Women's Health

Roe v Wade

In Roe v. Wade, the U.S. Supreme Court struck down state criminal abortion laws that did not take into consideration the stage of pregnancy at termination and included only an exception when needed to save the life of the mother. The Supreme Court found that those types of laws violate the Due Process Clause of the Fourteenth Amendment which protects a woman's right to privacy, including a woman's right to terminate her pregnancy. The Supreme Court held that during the first trimester, a state could not limit a woman's right to abortion. The Supreme Court held that during the second trimester and prior to viability, a state may regulate the abortion procedure in ways that relate to maternal health. The Supreme Court held that after viability, a State may regulate or prohibit abortion except when necessary to preserve the life or health of the mother.

Threats to Access to Abortion Services

Unfortunately, many challenges remain. Many states have banned abortions after viability. Anti-choice proponents have also tried to create other barriers to women's access to abortion services. There have been efforts by the Republican-led House of Representatives to defund Planned Parenthood and to decrease federal funding for other family planning clinics. Last year alone, 19 states adopted 43 new restrictions on abortion . That total represents the second highest number of abortion restrictions passed in a single year, second only to 2011 when 92 restrictions were enacted. 17 states mandate that women must be given some kind of counseling before receiving an abortion, 38 states require some type of parental involvement in a minor's decision to have an abortion, and 87% of counties in the U.S. don't even have an abortion provider.

The nearly 37-year old Hyde Amendment, which is added each year as a rider to appropriations legislation, bans federal health insurance programs from providing abortion coverage, except in the case of rape, incest, or if the life of the mother is endangered. Those restrictions apply to federal workers, the military, and women on Medicaid. This is a particularly troublesome restriction considering Medicaid recipients include some of the poorest women in our country. As the Center for American Progress points out, "abortion is becoming a poor woman's problem."

Until this year, coverage for our brave service women was even more limited. Until that time, our brave service women's coverage only covered abortion in instances when the life of the mother was at risk. That left service women who were victims of rape or incest without insurance coverage for abortion despite other federally-sponsored health programs including such coverage. As the 112th Congress was coming to an end, Congressional Democrats successfully pushed for the inclusion of the Shaheen Amendment in the 2013 Defense Authorization Act which lifted the ban on military insurance for service women and their dependents who are the victims of rape or incest. The Shaheen Amendment is a crucial victory considering more than 3,000 sexual assaults were reported in the military in 2010 and more than a quarter involved rape.

States have also taken steps to limit access to abortion coverage in the health plans sold on the health insurance Exchanges created by Obamacare. States have the authority to decide whether health plans sold on the Exchanges can offer coverage for abortion services. Sadly, many states have taken advantage of that provision, and so far, 20 states do not allow a woman to purchase an exchanged-based health care plan that covers abortion services.

Access to Preventive Care & Family Planning Services

Through the passage of Obamacare, we took a monumental step forward for women's health. Despite opposition, we passed the most sweeping reforms to our health care system since the passage of Medicare and Medicaid. Obamacare has already begun to play a vital role in protecting and promoting women's health, a trend that will continue as we move towards fully implementing the coverage expansions included in this law.

Obamacare requires health plans to cover women preventive services without cost-sharing. Under the provision, the Administration acknowledged that women's access to contraceptive services was critical to promoting women's health and wellness. As a result, starting August 1, 2012, private plans have had to cover contraceptive services without cost-sharing. Requiring health plans to offer contraceptives without cost sharing is particularly important because prior to Obamacare, more than half of all women between the ages of 18 and 34 struggled to afford them. Obamacare's preventive services requirements require plans to cover certain screening including mammograms and colonoscopies without cost-sharing.

Beginning in 2014, the law will require health plans to cover a minimum set of benefits, known as essential health benefits, which include maternity and newborn care. Prior to the passage of Obamacare, the National Women's Law Center found that only 12% of private plans included maternity services.

The health care reform law also prohibits discrimination based on a pre-existing condition – which includes pregnancy and being a woman. This prevents insurers from charging increased premiums or denying coverage due to a pre-existing condition. The National Women's Law Center estimates that insurers' practice of gender rating, in which insurers charged increased premiums based on the beneficiaries being female, cost women approximately $1 billion a year.

As we reach this 40-year milestone, it is important that we move forward, not backward. Prior to 1973 it is estimated that more than 5,000 woman may have died per year as a result of illegal, unsafe abortions. Such a statistic should never be repeated. We must remain committed to reproductive rights and continue to work to make sure that quality health care, including access to abortion services is accessible and affordable for all U.S. women.

Obamacare Ends Discrimination Against Women

As consumers, caregivers, family health care decision makers, business owners and providers, women have a very personal stake in fixing our broken health care system.  Women are less likely than men to be employed full-time, making them less likely to be eligible for employer-based health benefits. Difficulty finding and maintaining employer-based coverage is especially pronounced for older women, who are more likely to develop conditions like breast cancer. It is unacceptable that more women are uninsured and when insured, pay more for health care –  as much as 48% more for the same benefits --  than their male counterparts

Women face increasingly high deductibles, copayments, and other cost-sharing requirements, forcing them to make difficult decisions to make ends meet. Before the Affordable Care Act became law, insurance companies selling individual policies could deny coverage to women due to pre-existing conditions, such as cancer and even having been pregnant. Thanks to ObamaCare, it will be illegal for insurance companies to discriminate against anyone with a pre-existing condition. Insurers will be prohibited from charging women more because of their gender, health status or previous health history.  Maternity care – not now covered in 87% of insurance policies in the individual market – will be guaranteed.  In addition, women joining a new health care plan can receive recommended preventive services, like mammograms, new baby care and well-child visits, with no out-of-pocket costs.

Resources

National Women’s Law Center

NARAL Pro-Choice America

National Family Planning and Reproductive Health Association

Planned Parenthood

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