As the country processes Republican nominee Donald Trump having won the presidential election, one of the main questions remaining is what a Trump administration will mean for women’s health.
Trump’s policy proposals thus far have not been incredibly detailed, but what we do know does not necessarily bode well for many American women.
As Jennifer Gunter, MD, an ob/gyn and writer, summarized on Twitter last night:
Trump will defund Planned Parenthood
— Jennifer Gunter (@DrJenGunter) November 9, 2016
If Trump wins, forget your health insurance if you have a pre existing condition
— Jennifer Gunter (@DrJenGunter) November 9, 2016
Trump has called for the repeal of the Affordable Care Act (ACA), the defining legislative measure of the Obama administration, which expanded health insurance coverage for millions of Americans. Since the implementation of the Affordable Care Act, the Centers for Disease Control (CDC), reports that the uninsured rate in the United States has dropped from 18 percent to 11 percent. According to the Kaiser Family Foundation, women are less likely than men to receive insurance coverage from their employers — which means, as a result, ACA was particularly effective in guaranteeing more women, and young women especially, access to affordable health care. Low income women, women of color, and immigrant women are also more likely to be uninsured, meaning that these demographics also all benefited from the implementation of the ACA. Likewise, single mothers, for whom budgets are often already tight, are more likely to be uninsured than mothers in two-parent households. Millions of American women who would have otherwise been denied access to health coverage because of circumstance or cost were able to get it under the ACA.
In addition to mandating insurance coverage for anyone not covered by an employer health plan, Medicare, Medicaid, or other public insurance program, the ACA also made it illegal for insurance companies to deny coverage due to preexisting conditions. It also saw the implementation of a series of “essential health benefits” required to be covered in all insurance plans, including maternity and newborn care and additional preventive care and screenings covered in full, with no co-pay or out-of-pocket expense, including cancer screenings, well-woman annual exams, Pap smears, and contraception.
Young people in particular have benefitted from the implementation of the ACA. As Jen Mishory, executive director of Young Invincibles, a group that organizes millennials on social issues like labor and health policy, explains to Yahoo Beauty: “In the past six years, 3.5 million young people gained coverage on [online insurance] marketplaces, most with discounts, and 5.5 million young people stayed on their parents’ plan. Millions have enrolled in Medicaid, young women can access free birth control and can’t get charged more for coverage than men, and the 15 percent of young people with chronic conditions can’t get denied coverage due to their illness. Young Invincibles remains dedicated to fighting for the ACA’s right and benefits. Those looking to repeal the law will need to answer to the millions of millennials and other Americans who would lose access to coverage.”
According to the National Women’s Law Center, 55 million American women gained access to no-cost contraception as a result of the ACA, resulting in a savings to women of $1.4 billion on birth control pills alone in 2013. Because of the ACA, more women used their insurance to get birth control — which meant that more women were able to achieve greater economic security through both the cost savings it afforded to them and the ability to be able to control their fertility, and thus pursue their education and career as desired.
In other words, the repeal of the Affordable Care Act would also mean the repeal of these benefits for women, and the financial and physical autonomy that things like no-cost contraception provide.
The other issue pertaining to women’s health under the upcoming Trump administration is abortion access. Trump has voiced his desire to see Roe v. Wade, the Supreme Court ruling that guarantees the constitutional right to safe and legal abortion care, overturned, and has released a list of anti-abortion judges who would be almost certain to overturn this ruling should abortion access face a legal challenge that found its way to the highest court.
And such a change in the legal status of abortion access in the United States would be a pretty stark contrast to what the majority of Americans say they want: 56 percent of Americans believe abortion should be legal in all or most cases.
“The majority of Americans support legal access to abortion,” Hogue says. “That was true yesterday and it is true today.”
Hogue also points to the way that the Trump campaign recognized that attacking abortion access proved unpopular with voters, noting the “backlash” the candidate faced on the two major times he took on the issue: first, when he commented that there should be “some form of punishment” for women in the U.S. who receive abortion care should abortion become banned, and again, when he inaccurately described the mechanics and circumstances of late-term abortion during the third and final presidential debate.
“The election of Donald Trump says nothing about Americans’ opinions about abortion access or reproductive health,” emphasizes Hogue. She adds, though, “If we’re going to be extraordinarily generous and believe that [President-elect Trump] will be committed to reflecting the will of the people he governs, that would leave reproductive rights and abortion access alone. But that’s not realistic. The people he owes in the Republican Party are anti-choice extremists. He said he would nominate a bunch of people committed to overturning Roe v. Wade — and he told us to take him at his word on that. We did, and we will continue to organize like he’s good for his word. And if he’s not, we know [Vice President-elect] Mike Pence is.”
Hogue also notes, “Today, tomorrow, and on January 20th, we will be reminding people what they were elected to office to do and not to do,” pointing to overturning Roe v. Wade through Supreme Court appointments, implementing a 20-week federal abortion ban, and defunding Planned Parenthood as the most pressing policy measures ahead for abortion-rights advocates. They are issues, she says, that voters have repeatedly expressed to their elected officials to not get involved in.
(Take, for example, the pressure put on, and exerted by, Republican women to block the 20-week abortion ban when it came up in Congress last year — or the defeat of New Hampshire Republican Sen. Kelly Ayotte, who has a staunch anti-abortion voting record but attempted to campaign as a women’s health advocate; both can be seen as evidence of voters’ desire to not see their reproductive rights dictated by politicians.)
In a statement, Willie Parker, MD, the board chair of Physicians for Reproductive Health, shared, “My colleagues across the country are deeply disheartened by the election of Donald J. Trump. A Trump presidency will mean that attacks on access to abortion and all other reproductive health services will continue at the federal level and in states all across this country. As physicians, we know firsthand the medical and social harms inflicted on our patients by politically motivated policies that prevent access to safe and comprehensive reproductive health care, including abortion. Regardless of how we feel personally about abortion, women should have access to a full range of care options. Every patient faces her own unique circumstances, challenges, and potential complications and must be able to make medical decisions in consultation with her health care provider and what is right for herself and her family — without interference from politicians. We urge President-elect Trump to oppose all policies that harm the health, well-being, and dignity of our patients and that interfere with the doctor-patient relationship. We will remain vigilant and hope to find a way to work with the administration to protect our patients.”
Likewise, Staci Fox, the CEO of Planned Parenthood Southeast, which operates Planned Parenthood-affiliated health centers in Georgia, Alabama, and Mississippi, tells Yahoo Beauty, “The results of last night’s election leave us facing a great deal of uncertainty. However, what is certain is that we will never back down and never stop fighting to make sure our patients have access to the care they need. I recognize that members of our staff, supporters, and patients who have been targeted during this campaign face true threats to their safety. In the coming days and weeks we will make extra efforts to assure they are safe and supported.”
Fox adds: “A Trump-Pence administration has promised to roll back women’s health care in unprecedented and far-reaching ways. The majority of Americans, including those who supported President-elect Trump, support access to health care at Planned Parenthood, and want abortion to stay legal and safe. For 100 years we have faced challenges and attacks from those who oppose our mission to provide excellent sexual and reproductive health care, no matter what. Through every attack, we have come out stronger. These doors stay open.”