Under leadership of women of color, young people, in coalition with reproductive justice, health, rights and LGBTQ groups who make up the All* Above All coalition, secured a historic introduction in March of the EACH Woman Act or Equal Access to Abortion Coverage in Health Insurance Act (S. 758, H.R. 1692).
U.S. Sen. Tammy Duckworth (D-Ill.) introduced the EACH Woman Act for the first time in the Senate. Congresswoman Barbara Lee (D-Calif.) introduced the bill in the House. The EACH Woman Act repeals the Hyde Amendment and similar severe government restrictions on abortion coverage in Medicaid, to guarantee that every person who receives health care services or insurance through the federal government will have coverage of abortion services. As of now, 58 percent of reproductive age women enrolled in Medicaid live in states that withhold health care coverage of abortion services except in the circumstances of life endangerment, rape, and incest.
The introduction of the EACH Woman Act also reminds us that we must pursue bold policy solutions as we seek to reform our health care system. As our country works to tackle questions of universal coverage, single-payer systems, or improving the Affordable Care Act, we must strive to ensure that all people have access to health care they need to truly enjoy liberty in the U.S.
Policymakers compromised on abortion coverage to secure passage of the ACA. The result is that 26 states currently ban abortion coverage in Marketplace plans. The Trump administration, moreover, is seeking regulatory changes intended to wipeout coverage in some marketplaces, and make it extremely for people to find and afford plans that cover these health services.
Some policymakers are working to address this dire matter in their health care reform proposals. For example, Congresswoman Pramila Jayapal’s (D-Wash.) bill “Medicare for All” (H.R. 1384), and Sen. Bernie Sanders’ (I-Vt.) 2017 “Medicare for All” measure (S. 1804), and U.S. Sen. Brian Schatz and Rep. Ben Ray Lujan’s Luján (D-N.M.) Medicaid buy-in bill known as the State Public Option Act (S. 489, H.R. 1277) ensure coverage of abortion services. Other policymakers who seek to introduce legislation to reform our health care system should follow suit.
Reproductive and sexual health care advocates have additional questions and priorities when looking at these proposals. For example, how will preventive services like family planning be covered? For that matter, what about maternity care and gender-affirming care? Regardless of the type of health care service in question, advocates must think through how these health services will be updated to reflect the latest standards of care and how beneficiaries and communities who have been marginalized in our health care system will engage in such processes.
The questions of affordability and access also arise. How will we ensure that individuals and families on low-incomes will be treated equally in a new health care system? For example, the Medicaid program is designed to meet the needs of individuals with low incomes. If a new system supersedes Medicaid, how will we ensure a new system meets needs of low income people (for example, family planning services and supplies without cost sharing, non-emergency transportation, network adequacy, due process, etc.)? How will these proposals begin to undo the racist health outcomes produced by our current health care system lead us to a path of health equity? These are only some questions. There are more.
The EACH Woman Act centers the leadership and lived realities of those who are most marginalized within our society and elevates the disproportionate harm these individuals face when they cannot pay for the care they need. As we discuss proposals to implement universal coverage, all of us should take a page from the leaders and activists behind the EACH Woman Act and remain bold in our vision of transforming our broken health care system.