Once Again, the ACA Survived SCOTUS -- But the Fight Isn't Over Yet

Jun 25, 2015Andrea Flynn

Today the Supreme Court decided in favor of the government and the more than 6 million individuals who now have health coverage thanks to the Affordable Care Act’s subsidies. The 6–3 King v. Burwell decision—which determined that individuals in all states, not just those that established their own health exchanges, could be eligible for federal subsidies—is a win for President Obama, for the law more broadly, and for the health and economic security of millions of women and their families.

Today the Supreme Court decided in favor of the government and the more than 6 million individuals who now have health coverage thanks to the Affordable Care Act’s subsidies. The 6–3 King v. Burwell decision—which determined that individuals in all states, not just those that established their own health exchanges, could be eligible for federal subsidies—is a win for President Obama, for the law more broadly, and for the health and economic security of millions of women and their families. As I described in my recent policy note, the ACA has expanded women’s access to care, improved the quality of their coverage, and in the process increased women’s economic security. Today’s decision ensures that—for the time being—the law will continue to do all of those things and more.

The ACA expanded coverage to 16.5 million people and elevated the floor of coverage for women. Since 2010, 8.7 million women have gained maternity coverage; 48.5 million women with private insurance can access preventive services with no cost-sharing; and as many as 65 million women are no longer charged higher premiums based on pre-existing conditions. In 2013, the number of women who filled their birth control prescriptions without co-pays grew from 1.3 million to 5.1 million, and the share of women who had access to birth control with no out-of-pocket costs grew from 14 percent to 56 percent. This has been a significant improvement over the pre-ACA system in which women had to pay out of pocket for preventive services like pap smears and breast exams, were routinely charged more than men, and many couldn’t afford maternity coverage during pregnancy.

Over the past five years the ACA has begun to ease the financial burdens of health coverage and care for women, who are more likely than men to live in poverty. Today more than two-thirds of low-wage workers are women—half of them women of color—and many work long hours with no health benefits. Wage inequality causes Black and Latina women to lose approximately $19,000 and $23,279 a year, respectively. A loss of subsidies would have been especially harmful to women of color, who represent nearly half of all uninsured women eligible for tax credits in states using the federal exchange. Those subsidies are the only path to insurance for 1.1 million Black women, approximately 2 million Latinas, nearly a quarter-million Asian women, and more than 100,000 Native American women. Many of those women live in one of three states: Florida, Georgia, or Texas.

When women have good coverage and access to care, they are better able to make decisions about the timing and size of their families. They are able to prevent illnesses that cause them to miss work force them to lose a paycheck, and threaten their employment. They have healthier babies and children. Fewer out-of-pocket medical costs free up more money for food, childcare, education, housing, transportation, and savings. Health coverage won’t singlehandedly solve the serious challenges facing low-income women and families. Indeed, our country’s soaring inequality and persistent injustices demand sweeping social and economic reforms. But without the very basic ability to care for their bodies, visit a doctor, plan the timing and size of their families, and make independent reproductive health decisions, women will never be able to take full advantage of other economic opportunities.

Today’s decision is especially important for women considering conservative lawmakers’ relentless attempts to roll back access to reproductive health care. Consider that just yesterday House Republicans voted to completely eliminate Title X (the federal family planning program), to expand religious exemptions allowing employers and insurers to opt out of covering anything they find morally or religiously objectionable, to implement new abortion restrictions with no exception for the life or health of pregnant women, and to renew the Hyde Amendment, which prohibits Medicaid coverage of abortion.

So the ACA is safe for now, and the Supreme Court’s ruling will allow the law to become even more ingrained in our social and political fabric. However, we can be sure the vitriolic political opposition is not over. The GOP presidential hopefuls didn’t waste any time letting their constituents know today’s decision wouldn’t stop their attempts to undermine the law. And conservative lawmakers on the Hill will continue to push budget proposals that would unravel the law’s most important components and reduce funding for social programs critical to the wellbeing of low-income families. We should celebrate the King v. Burwell decision, but we must not stop making the case that for women and families, comprehensive, affordable health coverage—and by extension, care—is as much a matter of health as it is economic security.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter at @dreaflynn.

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NYC Taxi Owners Are Denying Benefits to Drivers. The City Council Can Stop Them.

Jun 25, 2015Richard Kirsch

Earlier this month, the New York City Council enacted basic protections for workers at car washes, one group of exploited, largely immigrant workers. Next up on the City Council’s to-do list should be reversing a court decision that robbed taxi drivers, another group of mostly immigrant workers, of health and disability benefits.

Earlier this month, the New York City Council enacted basic protections for workers at car washes, one group of exploited, largely immigrant workers. Next up on the City Council’s to-do list should be reversing a court decision that robbed taxi drivers, another group of mostly immigrant workers, of health and disability benefits.

New York City’s taxi drivers are one more group of workers who decades ago were legally considered employees but now are classified as independent contractors, with low and unpredictable wages, long work hours, and no benefits. Over the last two decades, taxi driving has become a career for many new immigrants.

Starting in 1996, drivers began organizing together, through the New York Taxi Workers Alliance, to win an increased share of cab fares and other protections. Two years ago, the Taxi Workers Alliance organized successfully to get the Taxi and Limousine Commission, which regulates the industry, to designate six cents from every cab ride to a fund to pay for disability and health benefits for drivers.

The Taxi Workers Alliance, through an RFP process, won a contract to set up a fund that would provide a modest disability payment of $350 for 26 weeks, plus other benefits, such as vision, dental, and hearing. Drivers would still be responsible for their own health insurance, with many relying on the Affordable Care Act.

Even though the fund does not cost the taxi owners a dime, they still sued to stop it, arguing that the commission overstepped its authority, and earlier this month a New York State appeals court agreed. As Bhairavi Desai, the Executive Director of the Taxi Worker Alliance, told me, the owners saw the health and disability fund “as a basis for the union…They were hell-bent on stopping the union and having the drivers have any benefits.”

An irony of the court’s ruling is that one reason that taxi drivers are considered to be independent contractors by the National Labor Relations Board (NLRB) is that they work in a highly regulated industry, in which many of their pay and working conditions are regulated by the Taxi and Limousine Commission. But when the commission acted to fund a much-needed benefit, the court, at the behest of the owners, blocked the way. The court said that it was up to a legislative body to decide on a new policy like using fares to finance a health and disability fund.

The other reason that the NLRB considers the drivers to be independent contractors is that they cruise for riders instead of being dispatched by the taxi companies. This in contrast with drivers of “black cars” in New York, who are dispatched by the limousine companies and therefore legally under their control. Some of the limousine drivers have joined the machinists union (IAMAW).

Looking into the future, competition from services like Uber may push New York’s cab companies to adopt an app for riders to call cabs. Earlier this month, the California Labor Commissioner’s office ruled that an Uber driver there was an employee, in part because of Uber’s reliance on apps.

For now, the court’s decision puts the issue squarely in front of the New York City Council. Since their election in 2013, both New York City Mayor Bill de Blasio and the new progressive majority on the council have made bolstering the ability of low-wage workers to care for and support their families a hallmark of their policies. One of their first actions was to strengthen a new law requiring that workers receive paid sick time. The new regulations establishing worker and environmental protections at car washes are the latest such action.

Laws that improve wages and benefits for New York’s working families are not only fair, they are a fundamental strategy to move New York’s economy forward. The more New Yorkers have the ability to care and support their families, the more New York will build a middle class that is the basis for strong communities and an economy not wholly dependent on Wall Street.

With some $2 million already collected and a contract with the Taxi Worker Alliance signed, passing an ordinance to approve using the six cents per fare for the health and disability fund should be an easy fix. But the taxi industry in New York is profitable and powerful and finances election campaigns. Still, that’s why New York City has public financing of campaigns and a pro-worker and pro-community mayor and City Council. Hopefully, they’ll quickly step up to the plate so that New York City’s taxi drivers can have their own organization provide essential benefits for their and their families’ health. 

Richard Kirsch is a Senior Fellow at the Roosevelt Institute, a Senior Adviser to USAction, and the author of Fighting for Our Health. He was National Campaign Manager of Health Care for America Now during the legislative battle to pass reform.

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King v. Burwell Could Turn Back the Clock for Women's Health

Jun 23, 2015Andrea Flynn

In the coming days the Supreme Court will decide King v. Burwell, a case on which the health coverage of more than 6 million individuals—and in some ways the future of the Affordable Care Act (ACA)—hinges. As we anticipate that ruling, and as conservative lawmakers propose potential solutions to the crisis that will ensue should they “win,” we should pause and remember that the ACA has profoundly improved the quality of women’s health coverage, expanded women’s access to care, and increased women’s economic security.

In the coming days the Supreme Court will decide King v. Burwell, a case on which the health coverage of more than 6 million individuals—and in some ways the future of the Affordable Care Act (ACA)—hinges. As we anticipate that ruling, and as conservative lawmakers propose potential solutions to the crisis that will ensue should they “win,” we should pause and remember that the ACA has profoundly improved the quality of women’s health coverage, expanded women’s access to care, and increased women’s economic security. As I describe in a policy note released today by the Roosevelt Institute, if policymakers are serious about the health and financial wellbeing of women and families, they should expand and strengthen the ACA, not reverse or repeal it.

The ACA expanded coverage to 16.5 million people and elevated the floor of coverage for women. In the pre-ACA system, women were routinely charged more than men, had to pay out of pocket for preventive services like pap smears and breast exams, and many couldn’t afford maternity coverage while they were pregnant. But since President Obama signed the ACA into law, 8.7 million women have gained maternity coverage; 48.5 million women with private insurance can access preventive services with no cost-sharing; and as many as 65 million women are no longer charged higher premiums based on pre-existing conditions. In 2013, the number of women who filled their birth control prescriptions without co-pays grew from 1.3 million to 5.1 million, and the share of women who had access to birth control with no out-of-pocket costs grew from 14 percent to 56 percent .

For millions of women, the ACA has begun to ease the financial burdens of health coverage and care. Before the ACA, women were far more likely than men to have to forgo care because of cost concerns, and for all women—but especially those without coverage—cost was a major barrier to care. Many women had difficulties paying their medical bills (52 percent of uninsured women and 44 percent of low-income women, compared to 28 percent of women overall). This should be no surprise, given that it’s more likely for women—particularly women of color—to live in poverty. Today more than two-thirds of low-wage workers are women—half of them women of color—and many work long hours with no health benefits. Wage inequality causes Black and Latina women to lose approximately $19,000 and $23,279 a year, respectively.

A loss of subsidies would be especially harmful to women of color. In states that are using the federal exchange, women of color represent nearly half of uninsured women eligible for tax credits. Those subsidies are the only path to insurance for 1.1 million Black women, approximately 2 million Latinas, nearly a quarter-million Asian women, and more than 100,000 Native American women. Many of those women live in one of three states: Florida, Georgia, or Texas.

Comprehensive, affordable coverage—and by extension, care—is as much a matter of health as it is economic security. When women have good coverage and access to care, they are able to prevent illnesses that take them out of work, threaten their employment, and force them to lose a paycheck. They are better able to make decisions about the timing and size of their families. They have healthier babies and children, fewer out-of-pocket medical costs, and more money for food, childcare, education, housing, transportation, and savings. Health coverage won’t singlehandedly solve the myriad challenges facing low-income women and families; indeed, the United States’ soaring inequality demands sweeping social and economic reforms. But without the very basic ability to care for their bodies, visit a doctor, plan the timing and size of their families, and make independent reproductive health decisions, women will never be able to take full advantage of other economic opportunities.

The political vitriol of the past five years has blurred our collective memory of just how badly we needed health reform before we got it. Opponents of the ACA argue that we cannot afford for the law to prevail. But the truth is we can’t afford for it not to. In most other countries families are not driven into poverty because they seek needed care, and they don’t avoid seeking care out of fear that doing so will drive them into bankruptcy. The United States is unfortunately exceptional in this regard. For too long the right to health has been unfulfilled in the United States, and the ACA has begun to change that for millions. Neither the Supreme Court nor conservative lawmakers should turn back the clock now.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter at @dreaflynn.

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Natalie Foster: Reimagine the Safety Net for the New Economy

May 21, 2015Laurie Ignacio

In the final installment of our "Good Economy of 2040" video series, we hear from Natalie Foster, co-founder of Peers.org and Rebuild the Dream.

In the final installment of our "Good Economy of 2040" video series, we hear from Natalie Foster, co-founder of Peers.org and Rebuild the Dream.

In order to ensure a good economy in 25 years, Foster would reimagine the safety net for the 21st century. “It’s important that we stop thinking about jobs and start talking about livelihoods as people will derive their income from a variety of different sources,” says Foster. She adds that we need a safety net that is designed not for the “old industrial economy where everyone had 9-to-5 jobs," but "for people who live much more fluid and free lives but who also have a greater level of economic instability."

To learn more about the future of the safety net, check out the links below

“Two Leaders in Labor Rethink The Safety Net For A Freelance Economy” (NationSwell)

“Safety Nets for Freelancers” (NY Times)

“George Takei and Michael Buckley on the Sharing Economy” (YouTube/AARP)

Natalie Foster has spent the last 15 years at the crossroads of social movements and technology. She’s transformed and run some of the largest digital teams in the country, including President Obama’s successful effort to pass health reform, and built two organizations from scratch. Most recently, Foster co-founded Peers.org, the world’s largest independent sharing economy community. Prior to Peers, she was the CEO and co-founder of Rebuild the Dream, a platform for people–driven economic change, with Van Jones. 

 

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Make the Stop Overdose Stat Act a Priority for 2015

Feb 26, 2015Emily Cerciello

It’s time for Congress to take an evidence-based and public health focused approach to the epidemic of opioid overdoses.

It’s time for Congress to take an evidence-based and public health focused approach to the epidemic of opioid overdoses.

Opioid overdose is an epidemic in the United States. Drug overdose death rates have more than tripled since 1990, with the vast majority of these deaths attributable to an increase in the prescription and sale of opioid medications. The death rate from heroin overdose doubled between 2010 and 2012, and young people are now more likely to die from drug overdose than from motor vehicle crashes.

These statistics may be surprising, but their causes are familiar – commonly abused prescription opioid medications include names such as Vicodin, OxyContin, Percocet, or codeine, as well as the illicit drug heroin, which creates similar pain-relieving effects. Prescription drugs are often considered a “gateway” to heroin use as heroin addiction often begins as a cheaper alternative to prescription painkillers.

In March 2014, Rep. Donna Edwards (D-MD) introduced the Stop Overdose Stat (SOS) Act to create a federal plan for preventing fatal drug overdoses and prioritizing community- and state-based efforts for the development of best practices. The SOS Act would provide federal support for overdose prevention programs, which can include training bystanders, law enforcement, and first responders in recognizing signs of overdose, seeking medical assistance, or administering naloxone. Naloxone is a life-saving medication that reverses the effects of heroin or opioid prescription overdose. As of December 2014, twenty-six states and the District of Columbia have removed legal barriers to provider prescription and layperson administration of naloxone. Additionally, 20 states and the District of Columbia have established Good Samaritan protection, which grants immunity from arrest for calling 911 to seek medical assistance in the event of overdose.

The SOS Act, cosponsored by 39 legislators, approaches opioid prevention and treatment through a public health and health equity lens. While no socioeconomic or demographic group is immune to the abuse of prescription drugs or heroin (the most dramatic increases have occurred among white, middle-aged women in rural areas), urban areas with large African American populations are still where the majority of overdoses are happening. The SOS Act would create a grant program administered by the Centers for Disease Control and Prevention that gives priority to community organizations working to prevent overdose in high-risk populations.

The SOS Act would also create a mechanism for detailed reporting of overdose data for the development of best practices for preventing overdose deaths. It would require the Secretary of Health and Human Services to develop a national plan to be submitted to Congress within 180 days of enactment that incudes a public health campaign, recommendations for expanding overdose prevention programming, and recommendations for legislative action.

The bill was closed out of the 113th Congress, but should be reconsidered in the current session as the issue builds momentum in both Democratic- and Republican-led states. The re-introduction of the SOS Act is an opportunity for Congress to take immediate action in responding to a significant public health issue with a bipartisan solution. States are implementing evidence-based laws to address the worsening overdose epidemic. It is time for the federal government to follow suit.

Emily Cerciello is the Roosevelt Institute | Campus Network Senior Fellow for Health Care, and a senior at the University of North Carolina at Chapel Hill.

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Daily Digest - February 24: How to Recreate a Strong Middle Class

Feb 24, 2015Rachel Goldfarb

Click here to subscribe to Roosevelt First, our weekday morning email featuring the Daily Digest.

Free the Middle Class (USA Today)

Senator Elizabeth Warren and Representative Elijah Cummings argue that bringing back a strong middle class requires government intervention.

Click here to subscribe to Roosevelt First, our weekday morning email featuring the Daily Digest.

Free the Middle Class (USA Today)

Senator Elizabeth Warren and Representative Elijah Cummings argue that bringing back a strong middle class requires government intervention.

Even Better Than a Tax Cut (NYT)

Continually cutting taxes won't be possible if the government is going to function, argues Lawrence Mishel, which makes policies that push wage growth far more important right now.

NJ Judge Overturns Christie's Pension Cuts (AJAM)

Yesterday's ruling says that Christie could not choose to shortchange pensions in his 2014 budget, and he is now expected to make up the pension deficit by the end of the fiscal year in June.

A Student-Debt Revolt Begins (New Yorker)

Vauhini Vara speaks to one of 15 students from a now-closed for-profit college who are going on a "debt strike" because they argue the school's false promises make their loans invalid.

Retail Workers Are Quitting Their Jobs Like It’s 2007 (Buzzfeed)

Sapna Maheshwari ties the retail quits rate to recent moves by large retail employers to raise their wages. If workers are quitting because they can get better jobs, employers have to catch up.

Why Reform Conservatives Should Join the Democratic Party (The Week)

Jeff Spross argues that so-called reformicons would have much better luck with their policy priorities if they worked with Democrats, who actually support programs that help the poor.

Obama's Newest Plan Might Drive Investment Advisers Out of Business. Good. (Vox)

Matt Yglesias argues that it's for the best if financial advisors for the middle class are driven out of business, because they are only pushing products that make them money.

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Daily Digest - February 18: Comcast Doesn't Want You to Know What You're Missing

Feb 18, 2015Rachel Goldfarb

Click here to subscribe to Roosevelt First, our weekday morning email featuring the Daily Digest.

The Big Lock-In (Medium)

Click here to subscribe to Roosevelt First, our weekday morning email featuring the Daily Digest.

The Big Lock-In (Medium)

Roosevelt Institute Fellow Susan Crawford explains how Comcast is trying to dominate online video to the point where consumers wouldn't even see that other alternatives exist.

Aid to Needy Often Excludes the Poorest in America (NYT)

Patricia Cohen says that in recent decades, assistance to the poorest – generally, those who are not working – has decreased, while government aid for those near the poverty line has increased.

Rep. Paul Ryan’s Double Standard: Only the Working Poor Must Comply With the Tax Code (WaPo)

Jared Bernstein calls out Rep. Ryan for allowing business tax breaks without compensating for the cost or strengthening enforcement, while any break for poor families must be offset elsewhere.

Illinois Governor Bruce Rauner: Organized Labor's Public Enemy No 1? (The Guardian)

The ferocity of Governor Rauner's attacks on labor, particularly public-sector unions, has surprised many, writes Steven Greenhouse, including labor leaders who need to negotiate new contracts.

Is Welfare Reform Causing Earlier Deaths? (The Nation)

Michelle Chen looks at a new study that shows how the shift from open-ended aid to our current welfare system, tied to employment, shortened lives and harmed children's cognitive growth.

American Companies Are Getting Older, Not Better (AJAM)

Aging businesses are creating fewer jobs than new companies, writes David Cay Johnston, and they also pay workers less and push for policies that slow economic growth as a whole.

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Daily Digest - February 13: Campus Network Award Has Local Benefits

Feb 12, 2015Rachel Goldfarb

Click here to subscribe to Roosevelt First, our weekday morning email featuring the Daily Digest.

Cornell Roosevelt Institute to Benefit From Grant (Cornell Daily Sun)

Click here to subscribe to Roosevelt First, our weekday morning email featuring the Daily Digest.

Cornell Roosevelt Institute to Benefit From Grant (Cornell Daily Sun)

Stephanie Yan reports on how the Roosevelt Institute | Campus Network's MacArthur Award will impact the Cornell chapter, which will benefit from new national training programs.

Philadelphia Joins the Growing Ranks of Cities Requiring Paid Sick Days (ThinkProgress)

Bryce Covert reports on Philadelphia's new paid sick leave law, which makes it the 17th U.S. city with such a law. Paid sick leave is expected to save businesses money due to reduced turnover.

These Motel Rooms Are the Last Resort for Families Without Homes (The Nation)

Leighton Akio Woodhouse profiles two families who are living in motels long-term because they cannot afford the upfront costs of an apartment, accompanied by photos by Elizabeth Lloyd Fladung.

At My Oil Refinery, My Life is Worth the Price of a Pie (The Guardian)

Butch Cleve, an oil refinery worker, explains why 5,000 oil and chemical workers have gone on strike for safer labor conditions. He shares stories of terrible – and preventable – accidents.

GOP Governors Want Higher Education Cuts to Recoup Budget Shortfalls (MSNBC)

Suzy Khimm points out four Republican governors whose states are still experiencing budget shortfalls, at least in part due to recent tax cuts, and are cutting education funding to close to the gap.

Jails Have Become Warehouses for the Poor, Ill and Addicted, a Report Says (NYT)

Timothy Williams reports on a new study from the Vera Institute of Justice, which shows how local jails imprison people for extended periods when they are unable to pay their relatively minor fines.

Obama Blasts Staples, and Reveals Larger Partisan Divide Over Workplace (WaPo)

Paul Waldman analyzes the president's statements about Staples limiting part-time workers' hours, noting that Democrats don't just aim to create jobs, but also try to improve workplaces.

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The Obama Budget: Weak on Reproductive Health

Feb 9, 2015Andrea Flynn

Family planning is both vital for econoimc stability and a solid investment with strong returns, so why wasn't it better funded in the President's budget?

Family planning is both vital for econoimc stability and a solid investment with strong returns, so why wasn't it better funded in the President's budget?

Last week President Obama unveiled a 10-year budget that reflects the ambitious and progressive agenda he laid out in his State of the Union address. With investments in infrastructure, education, and economic supports for the middle class, the President’s funding plan aims to lift up low-income families and address the growing and historic U.S. class divide. But Obama has fallen short on one area that is critical to women and families: reproductive health.

There were hopes that the president would request a significant increase for Title X – the nation’s only program dedicated to providing quality, affordable reproductive health services – and also the repeal of the Hyde Amendment, a 1976 law that prohibits women from using federal health benefits such as Medicaid to pay for abortion, except in cases of rape, incest, or life endangerment. But Obama did neither.

Given conservative control of Congress, President Obama’s budget has little chance of being passed as is. But as John Cassidy pointed out in the New Yorker this week, the budget is as much a political document as it is an economic one. “The White House is using it to frame the political debate for this year and for the run-up to the 2016 Presidential election – an effort that began with the State of the Union address,” Cassidy wrote. Obama had an opportunity to show that reproductive health is a critical component of any agenda meant to lift up low-income families, and one the federal government must invest in if their other efforts are to bear fruit. But he missed that opportunity.

The president’s $300 million request was a modest increase from last year’s budget of $286.5 million – Title X’s first increase since 2010 – but still leaves the program woefully underfunded. Title X has still not recovered from the drastic cuts it endured between 2010 and 2013, when lawmakers cut the budget from $317 to $278 million, and as a result prevented 667,000 patients from receiving care. Family planning experts estimate that in order to completely fulfill the nation’s unmet need for reproductive health care, Title X would require somewhere in the ballpark of $800 million, a far cry from today’s budget.

Title X is like the little engine that could of public programs. It prevents more than one million unintended pregnancies annually, and thereby avoids nearly 600,000 unplanned births and more than 400,000 abortions. Without Title X, the U.S. unintended pregnancy and abortion rate would be 35 percent higher among adult women and 42 percent higher among teens. Not to mention that in 2010 every dollar invested in Title X saved $5.68. How’s that for a return on investment?

Not only is the program underfunded, but in states across the country conservative lawmakers have implemented restrictions that have prevented Title X funds from actually going to family providers, effectively chipping away at what was once a robust health safety net and exacerbating a pre-existing shortage of reproductive health providers. It is largely low-income women, women of color, immigrant women, and young women who are left without anywhere to turn for preventative care.

And what happens when those women find themselves needing to terminate a pregnancy? Between the restrictions set forth under the Hyde Amendment and the rapidly shrinking network of abortion providers, they have few options. In 1976 – just three years after the Supreme Court’s Roe v. Wade decision legalized abortion – Congress passed the Hyde Amendment and made abortion the only medical procedure ever banned from Medicaid. Ironically, Medicaid covers all the costs related to family planning and pregnancy.

By this point, you might be thinking this is all irrelevant, thanks to the Affordable Care Act (ACA). If only. While the ACA has extended care to scores of women who were previously uninsured, conservative opposition has diluted its potential impact and many people will remain without health coverage. Indeed, nearly four million women will be left without coverage this year thanks to conservative opposition to expanding Medicaid. In addition, federal restrictions ban many immigrants from Medicaid, the contraceptive mandate has been compromised and contraception is now your boss’s business, and this term the Supreme Court may very well take federal subsidies away from millions who need them in order to afford health insurance.

We need an increased investment in reproductive health now more than ever. If we are serious about improving the circumstances of low- and middle-income U.S. families, we must extend critical care and services to all of those who need and want them, and also shape the political debate in a way that will give all women and families all of the tools – not just a select few – that they need to thrive.

When the president, who espoused his support for reproductive rights in his State of the Union address, doesn’t push for a significant expansion of reproductive health care while he is putting his political capital behind broader education, income, and work-family supports, it signals that reproductive health, perhaps, is not as critical as these other issues. It suggests that with other supports women can lead economically secure lives, even if they cannot control their fertility and determine the timing and size of their families. That is simply not the case.

An agenda without bold investments in reproductive health is not a comprehensive agenda for women and families. And if women cannot access quality and affordable health care, they will not be able to make the most of the other important initiatives the president has proposed.

Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter @dreaflynn.

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Daily Digest - January 29: Without Food Stamps, How Many Kids Would Go Hungry?

Jan 29, 2015Rachel Goldfarb

Click here to subscribe to Roosevelt First, our weekday morning email featuring the Daily Digest.

Census Says 16m U.S. Children are Living on Food Stamps, Double the Number in 2007 (The Guardian)

Click here to subscribe to Roosevelt First, our weekday morning email featuring the Daily Digest.

Census Says 16m U.S. Children are Living on Food Stamps, Double the Number in 2007 (The Guardian)

One in five American children would go hungry without food stamps, writes Jana Kasperkevic, which makes continued Republican efforts to cut the program especially worrying.

The Tax Loophole (Almost) Everyone Should Want to Close (Medium)

James Kwak breaks down the step-up in basis for capital gains loophole and why he thinks it ought to be eliminated: because it's strange that our system rewards dying with unsold assets.

  • Roosevelt Take: In his white paper on tax reform, Roosevelt Institute Chief Economist Joseph Stiglitz also argues against this loophole.

Fed Says It Will Be Patient in Raising Interest Rates, Citing ‘Solid’ Growth (NYT)

Binyamin Appelbaum reports on the Federal Reserve's latest statement and what it will mean for raising interest rates. At this point, rates won't be raised until at least June.

Don’t Mess With Government Giveaways to the Well-Off (WaPo)

Paul Waldman says the uproar over a suggested change to 529 college savings plans shows which welfare programs are safest: those that are open to all, but give most of their financial benefits to the upper-middle class.

Subprime Bonds Are Back With Different Name Seven Years After U.S. Crisis (Bloomberg Business)

Now called "nonprime" mortgage bonds, Jody Shenn says that this time the investment firms that originate the deals plan to retain the bulk of the risk instead of shifting it to other parties.

Obama Is Finally Getting Credit for the Recovery (TNR)

Danny Vinik says that the Republican arguments claiming the recovery happened in spite of the president's policies are falling apart, leaving no other option but to give him credit.

'Housing First' Policy for Addressing Homelessness Hamstrung By Funding Issues (TAP)

Rachel M. Cohen says that "housing first" policies are pretty clearly a more effective way to fight homelessness, but without sufficient funding and housing stock, can't be fully put into action.

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