Medicare for All & Reproductive Health for People with Disabilities
Recommendations from the Disability Committee of the Illinois Single Payer Coalition
A Note from the Authors
This group, the Disability Committee of the Illinois Single Payer Coalition, decided about a year ago (August 2024) to address the intersection of universal single payer health care and the need to expand reproductive rights for people with disabilities (PWDs). Over the last ten months we have had monthly discussions, done research and included input from 10+ PWDs into the final product.
We also decided we wanted to present it in an all-text form and to have a table form with the content organized into two categories. We hope that by having two formats we would reach more people. We feel that this work is important to distribute in the healthcare advocacy community and in the reproductive rights community.
Keep reading for the all-text version, or scroll below to the table format.
We appreciate any feedback you may have and encourage further discussion. Please email 8298sa@gmail.com with comments, questions, or requests.
Persons with Disabilities (PWDs) Under the Current Healthcare System
Access to care depends on insurance and disposable income.
Our current healthcare system is biased toward institutional, long-term care over home-and-community-based care.
PWDs who reside in congregate settings are routinely denied bodily autonomy, such as:
- the right to form intimate relationships,
- the right to have consensual sex,
- the right to parent children
- PWDs are often forced to receive assistance from people who are hostile to their gender or sexuality.
Parents with disabilities face many financial and social barriers to providing their children with the full range of healthcare and long-term care that they need, and otherwise to parenting their children in safe and sustainable communities.
Inequities are common, including life expectancy and maternal and infant morbidity and mortality, based on the type of disability, race, gender, ethnicity, income, geography, language, and other factors that worsen health outcomes associated with disability.
Persons with Disabilities (PWDs) Under Our Medicare for All System
All persons will have free access to all necessary care, including access to complete, accurate general and disability-specific information about general and adaptive sexual health &
reproduction (including availability of adaptive tools to maintain sexual and reproductive health), contraception, pregnancy, abortion, screenings, STI testing, gender-affirming treatments, fertility care and treatment, birthing, and child-rearing, from the consultants of their choice, including peer counselors, sex-positive and culturally responsive counselors, and consultants at centers of excellence, with no financial barriers or burdens. PWDs will have the right to be fully informed of the right to accept and the right to refuse risks, if any, associated with pregnancy and childbirth.
All PWDs residing in the United States, whether temporarily or permanently, and regardless of their purposes, will have the right to the full range of all necessary healthcare, including the full range of reproductive care and all essential long-term services and supports.
PWDs and all other persons will have the right to the full range of necessary sexual, gender-affirming, and reproduction-related healthcare, including, but not limited to, screening and preventive care with no financial barriers or burdens and with all necessary accommodations for their disabilities.
They shall reside in the community if they so wish, where they will have greater freedom to live as they choose and have access to accessible and disability-community-affirming sexual, gender-affirming, and reproductive care within their communities of choice
PWDs who reside in congregate settings will have the right to:
- Bodily autonomy,
- Choose caregivers who respect their gender and sexuality,
- Form intimate relationships, including sexual relationships,
- Have as many intimate relationships as they choose without judgment,
- Bear children,
- Not bear children, and
- Parent their children to the extent of their ability.
Long-term services and support for PWDs will include the right to assistance with having consensual sex as needed and desired.
PWDs will have the right to the full range of services and supports they need to parent their children, by birth, through foster care, or adoption, in home and community settings.
We work for all people with disabilities, beginning at birth,to have guaranteed access to lifelong healthcare, long-term services, and supports to the extent of need and desire, to enable full participation in home and community life, with no financial barriers or burdens. Parents and prospective parents will be fully informed about such services and supports.
We remove inequities, including life expectancy and maternal and infant morbidity and mortality, based on disability identity or type, race, gender, ethnicity, income, geography, language, and other factors that worsen health outcomes associated with disability.
All PWDs of any age, including children from birth, will have access to top-quality, equitable, accessible, and culturally-affirming care throughout the lifespan, including palliative care.
Recommendations on Reproductive Healthcare and People with Disabilities from the Disability Committee of the Illinois Single Payer Coalition (Table Format)
| Persons with Disabilities (PWDs) Under the Current Healthcare System | Persons with Disabilities (PWDs) Under Our Medicare for All System |
|---|---|
| Access to care depends on insurance and disposable income. | All persons will have free access to all necessary care, including access to complete, accurate general and disability-specific information about general and adaptive sexual health and reproduction (including availability of adaptive tools to maintain sexual and reproductive health), contraception, pregnancy, abortion, screenings, sexually transmitted infections testing, gender-affirming treatments, fertility care and treatment, birthing, and child-rearing, from the consultants of their choice, including peer counselors, sex-positive and culturally responsive counselors, and consultants at centers of excellence, with no financial barriers or burdens. PWDs will have the right to be fully informed of the right to accept and the right to refuse risks, if any, associated with pregnancy and childbirth. All PWDs residing in the United States, whether temporarily or permanently, and regardless of their purposes, will have the right to the full range of all necessary healthcare, including the full range of reproductive care and all essential long-term services and supports. PWDs and all other persons will have the right to the full range of necessary sexual, gender-affirming, and reproduction-related healthcare, including, but not limited to, screening and preventive care with no financial barriers or burdens and with all necessary accommodations for their disabilities. PWDs shall reside in the community if they so wish, where they will have greater freedom to live as they choose and have access to accessible and disability-community-affirming sexual, gender-affirming, and reproductive care within their communities of choice. |
| PWDs who reside in congregate settings are routinely denied bodily autonomy, such as: ● the right to form intimate relationships, ● the right to have consensual sex, and ● the right to parent children. PWD’s are often forced to receive assistance from people who are hostile to their gender or sexuality. | PWDs who reside in congregate settings will have the right to: ● Bodily autonomy, ● Choose caregivers who respect their gender and sexuality, ● Form intimate relationships, including sexual relationships, without judgment ● Bear children, ● Not bear children, and ● Parent their children to the extent of their ability. ● Long-term services and support for PWDs will include the right to assistance with having sex as needed and desired. |
| Parents with disabilities face many financial and social barriers providing their children with the full range of healthcare and long-term care that they need, and otherwise to parenting their children in safe and sustainable communities. | PWDs will have the right to the full range of services and supports they need to parent their children, by birth, through foster care, or adoption, in home and community settings. We work for all people with disabilities, beginning at birth, to have guaranteed access to lifelong healthcare, long-term services, and supports to the extent of need and desire, to enable full participation in home and community life, with no financial barriers or burdens. Parents and prospective parents will be fully informed about such services and supports. |
| Inequities are common, including life expectancy and maternal and infant morbidity and mortality, based on the type of disability, race, gender, ethnicity, income, geography, language, and other factors that worsen health outcomes associated with disability. | We remove inequities, including life expectancy and maternal and infant morbidity and mortality, based on disability identity or type, race, gender, ethnicity, income, geography, language, and other factors that worsen health outcomes associated with disability. All PWDs of any age, including children from birth, will have access to top-quality, equitable, accessible, and culturally-affirming care throughout the lifespan, including palliative care. |
The authors of this piece are members of the Disability Committee of the Illinois Single Payer coalition, a statewide alliance organizing for healthcare justice.