in 2000 and 2005, the Violence Against Women Act was the first comprehensive effort in our country to tackle domestic violence and provide new law-enforcement tools and support services to victims. The law provided programs for violence prevention, investigations, and prosecutions. It also provided new service resources for victims that are particularly important to low-income women, including court-appointed special advocates, a national domestic-violence hotline, services for runaway youth, new funding for domestic-violence shelters, and programs for battered immigrant women, Native American women, and other underserved populations.

Because the need was so great, the Violence Against Women Act sailed through Congress three times with overwhelming bipartisan support—until now. For the first time in its history, the legislation failed to make it through Congress and to the president’s desk. Why? House Republican leadership dug in its heels and refused to include new protections for Native American women, gay and transgender individuals, and immigrant women who were included in the Senate version of the bill that passed with a rare bipartisan supermajority of 68 senators, including the affirmative vote of every female member.

During this Congress, the Senate fast-tracked a nearly identical bill and passed it with even stronger support—78 votes to 22 votes. In a move even more cynical than before, House leadership proposed a watered-down alternative bill that fully stripped the gay and transgender provisions and added a loophole—essentially a “get out of jail” toolkit for non-Native men who abuse Native women. But due to this partisan hardline position, 19 Republican House members are now standing up to House leadership demanding the passage of a fully inclusive Violence Against Women Act similar to the Senate version. It now seems more promising that Congress will finally do the right thing and get a bill to the president’s desk.

The ability to call a national hotline for support, escape a violent spouse, protect a sexually abused child, or be represented properly in court without an abuser’s interference—all of these services are in danger without the bill’s reauthorization. The anticipated new version of the Violence Against Women Act would even expand housing support, which is critical considering that violence against women is one of the primary causes of women’s homelessness. These housing protections are crucial and are often the primary pathways out of violence for low-income women who lack economic independence from their abusers.

Sequestration will devastate low-income victims of domestic violence and their children

The still uncertain reauthorization of the Violence Against Women Act is only one of the major ways in which low-income victims of domestic violence are in danger. Current funding for vital domestic-violence and sexual-abuse programs, as well as other federal programs that support victims of domestic abuse, are also under threat due to sequestration.

If sequestration goes into effect, funding for the Violence Against Women Act could be slashed by more than $20 million, preventing nearly 36,000 victims of violence from obtaining shelter, legal assistance, and services for their children. The primary funding stream for domestic-violence shelters, the Family Violence Prevention Services fund, may see as much as $9 million cut from its budget, reducing services to as many as 113,000 victims. These cuts would come at a time when domestic-violence centers that provide much-needed assistance are already scrambling. Florida, for instance, may see a cut in its STOP Violence Against Women Program of more than $400,000, potentially leaving 1,500 victims in the state without services.

Other federal programs that support pathways to economic independence for low-income women are also threatened by sequestration. According to the Department of Health and Human Services, child care assistance—which eliminates a major barrier to work for low-income women and provides social and emotional development services to low-income children—would be slashed under sequestration, resulting in more than 30,000 children losing access to these vital subsidies. And more than 600,000 people would be cut from the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children, or WIC, an essential program that provides low-income expectant mothers and their infants with the healthy food, nutrition, and care they need during this critical phase of their lives. These and other federal programs provide women and their children with the support they need to escape violent situations.

The bottom line

No woman should be forced to stay in a violent situation because our country lacks the political will to provide them with the resources that they desperately need to protect themselves and their children.

Failing to reauthorize the Violence Against Women Act and allowing sequestration to take effect will have real consequences for low-income victims of domestic violence and their families. We know programs funded by the Violence Against Women Act work. These important programs save lives and provide women with the services they need to escape abuse. Tomorrow the House should vote down their partisan bill and pass the strongly bipartisan Senate bill.

With International Women’s Day approaching on March 8, there will be tremendous worldwide discussion about violence against women. The United States should take the opportunity to look back on what it has done in the past to improve the lives of women and children caught in the cycle of domestic violence—and determine what more can be done to put an end to domestic violence once and for all. We can continue toward that goal by making sure that the sequester and the stalled Violence Against Women Act do not further shrink the programs that provide low-income women and their children with pathways to free them from violence.

Erik Stegman is the Manager of the Half in Ten Education Fund at the Center for American Progress. Katie Wright is a Research Associate at the Center.

Interestingly—and perhaps not surprisingly—most of the states that are threatening to reject Medicaid expansion have the highest rates of uninsured women. It is probably no coincidence that these same states also have the fewest number of women in elected office, while the majority of states with the highest representation of women in elected office have chosen to expand their Medicaid programs.

The map below outlines the health needs of American women by state and indicates how well women are represented in each state legislature as their states make such crucial decisions about their access to health insurance and care. Nearly 4 million women could gain coverage in states that have yet to accept the Medicaid expansion program, but they will be left with nowhere to turn if their states reject the program.

Low-income Americans, and women in particular, face significant health disparities relative to more affluent groups in part because of inequitable access to insurance coverage and health care. In most states Medicaid currently only covers certain groups of low-income individuals—mostly working parents with incomes well below the poverty line. Because women are more likely than men to be poor and also more likely to be parenting, more women than men qualify for Medicaid under the pre-Affordable Care Act eligibility criteria. But there is still significant unmet need in access to health care coverage for low-income women living just above the income eligibility threshold for Medicaid in their state, as well as for women who are not pregnant or parenting.

To ensure that low-income Americans could gain access to the health insurance coverage they need, the Affordable Care Act expanded Medicaid eligibility to all people with incomes up to 138 percent of the poverty line—$14,856 a year for individuals—regardless of whether they are pregnant or parenting.* Of the 17 million uninsured who could become newly eligible for coverage under the Medicaid expansion, at least 7 million are women, 4 million of whom live in the states that have not yet expanded coverage.

In light of the Supreme Court decision, however, several states have chosen to opt out of the Medicaid expansion because of their ideological and political objections to Obamacare, despite the health needs of their low-income residents and the fact that it makes economic sense for them to expand. Most of the states that have indicated they will reject Medicaid expansion also have the lowest percentages of female representatives in their state legislatures. With the exception of Maine and Wisconsin, all of these states have exceptionally high rates of uninsured women. Texas, for example, has the highest percentage of uninsured women in the country, as a full 23 percent of women in the state are uninsured—nearly 1 million women would gain coverage if Texas expanded its Medicaid program.

At least 4 million of the women who would be newly eligible to gain coverage under the Medicaid expansion are of reproductive age, and the decision to reject the Medicaid expansion may have important implications for their existing family-planning coverage. The Medicaid program provides 75 percent of public funding for family-planning services in the United States—in part through Medicaid family-planning waivers that offer limited coverage for family planning to women who do not qualify for full Medicaid coverage under their state’s eligibility criteria. In six of the states that have indicated that they will not expand Medicaid, the state’s existing family-planning waivers will be one of the only lifelines for family-planning coverage for low-income residents who are uninsured. It is not clear whether those waivers will be extended past December 31, 2013, as the federal government anticipated this population of women would have full coverage through Medicaid beginning in 2014.

Nearly 4 million women would be eligible to gain coverage through Medicaid in states that have not yet committed to expanding their Medicaid program under the Affordable Care Act or that have explicitly rejected the program. Unless their states expand Medicaid, however, these women will have nowhere to turn for health care coverage. Many of the states that have not accepted the expansion also have the highest rates of uninsured women in the country and fare poorly on other health indicators such as preterm birth rates. Their governors and legislators have a responsibility to stop playing political games and stand up for women’s health in their home states.

Lindsay Rosenthal is a Research Assistant for the Women’s Health and Rights team and Health Policy team at the Center for American Progress.

* The eligibility threshold in the Affordable Care Act is 133 percent, but the law includes a special deduction to income that effectively raises the eligibility level by 5 percentage points.

SOURCE: AP/Manuel Balce Ceneta

Senate Judiciary Committee Chairman Patrick Leahy (D-VT), second from left, the lead author of the Violence Against Women Reauthorization Act, joined by, from left, Sens. Amy Klobuchar (D-MN), Maria Cantwell (D-WA), and Christopher Coons (D-DE), speaks during a news conference on Capitol Hill in Washington, following the Senate’s passage of the Violence Against Women Reauthorization Act, February 12, 2013.

House Republican leadership is expected to hold a vote this Thursday on yet another partisan version of the Violence Against Women Act reauthorization—a bill with a strong bipartisan history that has become the latest casualty of the far-right politics of the House Republican caucus. This latest version of the law has extremely high and troubling stakes for women who suffer from domestic violence and sexual abuse.

In the previous session of Congress, the Senate passed a bipartisan reauthorization bill—68-31—only to have it killed in the House. And at the very beginning of the new 113th Congress this year, the Senate moved quickly to reintroduce and pass an even stronger and more bipartisan bill—by a 78-22 vote. As of yesterday’s House Rules Committee meeting, it looks likely that there will also be a vote on the Senate bill tomorrow if the House bill fails.

The latest House version of the reauthorization—put forward by House Republican leadership last week—takes an even more extreme position than it did last Congress with respect to the provisions that protect Native American women, a population that suffers from epidemic rates of domestic violence in tribal communities at the hands of non-Native American abusers. Under the current legal framework in the United States, non-Native American men exploit jurisdictional black holes that allow them to abuse Native American women on tribal land and evade justice. On some reservations—such as the Ft. Berthold reservation in North Dakota—a recent oil and drilling boom has led to an influx of non-Native American oil workers that has more than doubled the community’s population. This is a serious concern for tribal communities because these increasing numbers of non-Native American men who may potentially abuse women in their community still have too many avenues to evade justice, especially if the House version of the reauthorization were to become law.

The “get out of jail free” card for non-Native American men

The Senate version of the Violence Against Women Act proposed earlier this year incorporates an important new provision that would restore for the first time since the 1970s the ability of local tribal governments to prosecute non-Native American offenders for a narrow set of domestic violence crimes.  This is a strong and well-reasoned provision that was carefully reasoned and proposed by the Department of Justice to the previous Congress.

Rather than support the Senate reauthorization, however, House leadership has proposed a sweeping new set of special protections for these non-Native American offenders, which amount to a jurisdictional free pass to abuse Native American women in their own communities. Although the Senate version incorporates a full set of constitutional protections for these defendants—including due process, a right to counsel, and other rights—the House Republican bill focuses on further protections for non-Native American suspects of abuse. In all, the House bill shields these suspects in the following ways:

• Establishes seven avenues of appeal for suspects of abuse to challenge their prosecution
• Limits punishment of non-Native American offenders convicted of domestic violence to a misdemeanor-level punishment, regardless of the extremity of the beating or of their status as a repeat offender
• Authorizes suspects of abuse to bring lawsuits against tribal law enforcement, which will only serve to further deter the protection of Native American women

For the Native American women who continue to suffer at the hands of these offenders, the proposal put forward by House leadership is both offensive and dangerous. By removing existing local controls, it will further complicate and exacerbate the maze of injustice that exists on reservations. The last thing non-Native American abusers need is an extra set of tools to game the already-failing criminal justice system in Native American communities.

Ignoring reasonable members and compromises within the Republican Party

Signaling an even more extreme position than it took in the previous Congress, House Republican leadership is also ignoring reasonable voices and compromises coming from its own caucus. There is a growing chorus of House Republicans who are now calling for the leadership to compromise. Last week 17 House Republicans signed a letter calling on House Speaker John Boehner (R-OH) and Majority Leader Eric Cantor (R-VA) to immediately reauthorize a fully inclusive Violence Against Women Act such as the one passed in the Senate last week.

This new movement of Republicans in the House is growing. Since the letter was sent, other House Republicans have signaled their support of the bipartisan Senate version of the reauthorization protecting all victims of abuse. One of the letter’s signatories, Rep. Shelley Moore Capito (R-WV) recently told The Hill that, “It is far, far past due to reauthorize VAWA. The Senate version of VAWA achieves the main purpose—helping protect women who are victims of domestic abuse—and for that reason, I would support it if the House decides to bring it up.”

But leadership is again ignoring these Republicans and others who have voiced concerns, such as Reps. Darrell Issa (R-CA) and Tom Cole (R-OK), who is an enrolled member of the Chickasaw Nation. Both introduced a far more reasonable standalone bill, which now has 14 co-sponsors, to amend the tribal section in the current House bill. This version responds to some of the caucus’s concerns by giving non-Native American defendants a far more limited option to petition federal courts for the removal of their case if they feel their rights are being violated. “The current law enforcement system for Native American women is broken,” Rep. Issa told The Washington Post. “Too many victims of domestic violence cannot get access to law enforcement during times of emergency and more will continue to suffer unless Congress acts.” Reps. Issa and Cole introduced a nearly identical compromise in the last Congress, but House leadership also ignored it.

It’s time to pass the bipartisan Senate bill

Since its original enactment in 1994, one of the Violence Against Women Act’s primary purposes was to identify underserved communities of women who suffer from domestic violence. The latest Senate bill passed with a 78-vote supermajority for a reason: It meets this purpose for Native American women, among many other important provisions that identify and protect other populations such as gay* and transgender women and immigrant women. Native American women have waited too long for an answer from Congress to the epidemic violence against them in their own communities, especially at the hands of non-Native American men, who exploit a system of justice that gives them a free pass to abuse.

Providing a new toolkit for non-Native American abusers to get out of jail and further exploit the system actually works against the original purpose of the Violence Against Women Act and, more importantly, hurts the victims its intended to help. The House should stop wasting its time with hurtful alternatives and move quickly this Thursday to vote against the partisan Republican bill, pass the bipartisan Senate bill, send it to the president’s desk, and get the ball rolling on improvements to the system of justice in tribal communities.

Erik Stegman is the Manager of the Half in Ten Education Fund at the Center for American Progress.

*In this column “gay” is used as an umbrella term to describe people that identify as lesbian, gay, or bisexual.

SOURCE: AP/Damian Dovarganes

Detection lead mammographer Toborcia Bedgood performs an advanced-imaging screening that promotes early detection of breast cancer for low-income patient Alicia Maldonado at The Elizabeth Center for Cancer Detection in Los Angeles, May 6, 2010.

If sequestration is allowed to take effect as scheduled on March 1, $1.2 trillion will be automatically removed from the federal budget in across-the-board spending cuts that would potentially reverse our economic recovery. These cuts—which take money out of critical investments in education, public health services and research, disaster preparedness, and national security—would have devastating consequences in communities around the country and would harm all Americans in a number of ways.

Sequestration also institutes several cuts to key public investments that would disproportionately harm women. Low-income women and women of color will be hit hardest by the sequestration.

These are the top five ways in which the sequestration harms women.

Sequestration cuts $424 million from Head Start and Early Head Start

More and more women and single mothers are heading their households, and they are struggling to balance work and motherhood in the absence of a universal child care system. Head Start and Early Head Start provide education, health, and nutrition services to low-income women and their families, and they are critical child care providers for women who could not otherwise afford care for their children. These programs aim to ensure that limited parental income does not get in the way of a child’s early education or inhibit women from being able to work. As soon as sequestration takes effect, however, 70,000 children will be cut from Head Start and Early Head Start programs due to the eliminated funding for the program.

Sequestration cuts $86 million from key women’s health programs

Between two and three women die each day from complications of giving birth. Black women in the United States die in childbirth at three to four times the rate of other racial and ethnic groups. The infant morality rate in the United States is twice as high as that of other wealthy nations, and rates are highest for low-income women of color, who often lack access to quality health care.

Sequestration cuts $4 million from the Safe Motherhood Initiative, which helps prevent pregnancy-related deaths; $8 million from the Breast and Cervical Cancer Screening Program, which provides cancer screenings to low-income women; $24 million from Title X family planning and reproductive health services; and $50 million from the Title V Maternal and Child Health Services Block Grant. The cuts to the Maternal and Child Health Services Block grant alone would mean 5 million fewer low-income families would be provided with prenatal health care and other services that help eliminate disparities in infant mortality and maternal health.

Sequestration cuts $29 million from services for victims of domestic violence

More than 6 million women are victims of domestic violence every year in the United States. On average, more than three American women are murdered by their intimate partners every day. The health-related costs of intimate partner violence exceed $5 billion a year.

Sequestration cuts $20 million from the Violence Against Women Act, which funds crucial sexual-assault and domestic-violence prevention and intervention services, and nearly $9 million from the Family Violence Prevention Services Act, which is the primary funding stream for shelters that provide housing to women and children who have fled a violent home. Cutting the Family Violence Prevention Services Act alone would mean that 112,190 fewer victims of domestic violence could receive services. The Department of Justice estimates that the cuts to the Violence Against Women Act would prevent 35,927 victims from gaining access to shelter, legal assistance, and services for their children. Cuts would also mean that domestic violence training would be eliminated for 34,248 police officers, prosecutors, judges, and victim advocates. Cutting these critical prevention and intervention services will only increase both the human and economic costs of intimate partner violence.

Nearly 600,000 beneficiaries would be cut from the Special Supplemental Nutrition Program for Women, Infants, and Children

About 16.7 million children in the United States live in food-insecure households, which means they are unable to consistently access the nutritious food necessary to live a healthy life. Sequestration would cut $600 million from the Special Supplemental Nutrition Program for Women, Infants, and Children, or WIC, which helps provide basic food security to poor mothers and their children at a time when the poverty rate for women is at historic highs. WIC provides low-income women and their children up to age 5 who are at nutritional risk with supplemental foods, health care referrals, and nutrition education.

Many public-sector jobs would be lost, which disproportionately harms women

Nearly two-thirds of mothers are either the breadwinner for their families or share that responsibility with a partner. Women’s wages are therefore critical to both their own and their families’ economic security. According to many estimates, thousands of public-sector jobs would be lost if sequestration occurs, and since women are 50 percent more likely than men to be employed in public-sector jobs—such as those in education—their jobs will be needlessly jeopardized by sequestration.

These cuts would only be the beginning. As the effects of the cuts ripple through the economy, more and more public-sector jobs will be lost, leaving more women unemployed. With such deep cuts to the federal budget, states will be forced to scale back on additional services. This would likely include limiting Medicaid benefits—a critical source of health care for low-income women.

While all Americans would be harmed by these senseless cuts that would throw the country into a manufactured fiscal crisis, no one would be hurt more than low-income women and women of color—and their families. Congress must stop protecting the bank accounts of the wealthiest Americans on the backs of the most vulnerable families in our country. It should act now to prevent sequestration from taking effect on March 1.

Lindsay Rosenthal is a Research Assistant with the Women’s Health and Rights team and the Health Policy team at the Center for American Progress.