Several failed efforts to repeal the Affordable Care Act have led to the worst replacement yet—especially for women.
In a last-ditch effort, Senators Lindsey Graham and Bill Cassidy has put forward legislation to repeal and restructure the ACA—and the Senate will vote on it next week. President Donald Trump has said he would sign the bill into the law should it pass.
But Graham-Cassidy goes further than the ACA repeal efforts before it—encompassing more aggressive attacks on and the dismantling of Medicaid, stripping women of reproductive healthcare access, cutting off critical care for the poor and elderly and legalizing discrimination against those with so-called pre-existing conditions.
NEW: What would Graham-Cassidy ACA repeal mean for women?
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— Andy Slavitt (@ASlavitt) September 20, 2017
Across the board, Graham-Cassidy hurts women. Here are just seven examples.
#1: It cuts federal funding for Planned Parenthood—which impacts what kind of care lower-income women can access.
Graham-Cassidy would completely eliminate access to Planned Parenthood for women on Medicaid for at least one year. Robbing Planned Parenthood of federal funding to care for Medicaid patients also robs low-income women of critical and life-saving —including STD testing, cancer screenings and vaccinations.
#2: It robs women of access to vital forms of healthcare by watering down the ACA’s “essential benefits” package.
Under Graham-Cassidy, states will be given more liberty to determine whether coverage of and which of the Affordable Care Act’s “essential benefits” are required by providers. This puts basic care—cancer prevention, maternity care and OB/GYN visits—at risk, and it also uniquely puts women’s lives at risk. It is estimated that 13.5 million women could lose maternity care alone. Essential care is just that—and regressing to the healthcare landscape before the ACA where women struggled to cover pregnancy costs and access gender-specific wellness care shouldn’t be on the table.
#3: It restricts abortion coverage.
Graham-Cassidy would make it so that anyone using tax credits to purchase a health insurance plan in the current marketplace would not be able to select a plan with abortion coverage. But the impact doesn’t just hit individual women—small businesses that receive the same tax credits won’t be able to provide plans that include abortion coverage to their employees, either. We know that cutting access to abortion doesn’t slow or end the rate of abortions—it just kills women. These kinds of political maneuvers will do the same.
#4: It would allow lawmakers to determine the quality of a woman’s care by her zip code.
The funding infrastructure as it stands under the ACA would shift entirely under Graham-Cassidy—and be slashed tirelessly. The Atlantic reported that, if passed, the bill would reduce overall federal health funding to all states by $215 billion by 2026 and $4 trillion by 2036—and in the process, money would be funneled away from states that expanded Medicaid and trend Democratic and toward more rural, red areas. Once the money hits states, those states also have more freedom to decide where it goes and to what it is devoted—meaning women in states with more hostile policiews and laws regarding their bodies will have an even harder time accessing proper, comprehensive medical care. When states are given the freedom to allocate funds in this manner, it’s a safe assumption that those funds begin to be diverted away from gender-specific programs that keep women, the sick, the poor and the elderly well.
#5: It will be harder for everyone to afford care—at a time when those struggling to afford care are often women of color heading up their own households.
Under Graham-Cassidy, healthcare costs will skyrocket and subsidies would be slashed. This would put women, especially, in dire straits—especially those in the 15 million households, a majority of which they helm, who rely on subsidies to close costs. Those households also tend to be Black and Latinx.
#6: In too many cases, it would make being a woman into a pre-existing condition.
Under the ACA, insurers were prohibited from discriminating against patients with so-called pre-existing conditions. Under Graham-Cassidy, those patients are once more left in the dark. Pre-existing conditions are often also disproportionately female conditions—those who would lack protections and, in some cases, access to coverage would include domestic violence survivors, sexual assault survivors, women who underwent C-Sections and women who struggled with or are struggling with postpartum depression. Now, their medical history—and their traumas—could determine their access to care.
#7: It would leave elderly women on the streets.
By restructuring Medicaid funding through block grants, Graham-Cassidy leaves the elderly and disabled at a unique risk. States receiving block-grant funding won’t be permitted to use it to cover elderly or disabled patients. Women make up a majority of the nursing home population. By eliminating their access to Medicaid funds, they’re going to be left on the street.
GOP Senators were relying on passing an Affordable Care Act repeal by September 30—the expiration date on a “reconciliation” process, which comes with restrictions but allows the body to pass laws by simple majority. Starting October 1, any healthcare legislation in the chamber would need 60, not 50, votes to pass—requiring input from Democratic members, who are currently in the minority. That could entirely reshape the conversations on Trumpcare, especially since up until now each repeal effort has been championed and written exclusively by men.
“This summer, we successfully fought off Trumpcare 1.0, Trumpcare 2.0, and Trumpcare 3.0 because we made our voices heard,” Eleanor Smeal, President of the Feminist Majority, said in an email yesterday to activists. “Thanks to you, Republican leadership was unable to sneak through devastating legislation that would decimate Medicaid, skyrocket premiums and kick 32 million people off of their health insurance. Now we have to stand up again to stop this bill before it is too late.” FM has been mobilizing against each attempt at Trumpcare through their Feminists Fight Back campaign.