The election is over, but the work of expanding and improving women's access to quality health care is just beginning.
Last month, the United Nations declared access to family planning to be a universal human right that all member countries should respect, protect, and fulfill—a decidedly non-controversial concept for most of the developed world, and indeed not a novel concept for the UN or its members. That is, of course, with the exception of the United States, where human rights are mostly regarded as instruments for other countries to adopt and implement while considered quite unnecessary for our own advancement and wellbeing. So far are we from adopting a human rights framework at home that it’s hard to imagine what would happen if U.S. policymakers approached access to health care – and women’s health in particular – as a right akin to free speech, bearing arms, or practicing our religion. However, given our domestic women’s health crises, we could certainly benefit from adopting some outside perspectives on the right to health care.
Women’s health issues were front and center in the 2012 presidential campaign, garnering far more mainstream attention than in previous elections. From serious discussion in the primary and general election debates to thoroughly considered policy positions to uncensored public remarks, hot-button women’s health issues—rape, abortion, contraception—created a gender gap in the electorate to which many attribute President Obama’s victory. As we look toward the commencement of Obama’s second term, it's clear that the president has numerous monumental challenges before him. But we must not let the protection of women’s health and rights be compromised by other priorities such as the fiscal cliff, the federal budget, or foreign policy crises.
Obama’s victory was a win for women in the short term because it averted the immediate decimation of women’s health funding and infrastructure promised by Romney and his Republican counterparts across the country. But the country needs a long-term win: one that will improve the lives of American women and girls for generations to come. Such a win will require the president’s unwavering determination to improve women’s access to health services and their health outcomes throughout the course of his second term. And it is the job of women and the people who love them to provide a constant reminder that he must deliver on his promises.
Our government should ensure that all women have access to affordable, quality health care not only because it is morally the right thing to do, but because it is the smart and necessary thing to do to strengthen the entire country. Critical indicators such as maternal mortality, teen pregnancy, and unintended pregnancy illustrate the high cost of treating women’s health care as a privilege instead of a right. The United States trails 49 other nations in a ranking of maternal deaths worldwide and has a teen pregnancy rate higher than almost all other industrialized countries. Moreover, nearly half of all pregnancies in the United States are unintended. The data below illustrate how the health circumstances of women of color and low-income women have truly reached crisis proportions and demand immediate action.
(Sources: 1. National Campaign to Prevent Teen and Unplanned Pregnancy, 2. Centers for Disease Control and Prevention, 3. Guttmacher Institute, 4. Ibid, 5. Amnesty International, 6. Ibid, 7. New York City Maternal Mortality Review Project Team)
These inequities in women’s health in the United States are shameful, are a violation of human rights, and are, of course, directly related to the quality and availability of family planning and reproductive health care. Obamacare is certainly a historic step in the right direction. It has already extended contraceptive coverage (including highly effective methods such as the IUD, hormonal implants, and injections) to more than 1 million young women, and by 2016 it will cover nearly 13 million more. It also mandates the inclusion of other critical services: one annual “well woman” visit to a primary care physician, access to emergency contraception (also known as the morning-after pill), HPV testing, screenings for STDs, screenings for gestational diabetes, and coverage for maternal health care, including breast-feeding support.
Despite the immediate improvements to women’s health and the long-term cost savings associated with expanded coverage, Obamacare faces a steep uphill battle. Twenty-seven states have filed suit against the president’s plan, challenging its constitutionality. Additionally, over the last year a number of states have attempted to defund Planned Parenthood and other facilities that provide information about, referrals for, or counseling on abortion (even though none of these providers actually perform abortions), threatening to dismantle an irreplaceable infrastructure that has provided millions of women across the country with critical health services.
So far none of these states have succeeded in their lawsuits, but new challenges pop up every day. In Texas alone, more than 50 women’s health providers have closed over the past year as a result of Governor Rick Perry’s decision to slash the state family planning budget by two-thirds and his promise to eliminate Planned Parenthood and other clinics from the state’s Women’s Health Program. Numerous court battles are underway, but regardless of their outcome, the governor has successfully chipped away at a system of care upon which thousands of women – particularly young women, poor women, immigrant women, and women of color – have relied for decades. This system cannot be easily rebuilt. As anti-choice and anti-family planning lawmakers across the country continue to face resistance from the courts, they will likely look to Texas for strategies of how to successfully defund our nation’s most effective, far-reaching women’s health care providers. Even if Obamacare succeeds in continuing the expansion of Medicaid and private insurance coverage, its impact will be diluted if women have fewer places to receive comprehensive, quality care.
The United States cannot afford these inequities. The National Campaign to Prevent Teen and Unplanned Pregnancy reports that nearly three in ten girls become pregnant in their teenage years and that teen childbearing now costs U.S. taxpayers more than $10 billion annually. Thirty-eight percent of African American girls and 36 percent of Latino girls who dropped out of high school in 2006 reported doing so because of pregnancy or parenthood. And only 40 percent of teens with children complete high school, with less than 2 percent finishing college by the time they are 30. Teen pregnancies levy an additional toll on young women and the U.S. public by contributing to these higher drop-out rates and reducing the potential lifetime income for teen moms.
Unintended pregnancy among women of all ages is a major drain on U.S. coffers. According to the Guttmacher Institute, public insurance programs paid for more than 60 percent of all births resulting from unintended pregnancies, with total public expenditures for these births totaling more than $11 billion in 2006. A number of studies have shown that by expanding contraceptive coverage to underserved communities, Obamacare would drastically reduce these expenditures.
Providing all women better care before and during their pregnancies is clearly the smart thing to do financially. It is also, plain and simple, the right thing to do. The UN says that access to family planning is a right that should be enjoyed by all women because it “permits the enjoyment of other rights, including the rights to health, education, and the achievement of a life with dignity.” Women fully understand that having the ability to control their bodies, preserve their reproductive and sexual health, and make fully informed decisions about when they will have children impacts their ability to thrive socially and economically.
The election may be behind us, but the battle for women’s health is far from over. States will continue to push back against the mandates of Obamacare and conservative legislators will continue to peel away at women’s health rights and their ability to access the care they need. Women in the United States must remain diligent as Obama begins his second term, reminding him, along with local, state, and national leaders that they demand and expect better health care and better health outcomes in the four years to come. They should do so because having affordable and accessible health care and the ability to make fully informed decisions about their bodies is a universal human right. And that is an idea that anyone invested in America’s long-term stability, strength, and security should embrace.
Andrea Flynn is a Fellow at the Roosevelt Institute.