How Trump and the GOP are setting back the clock on women’s healthcare. Part of our series, The GOP Con.
As campaign promises go, it was pretty spectacular. Throughout 2016, Donald told American voters that he had the answer to the nation’s healthcare crisis – and if he were elected, every single American would soon enjoy better healthcare at a far lower cost.
Who wouldn’t want that?
We’re now 15 months into Trump’s bait-and-switch presidency. And just as in every other arena on which Donald has left his imprint, healthcare hasn’t gotten better.
It’s getting worse. Much worse. Especially for women.
The list of GOP assaults on women’s health care is long – and growing by the month.
Early in his first year in office, Trump expanded the global gag rule, which forbids non-governmental organizations receiving U.S. funds from talking to the women they serve about abortion.
He then rescinded the rule that protects Title X patients’ access to family planning care at health centers that offer abortion services – even if they’re not seeking abortions.
Then came the nomination of Neil Gorsuch – a stridently anti-reproductive rights jurist – to the U.S. Supreme Court. We’ve yet to determine how that will impact American women…but it’s a pretty safe bet that it won’t be good.
Then there were three Republican attempts in 2017 to defund Planned Parenthood, as part of their unsuccessful quest to repeal the Affordable Care Act outright.
Failing that, the GOP snuck repeal of the ACA’s individual mandate into the fall 2017 tax bill. Experts now tell us that will drive a significant reduction in the number of insured Americans.
And cost increases. As Washington Post reporter Amy Goldstein wrote on March 8, “Insurance premiums for Affordable Health Care Act health plans are likely to jump by 35 to 94 percent around the country within the next three years.” She added that eliminating the individual mandate is the chief driver of that increase.
Here’s how the ACA helps women
So why is an assault on the ACA of particular concern to women? Largely thanks to the ways in which Obamacare expanded women’s health care protections.
The ACA forbade insurance companies from denying coverage or raising premiums based on gender or pre-existing conditions – a big deal for American women, since in pre-ACA days, insurers often cited a past pregnancy, or even monthly cramps, as a “pre-existing condition” that justified their denial of coverage.
The ACA also cut the cost of women’s healthcare, by requiring most insurance plans to cover preventive services such as contraception, mammograms, HIV testing and counseling, domestic violence counseling, and testing for gestational diabetes, without deductibles, co-pays or coinsurance.
Those coverage improvements helped convince more than 4.3 million American women and girls to purchase ACA policies during the first enrollment period in 2013 and early 2014. Millions more signed up through Medicaid programs in the states whose political leaders agreed to accept ACA funding.
And another 1.1 million women between 19 and 25 got health coverage through a parent’s insurance plan or through an ACA individual plan offered by their state or the federal exchange.
And here’s how Trump hurts us
In fall 2017, Trump began his assault, first by rescinding the Obama-era guidance letter that advised states not to defund Planned Parenthood.
He followed up with a sleight-of-hand move worthy of praise from David Copperfield: offering consumers “short-term” health plans – dirt-cheap policies he and the GOP claim are great for folks who can’t afford the high cost of health coverage (which cost, of course, their own actions are driving higher). But those “great” policies aren’t available to anyone with a pre-existing condition and exclude key benefits offered by the ACA, such as prescription drugs, maternity care and mental health services.
And then, claiming the need to protect religious freedom and “moral sensibilities,” Trump rolled back the Obama-era rule that required most employers to provide birth control coverage without co-pays to employees enrolled in their health plans.
This change disregards the fact that 68 percent of Americans support offering birth control coverage to women without a co-pay. It blows apart Obama’s carefully crafted religious exemption, which allowed churches, mosques, temples and other houses of worship to exclude birth control coverage in their employee policies. And it expands the Supreme Court’s 2014 Hobby Lobby ruling, which had allowed only closely held for-profit companies to deny contraceptive coverage to employees on religious grounds. Now any business, university or organization in America can opt out of offering that coverage.
It even undercuts the Obama rule’s provision that allowed employees to purchase birth control coverage directly from the insurer if their employer’s health policy excluded it as a coverage option. If your employer is against contraception, you’ll now pay full price at the counter…or go without.
For lower-income Americans who receive their healthcare through Medicaid, the news has been just as disheartening. Trump’s 2018 budget called for $250 billion in cuts to Medicaid funding over 10 years. It set new per-person limits on the amount of healthcare each Medicaid enrollee can use. And it ties federal Medicaid spending to inflation, which reduces its value for recipients.
Oh, and it converts part of Medicaid funding into a block grant delivered to the states – which means states no longer have to follow federal Medicaid rules regarding which medical benefits they must cover and which residents must be allowed into the program. Critics anticipate that GOP-led states will use the block grant funding mechanism to eliminate coverage for birth control and childbirth.
Since half of all U.S. births are currently covered by Medicaid, the block grant ploy is sure to jack up out-of-pocket costs for women who are either trying to prevent a pregnancy or hoping to have a child.
Either way, American women are getting…yeah…screwed.
// This report is an excerpt from Marcy Miroff Rothenberg’s Ms. Nice Guy Lost – Here’s How Women Can Win, now in pre-publication review. //