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Between a Rock and a Hard Place: Women’s Health in Health Care Reform

March 24, 2010

This is not just a public health scandal; it reflects widespread violations of women’s human rights. Patterns of marginalization and exclusion in this society are exacerbated by a discriminatory and dysfunctional health system.

– Alicia Ely Yamin at Amnesty International’s blog

Here is a conundrum: the US has one of the worst rates of maternal mortality in the developed world, and it has now officially become more dangerous to give birth in California than it is in Bosnia or Kuwait. Unlike pitiful maternal death rates in other parts of the world, which might be due to child marriage, female genital cutting, or a lack of trained personnel, the maternal death rate in the US is largely due to really crappy health care access.  If you don’t have health care, you’re probably not going to go to all your prenatal check-ups, get expensive genetic tests, do a hospital walk through and be able to pay for fancy doctors if something goes wrong.

This week, history was made, as the House passed Obama’s health care bill.  This will extend coverage to millions of Americans and is the first step forward for a country that is the richest and most powerful in the world, to be able to show its citizens that their well-being is critical to that.  We had a huge health care win, though, at the expense of reproductive freedom and rights.  So, while expanding coverage is an important action in reducing our egregious maternal mortality rate; its success came at the cost of women’s rights more broadly.

Abortion was always the hiccup in the health care debate; it is the never-ending saga and bug bear in this G.D. country.  Why it must be so political will always be beyond me, but never mind that now. Feministing posted a critique of the pro-choice community, for “rolling over” for the greater good, and not killing the bill despite its new clampdowns on abortion access.  Advocates accepted subtle but pernicious language by neurotic politicians like Stupak or Nelson, who are going to go to the nines to make sure it’s as difficult as it possibly can be – barring an overturn of Roe v. Wade – to get and afford an abortion.

Katha Pollit at The Nation has an interesting take on this, suggesting that, thanks to the mercy and goodness of the pro-choice community, we have a health care bill.  To thank us, she lays out a number of funding proposals and actions the government can fast-track.  How about overturning the Hyde Amendment?  In the reproductive rights community, we used to dream of the day when the Hyde Amendment might be overturned.  This was a cold, slimy reality check on that.

A major piece of the puzzle missing here was the lack of connection between access to health care – especially for women – and human rights.  Unlike much of the rest of the world, US politicians barely invoke the human rights language or framework despite myriad of opportunities.  I think to most people in the US “human rights” barely mean a thing, or at least they’re very unfamiliar with the numerous international human right agreements the US has signed…and should be held accountable for.

Perhaps if the pro-choice community had painted a clearer picture of how access to health care, especially for women and including abortion, is a human right, well, perhaps we might be looking at a slightly more enlightened health care bill.  For the right to access abortion can and has successfully been argued as a human right in courts the world over. 

So, I while I do say a genuine “hooray” for health care reform, let’s take a close look at the fight we just came through.  We need to look very closely at the issues that remained stumbling blocks, and what that really meant.  From this angle, restrictions on abortion access – in any way, shape, or form – look an awful like the most convenient way to restrict and oppress women’s human rights.  Put that on the back burner.

  1. Whit permalink
    March 24, 2010 11:56 am

    Thanks for the stats and the excellent post.

    As someone uninsured, I cannot say “hooray” for this bill, even in theory. The bill hurts women in ways aside from abortion/reproductive rights.

    The bill, from my understanding, will allow for age-rating, the practice of imposing higher premiums on older people. This practice affects women disproportionately.

    The bill also will allow for the continuation of gender-rating, the practice of charging women higher premiums simply because they are women.

    Add that to two additional ways, aside from reproductive rights, that women lost (the battle, the fight is NOT over!).

    Another issue is that the bill–as it stood when it was passed–imposes harsh restrictions on the ability of immigrants to access health care, such as a 5-year waiting period on permanent, legal residents before they are eligible for assistance such as Medicaid.

    But perhaps what it most disgusting to me about the bill, aside from the fact that women were sold out, is that it is almost identical to the plan written by AHIP, the insurance company trade association, in2009.

    I just don’t see this bill as reform or change. It seems to me to be a victory for the insurance companies, and that’s about it.

    The Dream of Overturning the Hyde Amendment, never fear, is something many of my activist friends and I share. I will not settle until it is overturned.

    • March 24, 2010 12:26 pm

      I think I’m with you there, Whit. I am so disappointed in politics right now and how this health care reform bill played out. I agree that it hurts women more than just reproductive health. I hate to be superstitious, but it seems as though the quality of health care will probably turn for the worst because of this bill. I wish that Dems and Pres. Obama hadn’t pushed so hard.

      It will be interesting to see how this bill affects us four years down the road, and from there…there’s no turning back.

      Thanks for writing this post, Jessica.

  2. March 24, 2010 2:28 pm

    Points well taken, Whit and Emily — reproductive rights is not the only arena where women (and other people) lost out in this bill! Sigh. Feels like we have to be grateful for getting ANYTHING passed, despite how crappy it might be. Very paternalistic!


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