The possibility of an Obamacare repeal is back from the dead once more, and there's a very real possibility that it will become law. This time, it's the Graham-Cassidy bill, and the Republican Senate is scrambling to pass it before a Sept. 30 deadline. The legislation would obliterate the Affordable Care Act's foundational elements by eliminating federal subsidies for low-income Americans and scrapping minimum health coverage requirements for insurance companies. Moreover, Graham-Cassidy would have a disastrous effect on women's health.
First, the bill would ban Medicaid recipients from using their insurance at Planned Parenthood. This means that millions of low-income women would immediately be cut off from one of the biggest women's health care providers in the country, imperiling their access to cancer screenings, pap tests, emergency contraception, breast exams, STI testing, and other services. Although some conservatives claim that other community health providers — that is, federally-qualified health centers, or FQHCs — will fill this gap, that's unlikely, as it would require FQHCs to double or triple their resources in states throughout the country to account for the gap in coverage, according to a 2015 study by the Guttmacher Institute.
Second, Graham-Cassidy would eliminate the Affordable Care Act's essential health benefits requirement, thus allowing insurance companies to opt-out of covering certain basic services in their plans. According to a 2015 study by the Century Foundation, scrapping this requirement would leave up to 13 million women without access to maternity care.
Graham-Cassidy would also replace Obamacare's premium tax credits — one of the biggest mechanisms by which the law makes health insurance affordable — and replace it with a block grant program to states in 2020. This would have many effects, but perhaps the biggest for women is that recipients of those block grant dollars — that is, lower- and middle-income Americans — wouldn't be allowed to purchase insurance plans that cover abortions. And that would, in turn, have a cascading effect: As fewer people bought insurance plans with abortion coverage, insurance companies would gradually stop offering plans that offer such coverage. This would affect the entire insurance market, and in a worst case scenario, could lead to the end of abortion coverage in private insurance plans.
And there's more: The latest Trumpcare bill would drastically reduce funding for Obamacare's Medicaid expansion, which has single-handedly provided health insurance coverage to over 12 million Americans since the Affordable Care Act was signed in 2010. Around 20 percent of American women receive health care through Medicaid, according to the Guttmacher Institute, including 31 percent of black women and 48 percent of women with incomes below the poverty level. In addition, around half of all births in America are covered by Medicaid. Slashing funding for the program's expansion by $83 billion, or 34 percent — which Graham-Cassidy would do by 2026 — would cut off these services for millions of low-income women. (Although, it's impossible to give an exact number, given that Republicans are attempting to pass the bill before the Congressional Budget Office can analyze its effect on coverage.)
Graham-Cassidy has several other provisions that would immediately or gradually undo the Affordable Care Act's expansionary measures. The bill would repeal Obamacare's individual and employer mandates, as well as its requirement that insurance companies offer coverage to people with pre-existing conditions. In addition to reducing federal assistance for health coverage in general, the bill would redistribute the remaining funding from bigger, and often bluer, states to small, often redder ones; the former states are among those who have expanded Medicaid. California and New York are poised to be hit the hardest, according to The Washington Post.
Although Obamacare repeal has died many deaths, it's returned from the grave every time, and this latest version of the bill is reportedly gaining steam amongst Senate Republicans. If it passes, President Trump will sign it, and millions of women will be cut off from access to affordable health care.
But it's not a done deal yet, and if you'd like to protest Graham-Cassidy during this crucial window of time before it's voted on, you've got a lot of options.