The Gender and Culture Wars - Reproductive Health

Let’s start this discussion with the premise that Health Care is health care, no matter who it is for. A child, a woman, a man – they all need health care. In fact, society needs them to have health care, because public health – for the good of everyone – functions best in non-epidemic situations.

Women’s health care is not separate from Health Care – it is integral to it. This fact is lost on the Trump Administration and the GOP majority in Congress. A Congress, I might add, that has no problem including Viagra under Medicare (given their average ages) or in every heath insurance policy out there (given their numerical majority in both Congress and the corporate world).

But let the topic of women’s health care – which is code for reproductive health care – enter the discussion, then the conversation changes and that starts up the beat on the gender and culture war drums.

This is hardly a new conversation; it has been going on for generations. Men know the way to control women is to make sure women can’t control their own fertility. Men run most governments – and religions – so controlling contraception and access to reproductive health is a way to keep and enhance their own power.

The first birth control clinic was opened in New York City just over 101 years ago on Oct. 16, 1917 by Margaret Sanger. The powers that be couldn’t wait to throw her in jail to halt the heresy she preached.

Sanger challenged the status quo by providing contraception and other health services to women and men and educating the public about birth control and women’s health. It is not an exaggeration to say that women's progress in recent decades — in education, in the workplace, in political and economic power — can be directly linked to Sanger's crusade and women's ability to control their own fertility.

Planned Parenthood, as Sanger’s American Birth Control League eventually became known, recently received the Lasker-Bloomberg Public Service Award, in recognition of its role as a critical provider of women’s medical services from breast-cancer screenings to tests for sexually transmitted diseases. The Foundation noted that Planned Parenthood helped 2.4 million women in 2015, including many who had no other source of care. (More about this later.)

The Affordable Care Act finally busted down the locked door to contraception by mandating that contraception was health care and had to be provided, free of charge, to women under most health care plans. And the ACA is still the law of the land, despite the best (or worse) efforts of Congress and the Trump White House to kill, repeal, or replace it.

Frustrated by the inability of Congress to enact legislation on his agenda, Trump has tried to kill the ACA by executive action. His administration issued rules that immediately carved out broad exceptions to the Affordable Care Act’s promise of no-cost contraceptive coverage, touching off lawsuits and renewed debate about the proper scope of religious liberty.

There are bumps in road, however, thanks to legal action by states Attorney Generals across the country. These efforts were led by Massachusetts Attorney General Maura Healey, who was the first to bring suit against the federal government over these newly issued rules giving employers the right to deny women birth control coverage by claiming religious or moral objections.

“This is about taking away women’s access to birth control under the guise of religious liberty,” Healey told reporters during a conference call. The suit charges that the new rules “promote the religious freedom of corporations over the autonomy of women.” [Shades of Citizens United.]

This is another instance of where you live determining how you live in this country. Trump’s executive action on the birth control mandate doesn’t affect women in New York State. Gov. Andrew Cuomo’s administration immediately clarified that despite the Trump administration’s move to roll back a federal requirement that birth control be covered by health insurance plans, New York’s regulations still mandate such coverage.

This Congress and Administration have been targeting Planned Parenthood funding especially hard in 2017. Why is this bad for Health Care in general and women’s health care particularly?

Planned Parenthood clinics offer a wide range of health services, including contraceptive care, testing and treatment for sexually transmitted diseases (STDs), HIV testing, and cancer screenings. Further, PP clinics are what public health people call “safety-net health centers”: a last-chance offering for those who couldn’t pay full price if they had to, but who are covered by Medicaid. In two-thirds of the counties in which a Planned Parenthood clinic is located, that clinic serves at least half of the women who turn to a safety-net health center to get contraception.

Earlier this year, then-HHS Secretary Tom Price wanted to see a list of counties where Planned Parenthood is the only option for women who need subsidized birth control. In 105 counties, Planned Parenthood is the only full-service birth control clinic. Did you know that 17 of those counties are here in New York State? A state where contraception is still mandated health care, but where there are still significant problems with access.

Did you know the US could save $12 billion a year if every woman had access to birth control? Not only is access to birth control reproductive and social justice, it is cost effective. A study from Child Trends commissioned by the Planned Parenthood Action Fund found that if every woman in the United States had access to the most effective birth control possible, it could save as much as $12 billion a year in health care costs.

In addition to attacking women’s health care access, the Trump Administration has been also defunding other programs, like pregnancy prevention programs. Trump cut $214 million in funding for teen-pregnancy prevention programs in July at a time when teen-pregnancy is at an all-time low. In a released statement, Leslie Kantor, the study's coauthor and the vice president of education at Planned Parenthood Federation of America, explained:

"Withholding critical health information from young people is a violation of their rights. Abstinence-only-until-marriage programs leave all young people unprepared and are particularly harmful to young people who are sexually active, who are LGBTQ, or have experienced sexual abuse."

Although we are living in the 21^st Century, what is happening to health care and women make it look like the country is poised to take a giant step backward to the 19^th. Why does this matter in 2017? Because when you go to the polls on November 7, who you vote for in your local and municipal elections help set the stage for 2018, when all the state legislators in Albany and every House seat and one third of the Senate in Congress are up for reelection.

People thinking about running in 2018 are looking to see who wins in 2017 and what issues top the voter’s concerns to gauge the success of their campaigns next year. We won’t change the culture of Washington, DC or Albany, NY by reelecting the same old, same old candidates, culture war dividers, or ideas.