Invisible Women: What’s Missing from Trump’s 2021 Budget Proposal

Ghosting: That’s what the Trump 2021 budget proposal does when it comes to funding programs that meet women’s needs for healthcare, family planning and paid leave. The budget proposal rends the tattered threads of the nation’s social safety net to make the 2017 millionaire tax cut permanent, while leaving women hanging.

The 2021 budget proposal may have ghosted women, but feminists won’t disappear, and we will not be silent. We’re outlining the problems with Trump’s proposal below—and breaking down why they matter.

(Peter Cedric Rock Smith / Creative Commons)

Medicaid… Ghosted.

Trump has repeatedly promised to protect Medicaid, but his 2021 budget proposal slashes Medicaid and the Affordable Care Act (ACA) by $1 trillion over the next ten years.

Medicaid matters to women. Nearly 40 million women, get their health coverage through Medicaid and count on the program for a range of care from childbirth and family planning to chronic disease and disability care.

Medicaid matters to women of color who, due to racial and gender income inequality, are more likely to count on the program for health coverage.

The Affordable Care Act… Ghosted.

A core element of the ACA is the requirement that insurance plans cover people with preexisting conditions. More than half of all women—almost 68 million—have a preexisting condition. There are about six million pregnancies each year, a condition that insurers cited as a preexisting condition to deny coverage before the ACA.

The ACA matters to women and especially women of color who experience chronic conditions such as asthma, diabetes, and cervical cancer at higher rates than men.

Let’s be clear. The 2021 budget proposal has no provision to protect people with preexisting conditions despite all tweets to the contrary. In fact, the Trump administration is urging the courts to strip ACA protections from people with preexisting conditions.

The proposal has no health care plan at all- it just includes an allowance for the president’s ‘health reform’ vision, which so far has focused on stripping away access and nondiscrimination protections, putting in danger the health and well-being of millions of Americans, especially women.

Family Planning and Reproductive Care… Ghosted.

The 2021 budget proposal prohibits any funding for family planning from going to Planned Parenthood affiliates and ends an evidence-based teen pregnancy prevention program. The Hyde Amendment, which bars Medicaid abortion coverage, remains in the budget plan, along with the Weldon and Church Amendments, which allows health care providers to discriminate by refusing health services.

Pregnancy and Maternal Care…Ghosted.

The proposal offers no additional funding to improve maternal health outcomes in Medicaid despite the maternal mortality crisis. Health care providers and consumer advocates have called for expanding postpartum Medicaid coverage to one year. Instead, the budget proposal calls for extending coverage only for beneficiaries with a history of substance misuse disorders. The proposal also cuts billions of dollars in funding for breastfeeding programs, which can improve rates of both breastfeeding initiation and duration.   

The 2021 budget recommendation also ends pregnancy assistance grants that support pregnant and parenting teens and women and combats violence against pregnant women.

Paid Leave… Ghosted. 

Instead of proposing a real paid family and medical leave plan, the president’s paid leave plan for new parents fails to meet the needs of working people by excluding the nearly 75 percent of workers who need paid leave for their own serious health issues, to care for ill or injured family members, or to deal with a military family member’s deployment; by straining already fragile unemployment insurance programs; and by exacerbating state-based disparities.

The president’s budget also does not propose any solutions to ensure people can take paid sick days to recover from shorter-term illnesses like the flu or care for a sick child, without sacrificing a paycheck.

With the recent news about the coronavirus, it’s shocking the president’s budget does not propose any solutions like paid sick days that would go far to promote public health. Paid sick days help families stay home without financial risk. Otherwise, they are forced to go to work and risk their health and the public’s health. A national paid sick days standard would give workers the time they need to recover and ensure healthier communities and workplaces.


National Partnership for Women & Families is a nonprofit, nonpartisan advocacy group dedicated to promoting fairness in the workplace, reproductive health and rights, access to quality, affordable health care and policies that help all people meet the dual demands of work and family. More information is available at