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Healthcare Compromise: Low-Income Women Get Bumped

by Jen Nedeau

Democrats in the Senate got what they wanted this Christmas: a passed health care reform bill.

Low-income women, however, seemed to be the ones with coal in their stocking.

Led by Vice-President Joe Biden, the 60-39 vote along party lines on December 24, 2009 ensured that this historic bill will move forward and potentially become law if the House and Senate can reconcile their two different versions of the legislation in 2010. The House will begin the reconciliation process on January 12, 2010 and the Senate on January 19.

The New York Times reports that "If the two chambers can strike a deal, as seems likely, the resulting product would vastly expand the role and responsibilities of the federal government. It would, as lawmakers said repeatedly in the debate, touch the lives of nearly all Americans.… If the bill becomes law, it would be a milestone in social policy, comparable to the creation of Social Security in 1935 and Medicare in 1965."

However, when it comes to the issue of abortion, it is a lose-lose situation for women, specifically those who are non-white and low-income. Both the Senate and House versions of the bill limit a woman’s access to abortion, as outlined by the Times.

In the House version, low and middle-income people who buy insurance through the exchange -- the public marketplace for insurance -- will not have any health care options that cover abortions. The additional danger with this stipulation added by Rep. Bart Stupak (D-MI) is that as the private market begins to mimic the public market, abortion coverage for women could decrease. Currently, 87 percent of private insurance plans cover the legal medical procedure and the House bill could effectively reduce women’s health care rights, rather than increase them over time in not only the public sphere, but the private one as well.

The Senate version is a little less obvious in its attack on women’s reproductive choice. While the public plan in the Senate bill would include abortion (with federal funds being separated from paying for this procedure), the legislation would allow individual states to prohibit coverage of abortion.

Currently, 17 states opt in to paying for abortion through Medicaid, indicating they will leave such coverage intact with the offerings through the exchange. It is unclear how the remaining 33 states will react, which makes it possible for abortion rights to be completely stripped from the hands of low-income women by the predominantly male-led state legislatures.

While one of the national non-profit plans in the exchange should cover abortion in the Senate bill, that choice is not left with women individually, but given to the state. If a state opts out of abortion coverage in the exchange, this would leave few viable options for those seeking access to abortion without a private insurance plan.

According to the Guttmacher Institute “nearly half of all pregnancies to American women are unintended and four in 10 of these end in abortion.” Guttmacher also reports that unintended pregnancies have increased by 29 percent among poor women while decreasing 20 percent among higher-income women.

When you review these basic statistics it becomes increasingly clear that the provisions in both the House bill and Senate bill would hurt low-income women, who are disproportionately non-white. The UCLA Center for Health Policy Research notes, “Latina and Native American women are the most likely to have limited family incomes while 41 percent of African American women, 28 percent of Asian/Pacific Islander women and 29 percent of multiple-race women have low incomes. In comparison, 16 percent of white women are in low-income families.”

In order to protest these rollbacks to reproductive choice, the Women's Media Center released a new video to increase the sense of urgency about women’s rights in the health care reform process. The center’s latest campaign,, asks individuals to call Congress, write letters and articles to make sure that women’s voices are heard and their rights are not thrown under the bus in health care reform.

While the short term goal is to keep abortion restrictions out of the final health care bill, is a long term project that will be working to move the conversation about health care back to the original problem – the Hyde Amendment and the need to repeal it – and change the media narrative to one that centers on women’s rights as human rights.

December 24, 2009

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Jen Nedeau is a new media professional, writer, progressive activist and feminist speaker. She was formerly the editor of the Women's Rights blog at She currently lives in New York City where she works as the Director of Digital Strategy at Air America Media.

Also see: “Women of Color Push Boundaries on Reproductive Justice” by Natalie Bell in this edition of On The Issues Magazine.

See: “The First of All Liberties: Making Health Care Meet All Women’s Needs” by Eesha Pandit in this edition of On The Issues Magazine.


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