In order for women to be truly equal with men, they need the same opportunities in life. Not only does that include the same financial opportunities—such as equal pay for equal work—but also the ability to have control over their bodies and health care decisions. In order to achieve broad economic security and help women exit and stay out of poverty, policymakers must ensure that women have meaningful access to comprehensive health care—not the limited coverage that is the current Republican agenda.
Researchers have long observed the economic benefits for women derived from the ability to choose when and whether to become mothers. Access to birth control has played a key role in enabling women to obtain a college education and the benefits continue after a woman enters the workforce. While most women still experience unacceptable short- and long-term decreases in income after having children, delaying motherhood until a woman’s late 20s or 30s can safeguard against significant financial losses. The decision of when to have a child is a deeply personal choice that no person should make for another. Progressive education, workplace, and health policy reforms are essential for all mothers to support their families no matter when they choose to have children. But for many women, delaying pregnancy can be key to completing secondary and higher education and also jumpstarting career growth. Supporting women’s ability to choose to start a family when they feel ready should be the goal.
Access to birth control must be protected, not limited
The Affordable Care Act, or ACA, brought affordable preventative care, including birth control without copayment, to millions for the first time. Despite being underfunded, the federal Title X program, which served more than 4.5 million patients in 2013, helps hundreds of thousands of low-income women prevent unintended pregnancy each year. The federal Teen Pregnancy Prevention Program, or TPP, gives competitive grants to private and public organizations for effective prevention program. And women’s health clinics, such as Planned Parenthood, play a vital role in supporting access to birth control for women with limited means.
Yet in February, congressional Republicans voted for the 63rd time to repeal the ACA. And while House Republicans have yet to unveil many of the 2017 appropriations bills—including the 2017 House Labor, Health and Human Services, Education, and Related Agencies spending bill—their 2016 version of the bill, approved by the House Appropriations Committee, contained a complete elimination of the Title X program and reduced the TPP program from $108 million to $10 million. To cap off these damaging policy decisions, House majority leadership also advanced a bill to defund Planned Parenthood.
If House majority leadership successfully eliminates access to family planning, struggling women and families would feel the brunt of these efforts. The evidence is clear on this point. For example, when Texas officials defunded Planned Parenthood, there was a significant increase in births among low-income women who had previously been receiving birth control from these clinics.
To secure and increase access to birth control, the ACA must remain law, investment in Title X and TPP should increase—not decrease—and Planned Parenthood must continue to participate in government programs that serve low-income women.
The right to choose must be accessible to be a reality
When birth control fails—or is unobtainable—a woman should have the ability to end her pregnancy, if she chooses. But both state and federal policy act to restrict women’s ability to do so by putting the cost of care out of reach for too many. When government restricts the availability of birth control women struggling economically are harmed the most.
Even as House leadership has busied itself scheduling votes to ban abortion care, there are still several pieces of pending legislation that, if enacted, would help make choice available for all women.
Although the ACA has made insurance affordable for the first time for many families, private insurance coverage for abortion care is severely restricted in many states. Moreover, the federal government has a longstanding policy against covering abortion care in most circumstances for women who receive their insurance through the government, such as those on Medicaid or those who access health care while serving in the military or Peace Corps. Introduced in the House in the summer of 2015, the Equal Access to Abortion Coverage in Health Insurance, or EACH, Woman Act would help ensure abortion coverage for all women—no matter how they get their insurance.
Across the country, states are imposing medically unnecessary restrictions on women’s health providers, designed to make abortion care too expensive for most women. The U.S. Supreme Court is currently weighing the constitutionality of these restrictions. But the Women’s Health Protection Act would make unlawful many of the kinds of state and local restrictions that block women’s ability to obtain high-quality reproductive health care.
Advancing and passing both bills will help ensure that the right to choose is not just theoretical, but also obtainable.
This column is far from a complete list of the changes that must be made to lift impediments to women’s economic growth. Congress must enact policies that support prenatal and postnatal care, fair pay, child care, and family leave—but when women do not have access to comprehensive health care, they are far more likely to wind up in poverty. Until Congress acknowledges the reality that women’s reproductive lives do not exist in a different world from the economy, any approach to ending poverty will fall woefully short.
Maggie Jo Buchanan is the Associate Director of the Women’s Health and Rights Program of the Women’s Initiative at the Center for American Progress.