What NOW | Centering Women in the Healthcare Debate

Centering Women in the Healthcare Debate | Jordie Davies

When I set out to write this piece, the Republican health care proposal loomed large in all of our political imaginations: skinny repeal, full repeal, and Medicaid cuts seemed imminent. These proposals were accompanied by demonstration after demonstration of political callousness from members of Congress and the Trump Administration.

As I listened to the debates and the public outcry over the procedural gymnastics that Senate Republicans had undertaken to pass their bill in the dark of night, it became clear to me that this bill was not about building upon the tangible progress and fixing the remaining problems in the Affordable Care Act. The Republican healthcare plan failed because, ultimately, it was not about people. It was a song and dance, political posturing and signaling to President Trump that his shallow campaign promise to repeal Obamacare would come to fruition.

When sensationalism passes for political action and politicians are more concerned with the latest headline or their own re-election than the real life consequences for their constituencies, Americans lose.

What if our politics were about people? Specifically, what if legislative agendas prioritized the poor, the marginalized, and women? I suspect that we would have better outcomes for a wider swath of Americans and a return to the hard data about the lack of access to healthcare many in this country face.

Concerning healthcare, particularly, women should be front and center. Motherhood places a premium on women’s healthcare expenses over their lifetimes. For those who become mothers or are tasked as caregivers (for either children or older family members), both their own and their dependent’s medical costs are major financial responsibilities — which must be borne even as women deal with a gender wage gap and, at times, a loss of income, since motherhood often includes time away from work.

In addition to more often being primary family caregivers, women are taking on economic burdens as they join the labor force. Single women head 25% of households with children and the number of female breadwinners in the US is steadily rising. According to the Center for American Progress, 42% of mothers were the only or primary breadwinners in their households in 2015 — with Black and Latina mothers more likely to be sole breadwinners. Still, families maintained by women are less likely than male headed or married couple families to have an employed family member at all, according to the Bureau of Labor Statistics.

Most studies agree that women pay more out of pocket healthcare costs than men: women accounted for around 56% of all personal healthcare spending in 2012, with working age women spending 66% more than males of the same age group. These differences are due to spending on maternity care.

Besides the costs of motherhood, the National Women’s Law Center reports that women are 35% more likely to be in poverty than men (at 13.4% compared to 9.9%), with higher rates among women of color. Women comprise the majority of Medicaid recipients, as the program covers 25 million women adults in the US. Clearly, then, women — especially low income women — must lead conversations concerning changes to Medicaid.

Budget cuts to Planned Parenthood would be devastating for many low income women, as the organization provides reproductive health as well as family planning services to nearly 3 million women and men in the United States, many for whom Planned Parenthood is the only affordable or available option. 75% of the organization’s’ patients are low income Americans.

These are all facts and figures that any new healthcare legislation should deal with directly. Because of the fraught economic state that many women and mothers find themselves in, we as a nation should without question prioritize and center women in healthcare legislation. Women should not only be at the table, they should lead conversations about any changes in American healthcare. Even as government institutions exclude healthcare advocacy organizations, many are taking matters into their own hands: the nationwide advocacy against this bill brought out women from all sectors, from reproductive rights advocates to disability activists. These groups — these women — were key at raising a public outcry against this dangerous proposal.

The day when politics and people intersect will be one where women are valued in national legislation that will impact their lives. The national discourse concerning healthcare legislation should be dead on arrival if it does not elevate women, women of color, trans women and their needs.

It seems as if all of this should go without saying, and perhaps the suggestion that women should be a “part of the conversation” does not ring as a very radical proposal. Yet, the most recent Republican effort at health care reform, the Better Health and Reconciliation Act, ommitted women’s healthcare needs in a spectacular fashion, as duly noted by several media outlets. Black women especially were at risk of losing positive gains in their healthcare access due to the bill’s cuts to preventative care and Medicaid.

This is the world that we live in. We cannot solve these problems if we pretend that women do not exist and do not have specific healthcare needs.

Republicans should put their nose to the grindstone and shore up the progress of the Affordable Care Act as it concerns American women. In light of the most recent Trumpcare failure, not only should the legislation itself change, eschewing Medicaid cuts and improving access to ACA exchanges, but the very conversation around American healthcare is one that must be by and for women, lest their needs be left behind once again in future legislation. As majority consumers of healthcare in the US, as mothers, as human beings, women deserve to be centered in all healthcare discussions.

Jordie Davies is a Political Science PhD Student at the University of Chicago. She enjoys researching and writing about political participation, media framing and social movement activity.

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