Healthcare-NOW organizes to win a national single-payer healthcare system and stands in solidarity with the movement for reproductive justice, which Sister Song defines as “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.”
The Affordable Care Act (ACA) took a step forward in requiring all health insurance plans to cover contraception, and categorized a range of maternity care services as “essential health benefits” that must be covered without co-payments and deductibles. These new regulations only benefit those with continuous health insurance coverage, though, and excludes those with “grandfathered” or “grandmothered” insurance plans that are exempted.
Additionally, access to abortion services are highly inequitable based on income, race, geography, insurance status and type – and have become more inequitable since passage of the ACA. While almost 87 percent of employer-sponsored health plans cover medical and surgical abortion services, the “Hyde Amendment” – which has been re-approved every year since 1976 by Congress – prevents federal funds from going towards abortion services. This means that Medicaid and Medicare recipients generally do not have access except in the 17 states that fully fund those services. Furthermore, 25 states ban coverage of abortion services in insurance offered through the state exchanges, and 10 of those states ban abortion coverage in any private insurance plan. Securing reproductive justice requires repealing the Hyde amendment and guaranteeing safe and accessible abortions services at no cost to every woman.
Beyond access to reproductive health services, 3.5 million children still lacked health insurance after implementation of the ACA, and millions more are underinsured.
Achieving a universal, single-payer healthcare system has the potential to dramatically increase equity in access to reproductive health services; to provide universal healthcare for children; and indirectly address broader systems of inequality that undermine reproductive justice by reducing income inequality, improving housing security, job security, and more. Hence, winning access to comprehensive, universal healthcare is integral to our ability to make fundamental, personal decisions about our sexuality, our health, and our family life.
While access to abortion and contraception are critical, Healthcare-NOW acknowledges the limitations of the health insurance system in addressing the totality of reproductive freedom. The movement for reproductive justice was developed by native women and women of color to shift from a narrow “pro-choice” framework – which is focused on the legal right to access abortion services – to address the broader social and economic inequalities that impact women’s reproductive health and ability to control their reproductive lives.
Having inadequate resources leads many of us to avoid pregnancy or to end a pregnancy – even though we would prefer not to do that if we enjoyed adequate income, job security, health care, housing, and education. Often a woman decides she must end a pregnancy because she cannot feed the children she has, let alone another child. Or she may fear that having a child or another child will result in her losing her job. In the U.S. today, 15 million children are being raised in poverty, which profoundly impacts the health future of children, limits their opportunities, and represents an additional, morally unacceptable barrier to the right to have and raise our children.
Many of us, including many low-income women, also decide freely to avoid or to end a pregnancy, based on our own complicated, unique circumstances, and not simply because of income and resource constraints.
Reproductive justice therefore involves addressing broader inequities than those found in the health insurance system. But achieving a universal healthcare system with equitable access to reproductive health services is necessary for achieving reproductive justice.
Healthcare-NOW fights to move from a system in which communities have access to dramatically different coverage depending on their class, race, gender, age, and job status, to a system in which every resident has access to one, comprehensive standard of care in which every resident is invested. Healthcare-NOW is committed to ensuring that this standard embraces and advances reproductive justice goals.