One of the very real dangers in the debate on how to fix American healthcare is that women's health will become a bargaining chip, with the GOP and anti-abortion forces trying to frame healthcare reform as an endrun to government ‘interference' in our lives by ‘mandating' abortion and gasp, contraception. Amanda Marcotte has an excellent post here that deconstructs the root of why they are using this tactic and looks at media complicity in fomenting these blatantly misogynist attempts to derail healthcare reform.
But I suspect that anti-choicers latched onto taxpayer-funded abortions, because they can count on a lot of the public to imagine the government funding female licentiousness.
Planned Parenthood has also issued an excellent press release (that should be read in its entirety) debunking the myths about abortion and healthcare reform proposals that are being circulated,
Singling out abortion for exclusion from plans in a health insurance exchange is both discriminatory and harmful to women's health. With the majority of private insurance plans covering abortion today, any attempt to restrict this coverage in the health insurance exchange would constitute an unprecedented restriction on women - taking benefits away that they currently have today.
The unfortunate truth is that women's health is not a priority in the national discussion about the critically ill state of our national healthcare. As Jodi Jacobson writes,
(Obama's) support for a woman's right to choose and for access to the services needed to prevent unintended pregnancy, stem the spread of infections and ensure all women have primary reproductive health care won't be enough to secure passage of a health reform bill that includes these essential health services.
In fact, both Republicans and conservative Democrats are pushing for restrictions in health reform legislation that could result in the loss of current benefits to millions of women.
Jacobson goes on to explain how Republicans may use abortion and contraception denial as a bargaining chip for their support of legislation and the devastating effect this could have on women's health:
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In order to ensure all Americans are covered, most health reform proposals include options for "insurance exchanges" and other methods through which the federal government might partially subsidize the costs of insurance coverage for those without employer-based insurance, or those who can not afford to pay out-of-pocket for an insurance policy. What the Republicans and the Democrats opposed to continuing current coverage (including current abortion coverage) for women want to do is to eliminate the possibility of coverage from either subsidized or private plans whether or not the federal government is subsidizing a particular person.
This is sort of like applying the "global gag rule" to private insurance plans because even if you are paying for 90 percent of your policy, the restrictions apply both to the federally funded portion (10 percent) as well as to the 90 percent of the policy you pay for. Moreover, some analysts believe the implication is that even in cases where you pay for 100 percent of the policy you choose, if the federal government is involved in any way in that insurance plan by subsidizing others, your coverage would still be restricted.
Martha Burk also points out that age-rating is also a potential bargaining point that would discriminate against people between the ages of 50-65, and " would particularly affect older single women, already lower on the income scale and less likely to have employer coverage. And as we have noted before, there is a gross inequity in the current system that forces many women to pay far more for health insurance than men do.
During the next few weeks, if not the next few days, the U.S. Congress and President Obama will be making decisions that will impact the health of every person in this country. The bottom line is that while a single-payer plan is undoubtedly the best thing that could happen to our collective health, the political chances of that happening are close to nil. And it is entirely possible that the compromises that will be made to placate Republican and anti-reproductive rights votes as well as the insurance and pharmacy companies that give so generously to politicians on both sides of the aisle will leave us with a healthcare situation that is only marginally better and could even become worse for some, including many women.
The time to take action is now. Call or write to your elected representatives. Or better yet, drop by and visit. Tell them that you want meaningful reform that provides for the health of every American. Tell them how much you spend on health care and health insurance. Tell them about coverage and care that was denied. Make it clear to them that the last election really was a mandate for change and that the American public will not abide by the business as usual that is continually selling us down the river. Our lives depend on it.
Addenda: The Urban Institute Health Policy Center has published an excellent analysis of the real financial impact of health care reform which should be read in its entirety. Among the highlights:
- $1.6 trillion is an estimate recently put forth by the Congressional Budget Office (CBO) on the cost of the Senate Finance Committee's health plan.
- While these numbers are indeed somewhat alarming initially, they need to be put in context. One source of confusion is that the $1.6 trillion is a 10-year number. Between 2010 and 2019, the total amount of gross domestic product (GDP) is projected to be $187 trillion, according to CBO.1 Thus, the estimated gross costs of health reform are less than 1 percent of the GDP over that period. And, importantly, the $1.6 trillion is a total or gross estimate. Other government costs would be reduced as a result of expanding coverage so significantly.
- The government costs also ignore the private savings to employers and individuals resulting from reform.
- Absent reform, total health care expenditures, public and private, will total $33.0 trillion, over the ten years 2010-2019.3 The $1.2 trillion that we estimate in net new spending will therefore increase expected health costs by only 3.5 percent. The problem that the nation faces is not the small increment necessary to expand coverage to the uninsured, but the high and growing baseline costs of the system. The high system costs must be addressed through payment and delivery system reforms.
- (F)ailing to enact comprehensive reform carries substantial costs as well. We recently analyzed changes in coverage and expenditures for a 10-year period, if reform was not enacted, using different assumptions about economic growth and health care cost increases. We showed that, absent reform, there would be considerable loss of employer coverage, particularly among the middle class, and a substantial increase in the number of uninsured, from an estimated 49 million in 2009 to over 60 million in 2019. The number of nonelderly people enrolled in Medicaid would increase substantially, from 44 million in 2009 to well over 50 million by 2019, increasing state and federal government costs appreciably. Because of the greater number of uninsured, the amount of uncompensated care that hospitals and clinics would provide would also increase dramatically, putting further pressure on government budgets. We estimate that Medicaid spending would increase over the 10 years by about $800 billion without reform and that the costs of uncompensated care by about $250 billion.
- Without health reform, employer costs would also increase substantially, as would costs to individuals and families from higher premiums and out-of-pocket costs.