Broad Rights: Reproductive Healthcare Effects Us All
Obama will be forced to decide whether reproductive health care is an essential service or merely a political chess piece.
After President Barack Obama signed his first piece of legislation, the Lilly Ledbetter Fair Pay Act, he remarked that it was a victory for workers and for civil rights. He did not say it was a victory for women but that "making our economy work means making sure it works for everyone."
I, for one, was thrilled. While the Supreme Court case that led to the Ledbetter legislation was mainly discussed in the context of gender discrimination, the rights restored by the passage of the Ledbetter Act truly are good for all workers. Hearing a president articulate this was nothing short of revolutionary. Women's rights are civil rights. Women's rights are human rights.
The reality that feminists have long grasped and conveyed to the public, with varying degrees of success, is that protecting women's rights is good for society as a whole. While different identity groups are often in need of different sorts of services or protections, their rights are, in fact, inseparable from those of the broader population. Yet historically, the rights of women, gay people, and people of color have been placed in separate boxes. Those who oppose these rights have not been taken to task for holding back society as a whole.
This dynamic is exceptionally stark in the debate over reproductive rights. If you ask most conservatives and even some liberals, reproductive rights are about women -- and, perhaps a bit more broadly, about women's role in society. Undercutting reproductive health is not seen as a blow to the overall health of the nation -- or indeed, the world. This is how we've gotten international policy that defines and regulates reproductive health services differently than other medical aid. This is why some insurance plans are allowed to deny coverage for contraception. This is why funding for core health services for low-income women remains a political football.
During the campaign, Obama's staff stated, "Sen. Obama believes that reproductive health care is basic health care," acknowledging that reproductive health care "is an essential service -- just like mental health care and disease management and other preventive services under his plan." And in a speech at Planned Parenthood in the summer of 2007, candidate Obama spoke at length about expanding the terms of the choice debate beyond the confines of abortion and contraception, to show how these rights are linked with the bigger, broader issues of health, work, and families.
But all that talk is pretty useless if, when it comes to actually passing legislation, President Obama caves to those who view reproductive health care as distinct from other types of care. In late January, as Congress debated the economic-stimulus package, Obama was eager to court Republicans by stripping out a provision that would have made it easier for states to access federal family-planning money. Rather than see this for what it was -- a way to reduce states' health-care costs -- Obama acquiesced to the right-wing view that these services were somehow inessential. At the time, other health--care provisions remained in the bill.
While Obama pledged to introduce legislation to help states access family--planning funds, he never publicly articulated why he felt such a provision didn't make sense in the stimulus package. Promoting preventive care is widely seen as a good way to reduce health-care costs, which makes regular gynecological care especially important; annual "well woman" exams are preventive in nature. According to the American College of Obstetricians and Gynecologists, many women consider their OB/GYN their primary-care doctor. (In fact, some health advocates have suggested creating a medical specialty for men's preventive health care as well, to get more men to see the doctor regularly.) And reducing the price tag of our health-care system is an effort that has clear bipartisan support. Ensuring more women are getting regular reproductive care is a means to that end.
This is not an isolated debate. Over the course of the next four years, there will be numerous fights over rights and health care, and Obama will be forced to decide, again and again, whether reproductive health is indeed an "essential service" or whether it is a political chess piece. In making tough decisions about health care -- in big ways as he pursues an overhaul of the health-care system, and in smaller ways as he makes decisions about funding existing programs -- I hope Obama applies the same broad lens through which he viewed the Ledbetter legislation.
After all, what's good for women is good for the country. Making our health-care system work means making sure it works for everyone.
© 2009 The American Prospect