How Women Would Be Hurt by ACA Repeal and Defunding of Planned Parenthood
Congressional Republicans and the incoming Trump-Pence administration have a loathsome preoccupation with crippling access to women’s health care. Notable efforts at the core of their anti-choice/anti-woman agenda are defunding Planned Parenthood and repealing the Affordable Care Act, or ACA. These efforts are front and center in current negotiations around the annual budget reconciliation bill and ensuing confirmation hearings for key political appointees, including Rep. Tom Price (R-GA) for health and human services secretary and Sen. Jeff Sessions (R-AL) for attorney general. Both men are on record supporting legislation to derail access to women’s health care. If congressional Republicans succeed in repealing the ACA and defunding Planned Parenthood, women would be tremendously disadvantaged by the loss of affordable health care.
The ACA significantly expanded affordable health care coverage for women
The ACA has helped ensure access to quality, affordable care for millions of women. Approximately 9.5 million women who were previously uninsured have gained health coverage through the ACA; 55 million women now have access to vital preventive care at no cost. Some of the covered preventive services include annual well-woman exams; breast-feeding support and supplies for new moms; birth control; screening and counseling for domestic and intimate partner violence; and screening and treatment for sexually transmitted infections. Such services provide critical, holistic care for women who previously struggled to meet these needs due to cost and lack of access.
One of the most popular aspects in the suite of ACA-mandated services is the requirement that all contraceptive methods approved by the U.S. Federal Drug Administration must be covered by insurance without cost sharing. A University of Michigan Health System poll found that nearly 7 in 10 Americans support this mandate. This benefit alone has saved women $1.4 billion in out-of-pocket costs each year since going into effect in 2012.
Additional supports for women’s health that are built into the ACA include the requirement that all small group and individual health plans provide coverage for maternity care. Furthermore, women can no longer be charged more for their health insurance or be denied coverage due to pre-existing conditions. And young women can stay on their parent’s insurance plans until age 26. The ACA also made it illegal for government agencies and federally funded health insurers and hospitals to discriminate based on sex, race, color, national origin, disability or age. This is the first time federal civil rights law has prohibited discrimination based on sex in federally funded health programs.
Significantly, the ACA provides women with benefits that go beyond physical health. When a woman doesn’t have to pay a $20 copay for a well-woman visit or $1,000 for an intrauterine device, or IUD, she can save that money or use it for household expenses. Countless studies have shown that health care costs are a barrier for women seeking health services. If the ACA is repealed, women’s insurance rates will increase because their health services are more expensive and women could be denied health coverage due to pre-existing conditions.
ACA repeal and the ensuing rollback of Medicaid expansion would drag the country back to a time when some women and families were forced to go without health insurance. Loss of vital services such as free birth control, maternity care, and preventive services will hit women of color and low-income women hardest—contributing to health inequity and health disparities. And if congressional Republicans defund Planned Parenthood in addition to repealing the ACA, they will push sexual and reproductive health care even farther out of reach for communities in need.
Defunding Planned Parenthood would bar access to health care through the safety net
Planned Parenthood has been a leader in providing health services to communities for 100 years. The organization currently operates 650 health centers throughout the country. Comprehensive sexual and reproductive health care is a part of Planned Parenthood’s DNA; often it is the sole source of family planning for many of the women it serves. Planned Parenthood clinics provide breast cancer screenings; testing and treatment for sexually transmitted infections; pap tests; cervical cancer screenings; family planning and birth control counseling and services; sexuality education and outreach; and more.
While Republicans have attacked Planned Parenthood for offering abortion services, abortion is an essential aspect in the continuum of sexual and reproductive health care and accounts for only about 3 percent of the services the organization provides. Nearly 5 million women, men, and adolescents are served by Planned Parenthood each year. One in five women in the United States will visit a Planned Parenthood health center at least once in her lifetime.
Withholding federal funding from Planned Parenthood would have a significant impact on the organization’s ability to provide much-needed services. In 2014, the organization’s total revenue was about $1.3 billion, with $533 million from the federal government. Planned Parenthood receives federal funds primarily through the Title X family planning program and Medicaid reimbursements. These funds are subject to the draconian restriction on federal funding for abortion, known as the Hyde Amendment. Nearly two-thirds of Planned Parenthood patients access their care through federally funded health programs. Because Planned Parenthood largely serves low-income women, women of color, young women, and immigrant women, these communities stand to face the worst health and economic outcomes if this safety net provider is blocked from receiving federal funds. Oftentimes, Planned Parenthood is the single access point of primary care for many of its patients, including women on Medicaid and the uninsured.
Reproductive freedom and sustained physical health are integral to women’s ability to remain productive and contribute to their own and their families’ wellbeing. Repealing the ACA and defunding Planned Parenthood would not only jeopardize many women’s physical health, but their economic security would also take a hit if they are forced to assume increased health care costs. The incoming Trump-Pence administration and anti-choice members of Congress are out of touch with what women need to lead healthy, productive lives that allow them to play a vital role in sustaining the nation’s communities. Women’s health care should not be a political wedge issue.
Jamila K. Taylor is a Senior Fellow at American Progress.
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Senior Fellow; Director, Women’s Health and Rights