From incentives for states to expand Medicaid coverage, to increases to Title X funding, the American Rescue Plan has several provisions that advance reproductive health care.
Last month, Congress passed President Biden’s American Rescue Plan Act, a $1.9 trillion COVID-19 relief bill. On top of direct stimulus checks, the plan also includes funding for schools and child care, increased child tax credits and rental assistance. But another—frequently overlooked—priority of this bill is expanding access to sexual and reproductive health care across the country.
Throughout the COVID-19 pandemic, women have been forced to take on ever increasing burdens at work, school and home. The economic crisis created by the pandemic has not affected everyone equally. Women—especially women of color and low-income women—have disproportionately lost their jobs, been denied promotions and have been exposed to COVID-19 at work.
In fact, women account for 55 percent of total job losses since the start of the pandemic. According to the U.S. Bureau of Labor Statistics, unemployment rates are even higher for Black and Latina women: As of March 2021, more than one in twelve Black women (8.7 percent) and one in fourteen Latina women (7.3 percent) ages 20 and up are unemployed, compared to one in twenty (5.0 percent) white women.
This month, the American Rescue Plan began this through a big expansion of the Child Tax Credit & the most significant investment in childcare since WWII, which will go directly to daycare centers and other providers. We want them to be there on the other side of this pandemic.— Secretary Janet Yellen (@SecYellen) March 31, 2021
These surging unemployment rates translate to millions of Americans who have lost access to their employer-provided health insurance—forcing them to turn to federal programs like Medicaid, or avoid needed medical care completely.
Jacqueline Ayers, the vice president of government relations and public policy at Planned Parenthood, spoke to Ms. about the American Rescue Plan’s impact on sexual and reproductive health. She explained:
“The pandemic’s harm has really exacerbated existing inequities in the health care system. Workers are being impacted, particularly Black, Asian, Latino workers, who make up the largest share of low-wage earners. And so, that’s meant that people are having to face going without care, and that includes sexual and reproductive health care.
“We’ve already seen, in the spring of 2020, 33 percent of women were facing delays in getting their contraception. We know that cervical cancer rates have increased, STI rates have increased. It just goes to really underscore that time-sensitive, essential sexual and reproductive health care matters right now, during the pandemic, and the need for this doesn’t stop; it just becomes much more critical.”
Expanding Access to Health Insurance
Luckily, the Biden administration seems to understand the increased importance of expanding access to sexual and reproductive health. The American Rescue Plan Act doesn’t just provide stimulus checks, allowing people to afford their health insurance—it also has several provisions directly related to advancing reproductive health care.
According to Ayers,
“It does incentivize states to expand Medicaid coverage by allowing increased federal funds. And that’s important for reproductive health care because Medicaid is the largest payer of reproductive health care in the country. And Black, Latino, LGBTQ, low-income folks are disproportionately enrolled in the program and rely on this program.
“One in five women of reproductive age relies on Medicaid for their health care. The bill expanding Medicaid coverage is going to directly mean that more low income people can get their care accessed.”
The plan also reduces monthly health care premiums under the Affordable Care Act, which will help Americans access needed health insurance. This provision plays well with the Biden administration’s recent extension of ACA open enrollment until August 15.
Increased Funding for Title X
Many reproductive rights organizations are also celebrating the American Rescue Plan because of its commitment to ensuring everyone can get access to reproductive care. As Ayers explained,
“The provision that we’re extremely proud that a pro-reproductive health care majority in both chambers supported, is $50 million in funding for the Title X Family Planning Program. That’s the nation’s only program dedicated to affordable reproductive health care like birth control. For patients who do not have insurance, it is a safety net program. And so it’s a really important access opportunity for people to get life-changing health screenings, access to birth control, STI testing and treatment.”
😷 You’ve been doing your part for the past year — and now we are going to receive the relief we’ve been fighting for: the American Rescue Plan, which prioritizes women and supports sexual and reproductive health care! https://t.co/lZXv9SsLrP pic.twitter.com/LmEGHijp6W— Planned Parenthood Action (@PPact) March 12, 2021
Addressing Racial Disparities in Maternal Health
Finally, the American Rescue Plan Act takes a significant first step towards addressing the maternal health crisis in our country—and the racial disparities that make Black and Native American women three times more likely to die from pregnancy-related causes than white women. Starting April 2022, and lasting for five years, states will have the opportunity to expand postpartum Medicaid coverage for women and their children from just 60 days to 12 months. This option could vastly expand Medicaid coverage for low-income women and reduce maternal mortality.
Next Up: Passing Momnibus Bill and Ending Hyde Amendment
The new legislation is a promising start, Ayers said, but fully addressing racial and gendered biases in medicine will require further work and commitment from Congress and the White House. There are several upcoming opportunities for President Biden and Congress to build on the work they’ve already done in expanding access to reproductive health care, and begin to undo the years of harm the Trump administration inflicted on women’s health. For example, the Black Maternal Health Momnibus Act “has a really comprehensive approach of more things that can be done in order to raise the alarm about the racial disparities in pregnancy outcomes for Black women,” according to Ayers.
Ayers is focused on other opportunities for the Biden administration to demonstrate its commitment to supporting comprehensive sexual and reproductive health care. She told Ms.,
“The American Rescue Plan is an important step forward, but we know it’s going to take much more to get people access to health care. We think that there will be important opportunities in the president’s budget that’s coming up soon. That would be an opportunity to show real investment in sexual and reproductive health care programs and also start to reverse the harm of some policies that have existed for too long, like the Hyde Amendment. A budget that repeals Hyde would be a really important signal that we have to continue to do work to support Congress taking that same action.”
“That would also be an opportunity to think about other legislation that Congress can do and the White House can support, like the EACH Act, which is legislation that ensures that anyone who gets insurance through the federal government, like Medicaid, they can get all of their health care covered, including abortion. And so, we think that there is much more to do, whether it’s in budgets, in future bills or with administrative action, it’s really important that they keep working to expand health care.”
While there is always more work to do to ensure equal access to health care, the American Rescue Plan Act is a signal the Biden administration is taking these issues seriously. Especially during the COVID-19 pandemic, which is disproportionately restricting already limited access to health care for low-income women and women of color, it is essential to push for policies that recognize the importance of reproductive health care access.
“We are really thrilled that there have been pro-reproductive health care majorities in Congress, and champions in the White House, that recognize the importance of investing in sexual and reproductive health care. We know that these issues are inextricably linked to health and safety during the pandemic, and the American Rescue Plan Act is recognizing that sexual and reproductive health care is essential.”
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