“The fact is, [health care is] an entitlement to this country if we’re going to have a great country.” – Donald Trump, interview with Larry King, 1999.
Yet the president-elect’s campaign promises included pledges to strip citizen’s entitlement to health care, especially with regard to reproductive rights. His proposal for six weeks of paid maternity leave is a step in the right direction. But he has vowed to fully repeal the Affordable Care Act (ACA), defund Planned Parenthood, ban abortion (with exceptions for rape, incest and threat to the life of the mother) and nominate pro-life justices to the Supreme Court in an effort to repeal Roe v. Wade. For secretary of the U.S. Department of Health and Human Services, Trump has nominated U.S. Rep. Tom Price (R-Ga.), who has already been condemned by reproductive rights groups for his efforts to repeal the ACA and defund Planned Parenthood.
Many of the liberties I cherish as an American now hang in the balance. Without the ACA, what will happen to my health insurance in the future? What will happen to my self-employed friends? Will we be able to afford well-woman exams next year? And most importantly, will affordable birth control still be an option? Some of my friends are even considering getting intrauterine devices (IUDs) to ensure that they will have birth control throughout Trump’s presidency.
Under the ACA, private insurance companies are required to cover numerous services related to reproductive health without charging co-pays. These services include well-woman exams, prenatal care and contraception. Specifically, the ACA covers the following types of contraception: barrier (diaphragms, sponges), hormonal (“the pill”), IUDs, emergency (Plan B® and ella®), sterilization, education and counseling. The ACA also prevents insurance companies from denying coverage to people with preexisting conditions, such as pregnancy. In short, the services and rights assured under the ACA are a huge asset for women and their health.
Providing these services at no cost also significantly reduces abortion rates and teenage birth. During President Barack Obama’s first term, national unintended pregnancy rates dropped significantly from 54 percent in 2008 to 45 percent in 2011. If the GOP’s goal is to reduce abortion rates, it would make sense to continue providing no or low-cost contraception. Restricting the accessibility of both contraception (through failure to provide coverage) and abortion (through federal or state legislation) would increase the percent of unplanned pregnancies, which often add undue burden to women and families who do not have the financial means to support an additional child.
The reality is that the impending political climate poses different threats to those who are covered by private insurance (especially those receiving subsidies) and those who depend on government-funded health care services such as Medicaid and Planned Parenthood. Planned Parenthood could be defunded rather quickly if the Republican-controlled House passes another bill like the “Defund Planned Parenthood Act of 2015,” which was blocked by Obama’s veto. If such a bill succeeds under Trump’s administration, it would strip many communities of their only resource for numerous types of preventative care, including cancer screenings and contraception. Despite promises to repeal the ACA, a full repeal is unlikely. Nevertheless, parts of the ACA that affect the federal budget could be overturned through a process called budget reconciliation, along with Planned Parenthood as was proposed in 2015.
With the uncertainties facing the future of reproductive health care coverage, women may be wise to consider taking advantage of free access to Planned Parenthood for well-woman exams and contraception consultations before the new administration settles into place. It’s better to be safe than sorry.
Christina Shields is a research assistant for the Baker Institute Center for Health and Biosciences. Her research focuses on biomedical regulatory and policy projects, including stem cells and regenerative medicine.