What Women Can Expect from a Biden Presidency: On Health Care

Editor’s note: President-elect Biden’s platform for women promises to be the most ambitious presidential agenda yet addressing issues that affect women and girls in the U.S. and around the globe. This piece is the first of a multi-part series covering the agenda, in areas including: health care, economic security, work and family, violence and security and the Equal Rights Amendment, among others.

New installations of the series will be released on Wednesdays. Get caught up here.


What Women Can Expect from a Biden Presidency: on Health Care
A fundraiser with President-Elect Biden and Vice President-Elect Harris in Wilmington, Del., on August 12, 2020. (Adam Schultz / Biden for President)

President-Elect Joe Biden has pledged to pursue an “aggressive and comprehensive plan to further women’s economic and physical security and ensure that women can fully exercise their civil rights.”

After four years of the Trump administration aggressively dismantling the federal government’s civil rights infrastructure and rolling back women’s rights, Biden has his work cut out for him.

Biden has provided details for how he will accomplish this pledge in an ambitious platform for women’s rights focused in five areas: health care, economic security, work and family, violence against women and global women’s rights.

The health care prong of Biden’s agenda for women includes protecting and strengthening access to reproductive health care, expanding access to high-quality, affordable health care, addressing maternal mortality and tackling health inequities. The platform focuses in particular on developing health care protections for LGBTQ+ women, women with disabilities, incarcerated women, women veterans and Native women.

While how much of his agenda he is able to accomplish depends on whether Democrats win the Senate, Biden can certainly accomplish many things without Senate approval by executive order or through executive branch agency action.

Global Gag Rule

Biden can immediately issue an executive order rescinding the global gag rule, which prohibits foreign nongovernmental organizations receiving U.S. global health assistance from providing information, referrals, or services for legal abortions, or advocating for abortion law reform—even with their own non-U.S. funds.

Ronald Reagan imposed the first global gag rule in 1984 to apply to family planning funds; Democratic presidents have always rescinded the global gag rule, only to have subsequent Republican presidents reinstate the restrictions. Trump, however, vastly expanded the rule to apply to all U.S. global health assistance. Trump’s global gag rule has been tremendously damaging to women around the world. Biden can rescind that policy with a stroke of pen.

Domestic Gag Rule

In his platform for women’s rights, Biden is also pledging to reverse Trump’s domestic gag rule, which blocks U.S.-based reproductive health clinics from receiving federal Title X funding if they make referrals to patients for abortion health care.

As a result of this policy, Planned Parenthood lost $60 million dollars from its annual budget and the Title X network’s capacity was slashed in half, according to the Guttmacher Institute. The Trump administration also began to grant federal Title X funds to anti-abortion organizations such as the coercive Obria Medical Clinics. Biden can unilaterally reverse the domestic gag rule by executive order, thereby restoring federal funds to reproductive health clinics and blocking anti-abortion organizations from receiving these funds in the future.

What Women Can Expect from a Biden Presidency: on Health Care
President-elect Joe Biden speaking with supporters at a rally in Clear Lake, Iowa, in August 2019. (Gage Skidmore / Flickr)

Contraceptive Coverage Mandate

Biden also pledges to reverse Trump’s erosion of the Affordable Care Act’s contraceptive coverage mandate. The Trump administration issued rules in 2017 allowing any employer to gain an exemption to federally required coverage of birth control in employee health insurance plans by claiming that contraception violates their religious beliefs or their “non-religious moral convictions,” vastly expanding earlier exceptions for religious organizations. 

Biden will restore the Obama-Biden policy providing an exemption for religious entities and an accommodation for nonprofit organizations with religious missions. But while some employers will still have exemptions, the accommodation will allow women at these organizations to access affordable contraceptive coverage, through their insurance company or a third-party administrator.

Abortion Rights

Biden’s legislative priorities include codifying Roe v. Wade, repealing the Hyde Amendment (which blocks Medicaid from covering abortion) and fighting for a public health insurance option like Medicare, which would include coverage of contraception and abortion. He has also said that his Justice Department will do everything in its power to stop the state laws that blatantly violate Roe v. Wade, such as TRAP laws, parental notification requirements, mandatory waiting periods and ultrasound requirements.

In addition, feminists will be advocating for policies beyond those in the Biden platform to fully revive sexual and reproductive health and rights in the Biden-Harris era by doing more, such as removing the FDA restriction on the abortion pill and defunding abstinence-based sex education. 


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Maternal Mortality

The U.S. has one of the highest rates of deaths related to pregnancy and childbirth relative to other developed countries, especially among Black women, who are 2.5 times more likely to die from pregnancy complications than non-Hispanic white women. Native women are 2.3 times more likely to die from pregnancy-related complications than are white women.

California came up with a strategy that halved the state’s maternal death rate: Medical centers collect data on health outcomes for mothers and infants, including how many mothers-to-be have died, and then use that data to implement changes in their emergency care practices dealing with hemorrhaging and infections. Biden has pledged to reduce maternal mortality across the U.S. by implementing the California strategy nationwide.

Health Care Access

Biden’s women’s rights platform pledges to fight for the Affordable Care Act, which Republicans are once again trying to eliminate in a case currently before the Supreme Court.

What Women Can Expect from a Biden Presidency: on Health Care
Joe Biden during a discussion on protecting the Affordable Care Act in Lancaster, Pa., on June 25. (Adam Schultz / Biden for President)

In particular, Biden has pledged to protect the ACA’s ban on sex discrimination in insurance benefits and gender-based pricing for insurance—a practice which, before the ACA, cost women $1 billion more for the same or less insurance coverage than men each year; the Act’s mandated coverage for pregnancy and maternity care; and the requirement that insurance companies cover people with preexisting conditions (before the ACA, pregnancy was a pre-existing condition that could block access to health insurance, as were menstrual irregularities, obesity, depression, anxiety and even a history of being a victim of domestic violence). Biden’s public option will protect and build on Obamacare—to expand access, lower costs and make quality, affordable health care a right for all.

Ensuring Health Care Protections for All

Biden’s platform addresses the needs of particular groups of women.

For LGBTQ+ women: Biden has pledged to reverse the Trump administration’s dangerous and unethical regulation allowing doctors, hospitals and insurance companies to discriminate against patients based on their sexual orientation or gender identity. He will require federal health plans to provide coverage for HIV/AIDS treatment, HIV prevention medication (PrEP), gender confirmation surgery and hormone therapy. And he pledges to ban so-called “conversion therapy.”

For women with disabilities: Biden will provide greater access to home and community-based services and long-term services and support in the most integrated setting appropriate to each person’s needs. In addition, Biden is pledging to direct his Department of Health and Human Services (HHS) Office for Civil Rights to issue guidance for states and health insurance programs clarifying how the American with Disabilities Act applies to benefits and reimbursement decisions. And he will ensure that entities funded by HHS do not deny medical care based on disability or age.  

For incarcerated women: Biden will condition receipt of federal criminal justice grants on adequate provision of primary care and gynecological care for women, including care for pregnant women.

For women veterans: Biden will ensure that each VA Medical Facility has at least one full-time women’s primary care physician; and, within 200 days of taking office, make available a women veterans training module for community health care providers. Biden will also work with Congress to eliminate co-pays for preventive health care for women veterans and to enact the Deborah Sampson Act and ensure that the safety and privacy concerns of women veterans are addressed throughout his Administration.

For Native American women: Biden has called for dramatically increasing funding for Indian Health Services and making that funding mandatory in order to increase access for Native American women to comprehensive health care, including preventive screenings, such as mammograms, trauma-informed care and mental health treatment.

Finally, Biden will re-enter the United States into the World Health Organization and exit the anti-abortion “Geneva Consensus Declaration,” a global pact the Trump administration co-sponsored and signed that denies the international human right to abortion. Biden could also rejoin the United Nations Human Rights Committee consensus that promotes safe, legal and affordable access to sexual and reproductive health care, including abortion.

Biden’s ambitious platform for women’s rights will go a long way toward protecting reproductive rights, providing affordable, high-quality health care and addressing the health care inequities women experience. While some of these policies require Congressional action, many Biden can implement within the executive branch without Congressional approval.

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About

Carrie N. Baker, J.D., Ph.D., is a Professor in the Program for the Study of Women and Gender at Smith College. Her 2007 book The Women's Movement Against Sexual Harassment won the National Women’s Studies Association Sara A. Whaley Book Prize. Her second book, Fighting the U.S. Youth Sex Trade: Gender, Race, and Politics, tells the story of activism against youth involvement in the sex trade in the United States between 1970 and 2015. Baker is the President of the Abortion Rights Fund of Western Massachusetts.