Republicans in Congress are celebrating International Women’s Day this year by pushing forward a health care bill that could be disastrous for America’s women.
On Monday evening, lawmakers in the House unveiled legislation to repeal and replace Obamacare that would defund Planned Parenthood, eliminate affordable abortion coverage, and roll back access to health care altogether.
Rep. Lois Frankel (D-FL), the co-chair of the Congressional Women’s Caucus, called the called the proposal a “triple whammy for women and children and their families” when reached by ThinkProgress on Thursday.
Dr. Willie Parker, board chair of the Physicians for Reproductive Health, called the bill “a direct attack on many Americans’ access to health care [that] is especially devastating to women’s health,” in a statement emailed to ThinkProgress.
That hasn’t stopped congressional Republicans from moving quickly. On Wednesday, the GOP replacement began advancing through Congress as lawmakers on two different committees started the markup process.
The line outside Ways and Means hearing room, 1.5 hrs before markup starts on O'care replacement. Lots of pink for Planned Parenthood. pic.twitter.com/9AN1Un6Gve
— Paige W. Cunningham (@pw_cunningham) March 8, 2017
The GOP bill hasn’t been finalized yet — and, as it’s unlikely to obtain any Democratic votes, Republicans need almost their entire caucus to sign on to support the legislation in the Senate.
As it stands, however, the bill would be a devastating blow for women’s access to a wide range of health care services. Because so many of the bill’s tenets would affect women — and because health insurance is a dense, interlocking system — any version of the bill is likely to be a step back for women’s ability to access and afford health care.
Defunding Planned Parenthood
One of the starkest measures in the bill is a provision that would defund Planned Parenthood — essentially, preventing the women’s health clinic from receiving any federal funding.
Planned Parenthood currently receives about $500 million from the federal government. As it stands, the Hyde Amendment prevents any of that money from subsidizing abortion care.
That means in reality, when politicians talk about defunding Planned Parenthood, they’re actually talking about taking away money that subsidizes cancer screenings, birth control consultations, STD testing, and other basic health care services for low-income women who otherwise wouldn’t be able to afford this care.
In fact, the vast majority of Planned Parenthood’s federal funding — 75 percent — is in the form of Medicaid reimbursements. Federally defunding Planned Parenthood would essentially eliminate it from the pool of Medicaid providers, pricing out many low-income and rural women for whom Planned Parenthood serves as a primary care provider. Over 2.5 million people — both men and women — receive care at the organization’s clinic every year.
“For people who rely on Medicaid coverage — including people of color, people with low incomes, and those who live in rural areas — and already face obstacles to getting health care, removing Planned Parenthood as an option would put essential health services further out of reach,” Dr. Parker said.
Eliminate affordable abortion coverage
The bill would also fundamentally alter access to abortion coverage for people who buy insurance plans in the state marketplaces. It prohibits people from using their tax credits toward any insurance plan that covers abortion — unless it’s for the very rare case of rape or incest.
The government provides tax credits to help offset the cost of monthly insurance premiums for some Americans. So while the bill doesn’t prohibit abortion from being covered, it would make plans that include abortion coverage more expensive for people to access — and carve out abortion as a separate issue, rather than an unexpected medical cost like any other.
That means that providing abortion coverage would be both more expensive and more logistically complicated for both individual consumers and small businesses choosing insurance plans for their employees.
This could have a sweeping effect through the entire insurance industry, impacting the ability of even women with private insurance to receive affordable abortion care.
Taking away health insurance from millions of women
A preliminary analysis of the plan by Standard and Poor indicated that somewhere between 6 and 10 million people who currently have insurance will lose access as a result of the GOP plan.
These losses will disproportionately affect women because they make up a larger share of low-wage workers who rely on government aid for their health care. Currently, 69 percent of adult Medicaid enrollees are women.
The GOP plan would drastically change the Medicaid program. For one, it would cut off Obamacare’s Medicaid expansion starting in 2020 — meaning that people who are already on Medicaid can keep their insurance (as long as they don’t have any coverage gaps at all), but people that could have signed up under the expansion will no longer have the option.
The plan will also cap Medicaid spending based on enrollment levels rather than on health care spending, which will likely make it tough for states to cover the cost of the program and, eventually, lower the number of people covered by Medicaid even further.
S&P’s analysis doesn’t take that change into consideration, meaning that the total number of people who will lose coverage could be even higher.
The GOP’s proposal would also make health insurance more expensive for seniors. Under the plan, older people can be charged premiums that are five times higher than those for younger people. They also receive a higher tax credit — but only twice as much as a younger person.
This change makes health insurance easier to purchase for young people, who tend to be healthier and more profitable for the insurance industry. On the flip side, it will make health insurance more expensive for seniors — likely driving seniors to switch to thinner, less-effective plans or to forego health insurance entirely.
That change, too, will hit women harder — the senior population skews female because women tend to live longer.