On Monday evening, House Republicans released two bills outlining their proposals to replace the Affordable Care Act. These bills propose extensive changes to existing healthcare policies — particularly around availability and affordability of coverage, especially for low-income individuals. Unfortunately, the women's rights components of the Obamacare replacement plan could also result in negative consequences for women's healthcare — something which certainly requires further examination.
Abortion access constitutes one of the biggest casualties of the GOP's proposed healthcare plan, as insurance coverage for abortion is reduced in several ways in the proposed plan. Vox reports that under the GOP plan, insurance plans that cover abortions, except in the case of rape or threats to the mother's life, are not eligible for tax credits that help subsidize the cost of the plan. It is also important to note that if a woman has an abortion late in pregnancy because her pregnancy becomes risky but not life-threatening, or if she discovers that her baby will not survive birth and has an abortion instead of carrying it to term, these abortions would be considered "elective" under the proposed law and would also not qualify for tax credits.
All of these new proposed regulations on insurance abortion coverage, according to Vox, essentially mean that the proposed bills could "effectively eliminate private insurance coverage of abortion." This is likely the case because, due to the cost, consumers would not seek out insurance plans that cover abortions and insurance companies would effectively offer fewer, if any, of them.
Furthermore, under the proposed law, access to affordable abortion could be completely eliminated for low-income women who rely on Planned Parenthood for services. This is sadly a possibility because the proposed GOP plan eliminates funding for Planned Parenthood, which, in addition to many other essential reproductive health services, provides abortions for thousands of low-income women in the United States every year.
While Planned Parenthood already does not use federal funds for abortion due to restrictions imposed since 1976 by the Hyde Amendment, the proposed GOP law bans Planned Parenthood from receiving any federal funding via Medicaid at all, even for preventative health services. A lack of Medicaid funding would likely force many planned Parenthood clinics to close, essentially eliminating one of the few affordable abortion providers for women across the United States.
Of course, abortion is not the only service that would be affected if the proposed defunding and related closures of Planned Parenthood occurred. Planned Parenthood offers patients a full spectrum of reproductive health services, like preventative gynecological exams and birth control, among others.
Since the GOP's proposed health plan prohibits Planned Parenthood from seeking Medicaid reimbursements for services, low-income patients who rely on Medicaid for health coverage would not be able to use Planned Parenthood's reproductive services unless they paid out-of-pocket. And, of course, even if they could afford out-of-pocket care, patients might have to travel long distances to reach a Planned Parenthood clinic if diminished funding results in clinic closures.
Finally, in addition to diminishing abortion access for all women and access to reproductive healthcare for low-income women, the proposed GOP legislation could vastly diminish the entire spectrum of women's health services that private insurers are willing to cover. The GOP plan eliminates minimum essential coverage provisions that Obamacare established, meaning that insurers would no longer be required to offer women-specific services like birth control, maternity care, or preventative gynecological healthcare, including breast and cervical cancer screenings. This of course also means that if women do wish to attain policies with this coverage, they will likely be much more expensive in a "Trumpcare" world, if they are available at all.
Overall, the proposed GOP replacement for Obamacare is hugely detrimental for women's health in a myriad of ways. It threatens all women's rights to access affordable, quality reproductive healthcare services and would constitute an absolutely unacceptable step backwards for women's rights.