Goodbye Obamacare, Hello... Obamacare?

The Affordable Care Act did wonders for women’s reproductive health during Obama’s administration. In 2010, when Obama signed the Affordable Care Act into law, he did really set forth a revolution that would be largely accepted in the United States as women became more in control of their health, their bodies, and, importantly, their reproductive rights.

The Affordable Care Act (Obamacare), according to the Center for Reproductive Rights, expanded coverage to female preventative health, which includes contraception, cancer screening, STI testing, primary care visits, and prenatal and post-partum care, which could be both physical and emotional. It even allowed for both annual well-woman checks and birth control to be covered without copay, which is extremely important in women’s health.

Trump had decided from the get-go of becoming president that under his governance, the ACA would no longer stand, partly due to his conservative viewpoint toward abortion.

NY Mag has stated that approximately 22 million people could lose their healthcare under Trump’s administration and the rollback of Obamacare – and the people most likely to be affected by this change are residents of lower-income areas, which could create a harsh cycle in an area that already suffers from poverty and low health. The Urban Institute’s Center on Society and Health published a report that established a correlative relationship between lower income and a higher reporting of poor health and likelihood of disease.

Trump also wants to defund Planned Parenthood, which he has acknowledged spends the VAST majority of its money on non-abortion related services – and cutting PP funding can have devastating results. Planned Parenthood is a large provider of STI testing and treatment, but the United States continues to have devastatingly high occurrence rates. Cutting this funding would not only be highly detrimental to these rates, but also would not decrease abortions by any means. Historically, banning abortions has just increased the number of unsafe abortions.

Image courtesy of FactCheck.org

 

Another concern is the controversial comments that Trump and Pence have made about Roe vs. Wade and their desire to overturn this critical Supreme Court ruling. Following the death of Supreme Court Justice Antonin Scalia, the 2016 election became all the more contentious as people became aware that the winner of the election would also be the nominator of the swing vote on the Supreme Court – essentially, whoever emerged victorious would also have control over the tone of the Supreme Court for the next however many years until a seat became available.

Additionally, Trump has expressed support for the Susan B. Anthony List (Don’t be fooled – Susan B. Anthony did wonders for women’s suffrage, but unfortunately this organization is completely anti-abortion). The funny thing that NY Mag reported on is that the SBA is completely misinformed in the platform they support, stating that they oppose the use of emergency contraception and IUDs which they believe can cause early abortion. This is completely false.

Don’t panic yet, though, if you’re worried about Trump rolling back women’s reproductive rights, because he hasn’t indicated any legislation coming up about this kind of thing in the near future. His current focus is his healthcare plan which failed. Hard.

If you’ve been following the news recently, it was publicized that the Republicans in Congress pulled out their decision about how to overhaul American healthcare because it did not have enough votes, which was a major loss for Trump and a slash to his confidence in leadership.

In an interview with Mary Agnes Carey, a senior correspondent for Kaiser Health News, Carey expressed that although Obamacare has its flaws – including a significant hike in the price of premiums, it has not “exploded” like President Trump has alleged. Carey stated that the major issue is due to people opting out of coverage, especially young people, and then when they get sick, the price is much higher. Essentially, it costs less to be preventative than it costs to not pay up front and then have to pay for treatment – and people that disregard this mentality are a major component in the rising prices.

Essentially, this loss for Trump still leaves a lot of loose ends out – especially regarding the future of women’s reproductive health. Ideally, women’s reproductive rights would remain protected and certain things would be covered by insurance, but we don’t live in an ideal world.

Global Gag

When the United States elected Donald Trump as our 45th president, many people were wooed by his "Make America Great Again" slogan. These four simple words became extremely polarizing for their America-centric meaning and xenophobic undertones. One of his more recent actions was reinstating the global gag rule, which is essentially a ban on the United States providing federal funding to other nations' providing abortions and other female health services.

Donald Trump's stance on abortion has fluctuated greatly in the past. According to Business Insider, Trump stated he was pro-choice in 1999, but came out as pro-life in 2011. As he narrowed his scope in his mission to become president, he stated he was pro-life with exceptions for cases of rape, incest, or risk to the mother's life. One of his most notable statements was that women who got abortions should be punished - which he quickly took back.

The Global Gag Rule, or Mexico City Policy, is defined as a policy that restricts United States' funding non-governmental organizations that provide family planning and female health services if one of those services is abortion. According to GenderHealth.org, the policy was first introduced in 1984 by President Reagan, and the plan explicitly states that these NGOs that do provide family planning funding “cannot inform the public or educate their government on the need to make safe abortion available, provide legal abortion services, or provide advice on where to get an abortion [but] policy allows for exceptions in the cases of rape, incest, and life endangerment”

Historically, Republican presidents have reinstated this gag rule ever since it was first proposed since many Democratic presidents have rolled it back, saying that it was unfair. It had been bounced back and forth and is now being reinstated by President Trump in accordance with his beliefs toward “Making America Great Again” and his conservative view towards abortion.

The repercussions of this act, especially in today's climate, could be significant. According to the Huffington Post, the paradigm of opinions toward premarital sex are shifting from condemnation to acceptance. The article analyzed Pew Research data and came to the conclusion that there was a positive correlation between higher GDP and acceptance towards premarital sex, as well as a positive correlation between number of women in the workforce and acceptance towards premarital sex. As many third world countries develop greater equality in the workforce for men and women, we can assume that this trend would follow – greater premarital sex occurring, and with the gag rule in place, this creates an atmosphere of uncertainty because of issues that are bound to occur in cases of sex – diseases or pregnancies, either wanted or unwanted.

In Nepal, one country that benefited from the United States’involvement, there is evidence to show that cutting funding to reproductive health services led to an increase in the number of unwanted pregnancies and the number of abortions also did not decrease – but one can imagine the number of undocumented abortions and therefore unsafe abortions also increased. The United States also provided funding to family planning organizations in Africa and other Asian nations. By cutting these funds from numerous organizations, the gag rule does not just “stop abortions” it also stops education programs about many horrible phenomena still occurring in developing countries.

According to an article by Nawal M Nour, MD, MPH, an additional issue that arises from cutting this funding is that there are health issues that do not exist currently in the United States – like certain diseases or lack of certain vital nutrients exist in specific parts of the world. Other issues, like maternal mortality, female genital mutilation, child marriage, and HIV/AIDS are still prevalent in developing countries. The education programs that the now defunded NGOs used to have were providing information to women about their rights under the law and how to escape antiquated practices like female genital mutilation and child marriage. Additionally, these cut services provided testing for different diseases, like HPV and Papanicolau, and will no longer be provided in these countries, which could lead to more outbreaks of diseases.

The implementation of this global gag rule will have devastating effects in numerous ways, on global feminism and also on the health of numerous men and women in developing countries. It also marks the beginning of an era of a more restrictive administration toward women’s reproductive health. Although it could be an element of Trump’s goals to reallocate funds towards programs in the United States, the US’s role as a world power has had the responsibility of overseeing programs in other nations with lesser economies or less developed health systems. However, even though the United States has the power to cut off these programs, they should have a plan in place to slowly pull their programs out and allow the communities to develop programs of their own.