On Tuesday, Nov. 29, President-elect Donald Trump announced his nomination of Rep. Tom Price, R-Ga., to be the next secretary of the Department of Health and Human Services (HHS). Price, an orthopedic surgeon who presently represents the northern Atlanta suburbs, has been a vocal member of Congress on a wide range of health care issues, from abortion care to contraception access to in vitro fertilization to the Affordable Care Act (ACA). Below, we break down what Price’s appointment might mean for three major issues relating to women’s health.
Price has been a consistent and loud opposing voice to the ACA, known colloquially as Obamacare, and has long pushed for its repeal and replacement with his own legislation, which most notably would replace the current financial assistance ACA gives people to buy health coverage with tax credits that are based on age, not income level.
Also at stake, however, in the potential dismantling of the ACA would be the contraception coverage clause that was one of the biggest wins for women’s health during the Obama presidency. Under the ACA, all health insurance plans must cover the cost of contraception in full, with no deductibles or copays.
Jamila Taylor is a senior fellow specializing in women’s health policy at the progressive policy and advocacy organization the Center for American Progress. She tells Yahoo Beauty that what she most fears about the Price appointment is what’s at stake for the contraceptive benefit of the ACA.
“All the aspects of the ACA that focus on women’s health, from contraceptive services to preventative services to well woman’s care, have been important aspects in ensuring that all women, and especially low-income women, have access to the health services they need,” Taylor says. She adds, “[Price] is already on the record saying there is no woman out there who cannot afford birth control — it just shows how ignorant he is, and he’s a doctor. He hasn’t taken the time to look at the data regarding cost sharing and how that impacts women who use birth control.”
Taylor also notes that while she doubts, due to the nature of how business is done on the Hill, that the ACA will be repealed and replaced in its entirety, she remains deeply concerned that when it comes to a redesigned health care legislation package, “women’s health provisions could be some of the first things dropped.”
Another thing at stake when it comes to contraception access under a future Secretary Price is the way women access such health care services through Title X, the federal grant program dealing solely with family planning and contraception.
The Obama administration proposed a new rule in September stating that states cannot withhold Title X federal family planning dollars from certain recipients for any reason other than a provider’s “ability to deliver services to program beneficiaries in an effective manner” — meaning that states cannot move to block Planned Parenthood from receiving federal funding through Title X and Medicaid just because that state’s governor or legislature personally and politically disagrees with the fact that some Planned Parenthood health centers also provide abortion care. As Planned Parenthood serves over a third of all Title X patients, 85 percent of whom have annual incomes below $23,500, eliminating Planned Parenthood as a Title X provider could be devastating to the low-income women who rely on the centers for contraception and general wellness care. Planned Parenthood is also the only “safety net” health center with contraception services in 103 counties in the United States, serving more than 40 percent of all women obtaining contraceptive care from a safety net family planning health center in the U.S., and more than half of the women located in 11 of 18 of those states.
In other words, should Price as secretary of HHS roll back the Obama administration’s new regulation regarding Title X funding and Planned Parenthood, a huge number of women in the U.S. could lose access to their current contraception provider. And such a move seems more than possible given that Price himself has voted six times against federal dollars going to Planned Parenthood as a Title X and Medicaid provider, a position all the more striking given that Title X already prohibits its funding from being used for abortion care and that a recent study by the Guttmacher Institute, a reproductive and sexual health policy and research organization, found that Planned Parenthood is the most effective of all Title X providers at offering comprehensive FDA-approved contraception methods and same-day care in providing contraception to patients, from oral birth control pills to long-acting reversible (LARC) methods like intra-uterine devices (IUDs) and implants.
And Taylor agrees that defunding Planned Parenthood, and thus reversing the Obama administration’s rule on Title X, would definitely be a priority for Price: “Price has voted in Congress again and again to withhold funding from Planned Parenthood and to restrict funding for Title X overall, so that’s a target for him, for sure.”
In May 2015, Price voted for a bill he cosponsored that would prohibit abortion past 20 weeks of gestational age and would impose criminal penalties on doctors who violate the ban, providing exceptions only if the woman’s life is in danger or if the pregnancy is the result of rape against an adult woman — in which case the woman would have to have received counseling or medical treatment for the rape at least 48 hours prior to the abortion. In 2013, Price cosponsored and supported the previous attempt at a national abortion ban, which also sought to ban abortions after 20 weeks gestational age and punish violators of the ban.
As Taylor explains, “The secretary of the Department of Health and Human Services is the authority for health policy in the United States — and we’re already looking at a situation where we have an administration … that has been clear about rolling back reproductive rights. And those are the same ‘values’ that Mr. Price holds himself. He can end up doing a lot of damage on these issues, as he’ll be the president’s closest adviser on health policy issues.”
Destiny Lopez, the co-director of All* Above All, a group organizing and advocating for the repeal of the Hyde Amendment and the implementation of public insurance coverage for abortion care, tells Yahoo Beauty, “[Price] wants to take away our ability to make our own decisions about abortion. The secretary of HHS is charged with oversight of our nation’s health programs — yet Price has spent his career ignoring or attacking health care for half the population.”
She adds, “For 40 years, politicians have used the Hyde Amendment to deny a woman’s health coverage for abortion just because she’s poor. Price would no doubt take us backward even farther. Trump may be our next president, but he doesn’t have a mandate to take away women’s basic rights. And women — however they are insured and wherever they live — will still need abortion care and coverage. So we’ll keep fighting for a future where our families can thrive, which includes women making our own decisions about pregnancy and parenting.”
Conversely, Melanie Israel, a research associate for the DeVos Center for Religion & Civil Society at the Heritage Foundation, a conservative policy and advocacy group, who specializes in issues pertaining to the definition of life, tells Yahoo Beauty that she’s seen nothing but “excitement from all the different life groups” in response to Price’s nomination.
Price, Israel says, “has been an advocate for life for so long. He has a rock-solid pro-life record. [His appointment] is a real victory for the life movement.”
Israel notes that because of the years Price has served in Congress, he’s particularly well-positioned in his new role at HHS to provide guidance to the Trump administration on issues pertaining to abortion.
“He’s seen years and years of debates and what those debates have looked like in multiple administrations. He’s bringing a perspective of having that longevity in Congress, knowing the lay of the land on how debates have gone and what the goals have been over the years. And that perspective will be a real asset,” Israel says.
She adds, “Congress has a really unique opportunity that we haven’t seen them have for a number of years. They’ve attempted to pass the Pain Capable Unborn Protection Act [the name of the federal 20-week abortion ban], to defund Planned Parenthood — but they haven’t been able to because we haven’t had a Republican president. Now there is a unique opportunity where Congress can go back to this legislation and also to things like the Hyde Amendment and instead of needing to rely on the appropriations bill, they can make these things permanent. They can do that confidently knowing they were reelected by their constituents and have a mandate to act on those things and now have a president who has indicated he’s onboard with the pro-life agenda.”
And these are all things, seemingly, that Congress will be all the more bolstered to do knowing that Price is heading up HHS and setting the national policy agenda when it comes to abortion and other women’s health issues.
In 2007, Price cosponsored the Right to Life Act, which defined “the right to life guaranteed by the Constitution in each human being” as “encompass[ing] all stages of life, including but not limited to the moment of fertilization or cloning.” This definition of personhood, however, could be catastrophic for both those individuals seeking to grow their families through in vitro fertilization (IVF) and for scientists who use stem cells from unused frozen embryos for their research. By defining life as beginning at the moment of fertilization of an egg cell by a sperm cell, not only do contraception methods such as IUDs, the morning after pill, and even oral birth control pills become potentially illegal, but so does the process of IVF, in which embryos are created for transfer to a woman’s uterus with the hope of fertilization.
Unused and untransferred embryos, however, are often frozen and stored — but personhood bills such as Price’s would define those embryos, frozen or otherwise, as citizens with rights, thus opening up a whole host of potential problems, and potential criminal wrongdoing, by the physicians, embryologists, and lab techs who work with embryos while facilitating family-building through IVF. An embryo accidentally damaged or destroyed in a lab could constitute murder. Frozen embryos stored in reproductive endocrinology practices could be seen as children needing to be turned over to the state. And should individuals and couples undergoing IVF elect to have any unused frozen embryos destroyed or donated for stem cell research, all parties could be, in theory, implicated in felony murder. And many IVF practices in states where personhood amendments have appeared on state ballots have said that the passage of such laws, at the state or federal level, would result in these practices having to shut their doors.
Given Price’s record on defining personhood and life, it remains to be determined whether those still hoping and struggling to have children might also be at risk of having their chances of utilizing IVF slashed through Price’s oversight of the nation’s health policy.