Medicare-For-All Vs GOP War on Women’s Healthcare
During the first two rounds of primary debates, the candidates for the Democratic presidential nomination spent a good deal of their allotted time discussing healthcare reform and, in particular, versions of an expanded Medicare public option.
Senators Bernie Sanders and Elizabeth Warren support a Medicare For All plan that would phase out private insurance over four years. Others, like Mayor Pete Buttigieg and Senator Michael Bennett have called for a more moderate approach that would expand Medicare coverage to all who choose to opt in, with the potential that the market would naturally eliminate the need for private insurance over time.
There are many benefits to a universal healthcare system including much-needed expense management, potentially better health outcomes. According to the most recent Kaiser Family Foundation data, more than half of those polled supported a single-payer healthcare system. There is even modest bipartisan support for a Medicare buy-in option.
However, there are concerns about who would decide the scope of that coverage, particularly for women, minorities, and the LGTBQ+ community. A look at the anti-abortion laws passed in 2019 alone paints a clear picture of what would be in store for reproductive rights under a public option.
How is women’s healthcare access limited right now?
States including Georgia, Alabama, and Missouri, have passed laws in 2019 effectively banning abortions and potentially criminalizing the procedure after 4-8 weeks of pregnancy, often before many women can confirm a pregnancy, let alone find a doctor, save some money, request time off work, and travel to one of the few remaining clinics in these states. At the time these laws were passed, 96% of the counties in Georgia did not have a single abortion provider and Alabama had only three remaining clinics, making access difficult.
Since the passage of Roe v. Wade in 1973, which legalized abortion in the United States, innumerable laws and regulations have been enacted that limit women’s access to safe, legal abortions. Then, in 1976, the Hyde Amendment was passed, attached to a spending bill and signed by most members of Congress over the years, including Elizabeth Warren, Michael Bennet, Cory Booker, Kirsten Gillibrand, Kamala Harris, Amy Klobuchar, Beto O’Rourke, and Eric Swalwell as recently as 2018.
The amendment, which bans the use of federal funds for abortion care, effectively limits access to women who are covered under Medicaid, Medicare, Tricare (the health insurance offered to members of the military), and the Indian Health Service. Additionally, those who receive subsidies for health insurance purchased on the Affordable Care Act (ACA) exchanges cannot be covered for abortions. Currently, twenty-six states have at least one restriction on abortion coverage through private insurance.
Where do the candidates stand on Hyde
The Hyde Amendment has taken the right to a safe abortion away from many low-income and minority women who, without access to affordable care, do not have access at all. As Senator Kirsten Gillibrand pointed out on Twitter recently, “Repealing the Hyde Amendment is critical so that low-income women in particular can have access to the reproductive care they need and deserve. Reproductive rights are human rights, period.”
On a Saturday in June, Planned Parenthood hosted ‘We Decide 2020 in Charleston, S.C’. The conference brought together members of the Planned Parenthood Action Fund and twenty of the Democratic primary candidates. All who attended discussed their history of supporting reproductive rights and their plans were for continuing to support access to abortion care. They vowed to appoint judges who would protect abortion access, codify Roe v. Wade into law, and get rid of the Hyde Amendment altogether, despite their previous readiness to pass bills with the amendment included.
Joe Biden, who had changed his position on the Hyde Amendment just days earlier, spoke about how he would ensure coverage for abortions in a federal healthcare system.
“I laid out a healthcare plan that is going to provide federally funded healthcare for all women…I provide for a Medicaid and Medicare type policy that is in fact going to provide all the same services. So, it became really clear to me that although the Hyde Amendment was designed to try to split the difference here to make sure women still had access, you can’t have access if, in fact, everyone is covered by a federal policy. So, that’s why, at the same time, I announced that I could no longer continue to abide by the Hyde Amendment.”
How do we move forward
Despite the hurdles, the fight for healthcare reform is eminently important. Members of all parties have consistently named healthcare as one of the most pressing issues in the U.S. today. The current system, though in many ways better than what it was even ten years ago, is not perfect, and for many, the cost of healthcare, with or without insurance, remains prohibitively expensive.
“I don’t believe only in reproductive freedom, I believe in reproductive justice,” Julian Castro said during the first round of debates, noting that any steps taken to reform the U.S. healthcare system would require a firm stance against conservative attacks against women and the LGBTQ+ community. For them, the continuing attacks on healthcare access make the potential costs of reform exponentially higher.