Changing the Law to Undermine Reproductive Rights and Women’s Health

May 25, 2017
Guest Post

*This piece is part of the ACSblog Symposium: 2017 ACS National Convention. The symposium will consider topics featured at the three day convention, scheduled for June 8-10, 2017. Learn more about the Convention here

by Jamille Fields, Policy Analyst, Government Relations at Planned Parenthood Federation of America

We are not long past President Trump’s first 100 days and the start of this new Congress. Despite this short timeframe, there have been several legal and policy proposals that threaten reproductive rights and women’s health care access more broadly. Here are six ways in which reproductive rights have been threatened since the start of this year alone:

1.     Attempting to Block Access to Planned Parenthood

The American Health Care Act (AHCA) not only attempts to repeal the Affordable Care Act (ACA), which greatly advances women’s health care, but also includes a politically motivated provision that would block low-income women and men enrolled in the Medicaid program from using their coverage to receive services at Planned Parenthood. This provision is the only non-health insurance related provision in the bill and the intent is clear--restrict low-income individuals’ access to the provider of their choice and block people’s access to safe and legal abortion. If the bill becomes law, it will harm the 2.5 million people who annually visit Planned Parenthood health centers to access birth control, cancer screenings, STI counseling, HIV treatment and other preventive health care services. Unlike most other parts of the bill, this provision would take effect immediately.

2.     Rescinding a Regulation Protecting Patients Right to Select Provider

Congress also passed, and the president signed, a bill to rescind a federal rule affirming that it is a violation of federal law for state and local governments to withhold Title X family planning funds from health centers for reasons other than the centers’ ability to provide services. Title X is the only domestic federal program focused solely on family planning and the program provides family planning services to people who cannot afford to pay for care, adolescents seeking confidential care and a disproportionate number of people of color. The rule, put into place by the Obama administration, responded to a growing wave of state efforts to exclude, terminate or otherwise restrict certain family planning providers, like Planned Parenthood, from participating in Title X, thereby limiting low-income people’s access to critical health care from trusted community providers. Repeal of the final rule does not change existing law, but it signals to states that the administration will consider allowing them to arbitrarily discriminate against qualified health care providers and block people’s access to family planning care. 

3.     Championing the American Health Care Act -- the Worst Legislation for Women’s Health in a Generation

The ACA significantly improved women’s access to reproductive health care by providing financial assistance to purchase private insurance coverage; expanding eligibility for Medicaid, the largest payer of reproductive health services; providing 55 million women access to birth control with no out of pocket costs; prohibiting gender rating, which cost women annually $1.4 billion more than men in insurance costs; and for the first time – surprisingly -- creating a federal prohibition against discrimination in health care on the basis of gender, race, national origin and disability. The AHCA seeks to backpedal on those significant gains and specifically places women’s health in its crosshairs. In addition to eliminating health coverage for an estimated 24 million people (an estimate that is likely to increase), it would: effectively end private insurance coverage of abortion, jeopardize coverage for maternity and newborn care for up to 13 million women, permit insurers to once again discriminate against women and charge them more for coverage and radically transform the Medicaid program. The bill is expected to change in the Senate, but if the bill maintains any resemblance to its current form, women’s financial and health security will be damaged.

4.     Appointing Neil Gorsuch as Supreme Court Justice

Over 40 years ago, the Supreme Court held that women have a constitutional right to abortion, but as a candidate, Donald Trump vowed to appoint a Supreme Court Justice who would overturn Roe v. Wade. He is attempting to keep this promise with the nomination of now-Supreme Court Justice Neil Gorsuch. Justice Gorsuch has a dismal record on women’s health, including ruling in the 10th Circuit decision on Hobby Lobby v. Burwell where he expressed that a corporation should have the ability not to cover contraceptives in its health plan for employees if the employer has personal religious objections. Further troubling, Justice Gorsuch has declined to state his position on Roe v. Wade, but the long-standing decision is certainly in jeopardy with him on the Court.

5.     Issuing an Executive Order that Threatens Contraceptive Coverage

On May 4, President Trump issued an executive order that aims to undermine access to women’s preventive services, particularly birth control coverage. The ACA requires most insurers to cover birth control, well-woman visits, domestic violence screenings and other women’s preventive services with no out of pocket cost to the woman. The executive order instructs the U.S. Departments of Health and Human Services, Treasury and Labor to consider issuing policy that will allow employers, schools and other entities to refuse to cover women's preventive health services in their insurance plans on the basis of religious or moral objection. Under current guidance, certain religious entities are completely exempt from coverage, while others receive a special accommodation. This order sets the stage for the named agencies to expand the existing religious exemption to scale back women’s health care access under the guise of religion and further allow companies, schools and employers to discriminate against others, like LGBTQ individuals, under the pretext of religious liberty.

6.      Expanding the Global Gag Rule

The Global Gag Rule, previously known as the Mexico City Policy and now Protecting Life in Global Health Assistance, prohibits international organizations who provide, counsel, refer, or advocate for abortion services from receiving U.S. global health assistance - even, if the organizations provide the abortion-related services with their own money. On Jan. 23, only a few days after President Trump assumed office, the president reinstated the Global Gag rule, and on May 15, the administration issued guidelines to implement the rule. Under previous administrations that implemented the policy, the funding restriction applied only to international family planning and reproductive health programs (a scope of $600 million), but this iteration applies the policy to international organizations, generally. This expanded Global Gag Rule applies the policy to $8.8 billion in global health funding in more than 60 countries and impacts programs for HIV/AIDS, maternal and child health, Zika Virus response, and other public health efforts.  

These efforts to scale back reproductive rights and undermine women’s access to health care threaten women - domestically and abroad. These changes to the law impact low-income women, women of color and women with chronic illnesses the most. These attacks on women’s reproductive health care are not likely to stop anytime soon, and legal advocates will need to be watchful to defend against efforts to undermine women’s rights. For more information and to join the fight, please click here.